How Superhero Costumes Reduce Pre-Surgery Stress in Children: A Brazilian Surgeon's Experience

Brazilian pediatric ENT surgeon Leandro Brandão Guimarães started offering young patients superhero costumes before surgery six years ago — and children stopped crying in the operating room. The methodology, which the doctor funds from his own pocket, transformed the hospital corridor into a place where patients laugh instead of screaming in fear. Experience shows that when a person gains the ability to control even one element of a stressful situation, their anxiety drops so significantly that it changes the behavior of all participants in the process — from parents to medical staff.

Why traditional surgical preparation amplifies stress

Fifteen years ago, when Guimarães first started operating on children, he encountered standard practice: parents were not allowed in the operating room until anesthesia was administered. The child ended up alone in an unfamiliar room with masked people, which provoked crying and screaming. The doctor describes these moments as personally difficult — especially after having his own children.

The first step was refusing to perform surgeries at clinics where parents were forbidden to be present before anesthesia. This decision was based on understanding that separation from the primary source of security at a critical moment traumatizes both child and adult. However, a parent's presence reduces but does not fully eliminate anxiety — a second tool was needed.

How costume choice changes perception of the situation

The idea was born after a conversation with a colleague from San Diego who allowed children to enter the operating room in an electric car. For Guimarães, this option turned out to be financially inaccessible, but the principle became clear: the child needed an illusion of control and a sense of power. The doctor formulated the task this way — make children feel like superheroes capable of overcoming fear.

He found a costume manufacturer in Brazil — a single mother for whom these orders became a stable source of income — and bought the first batch with his own money: Superman, Batman, Spider-Man, princesses, Wonder Woman. When the first child walked down the corridor in a costume, the result exceeded expectations: instead of anxiety — laughter and joy. The child forgot about fear.

When a child walks down the corridor in a superhero costume, they don't think about the operation — they play the role of a hero who can handle any difficulties.

Preparation protocol: transparency and game mechanics

Guimarães builds preparation on two principles: complete honesty and game-based distraction. During pre-surgery appointments, he explains to the child and parents exactly what will happen — intervention in the nose or throat to improve breathing or sleep. The doctor doesn't hide the fact of surgery, but creates an atmosphere of play in the office: he offers toys, jokes, and works to make the child perceive him not as a threat but as an ally.

On surgery day, the algorithm is as follows: the child chooses a costume from the available options, then the doctor suggests "flying" down the corridor — carrying the patient on his shoulder while imitating a superhero's flight — or "running." Children laugh, staff and parents smile. This short transition becomes a moment of joy instead of a final panic spike before anesthesia. After surgery, the costume stays with the family as a reminder of their courage.

Adapting the method for different age groups

The doctor doesn't offer costumes to teenagers — almost all decline. For older patients, a different strategy works: respectful dialogue, willingness to answer any questions, conversation and jokes on the way to the operating room. The goal is the same — to distract from anxiety, but the tool changes depending on age and maturity.

This differentiated approach shows that there is no universal scenario for reducing stress. For preschoolers, playful transformation of reality is effective; for teenagers — acknowledgment of their adulthood and right to know details. What's common is the ability to influence the process: choose a costume or ask the doctor questions directly.

What the method changes for medical staff and parents

Guimarães notes that changes affected not only children. The doctor admits that his love for his work has grown because he almost never encounters patients crying before surgery anymore. Parents, seeing a laughing child, calm down themselves — adult anxiety is often transmitted to children and amplifies their fear; here the cycle is broken. Hospital staff gets drawn into the game, creating a positive atmosphere instead of a tense one.

The doctor formulates his task this way: treat not just the physical problem, but the entire patient experience. Surgery is not an isolated medical intervention, but an event that a child will remember. The goal is to make the memory one of courage and support, not helplessness and fear.

Applicability of the approach to brand communication

The experience of the Brazilian surgeon translates directly to the marketing of services and products related to stress or uncertainty. When a brand works with an audience at a moment of anxiety — financial decisions, medical procedures, major purchases — the key becomes not hiding complexity, but providing a tool for control. A superhero costume in this logic is a visual symbol of choice and power.

For brands, this means: process transparency plus an element the customer can control. A bank that explains each step of credit approval and lets you choose a convenient payment schedule. A clinic that shows the operating room in a virtual tour and gives the patient the right to choose music for anesthesia. A developer that offers a layout configurator instead of fixed options. The mechanics are identical: reduce anxiety through a combination of honesty and control.

Checklist for brands: how to reduce customer stress at critical moments

• Identify the point of maximum anxiety in the customer journey — the moment when the customer feels most vulnerable or uncertain.
• Ensure complete transparency of the process: explain what will happen, in what sequence, how long it will take, what sensations will arise. Uncertainty amplifies fear more than unpleasant but understandable information.
• Introduce an element of choice that the customer can control: this could be the choice of communication channel, call time, packaging option, service scenario. What matters is the fact of the decision itself, not the scale of choice.
• Add game-based or emotionally positive mechanics if the audience allows for it: gamification of waiting, personalized messages, unexpected pleasant details. The goal is to shift focus from anxiety to engagement.
• Give the customer a tangible reminder of their decision or courage: a certificate, a personalized item, a photograph, a story. This reinforces the positive experience and drives word-of-mouth marketing.
• Adapt the approach to segments: what works for children won't work for teenagers. What older clients need can annoy millennials. The mechanism for reducing stress should match the age, experience, and expectations of your audience.

Limitations and risks of transferring the method

It's important to understand that Guimarães's approach works in the context of pediatric medicine, where game logic is natural. Direct transfer of game mechanics to areas where the client expects seriousness — law, funeral services, oncology — can cause rejection. The risk of infantilizing the audience arises when a brand uses game elements where a person wants to feel adult and competent.

The second risk is simulating control instead of providing real control. If the choice a brand offers doesn't affect the outcome or is too limited, the customer will sense manipulation. The costume works because the child actually chooses from several options and actually goes into the operating room in that costume. If a brand offers pseudo-choice — two identical tariffs with different names — the effect will be the opposite.

Connection to influencer marketing: trust through personal experience

Guimarães doesn't run advertising campaigns for his method, but his approach spreads through the stories of patients and their parents. This is classic word-of-mouth mechanics, amplified by emotional coloring: parents share photos of children in costumes, tell friends, leave reviews. The experience becomes content.

For brands, this means: reducing customer stress is not just a service improvement, but also a marketing asset. When a person goes through a potentially unpleasant situation and comes out of it with a positive feeling, they become a brand ambassador. In the logic of influencer marketing, such a customer is a micro-influencer with high trust levels in their circle. The brand's task is to create an experience worth sharing.

Frequently asked questions

Does game-based mechanics work to reduce stress for adult customers?

It works, but requires adaptation. Adults don't need a costume—they need a sense of control through process transparency and genuine choice over service parameters. Gamification elements are appropriate for streamlining routine processes—points accumulation, achievements, challenges—but during moments of real stress, adults value respect for their competence and access to complete information.

How to measure the effectiveness of reducing client stress?

Direct metrics include reduced drop-off rates at the final funnel stage, increased NPS and referral volume, and higher repeat engagement. Indirect metrics involve sentiment analysis of reviews, decision-making time, and support request volume during the consideration phase. For precise assessment, you can conduct surveys asking about anxiety levels before and after implementing changes.

Which choice elements are most effective for reducing anxiety?

The most effective choices are those that improve process comfort without adding complexity. Communication timing and format, stage sequencing, visual design, optional features—anything that creates a sense of personalization without increasing cognitive load. Avoid choices that require expertise clients don't possess, as this will amplify anxiety rather than reduce it.

Key takeaways

• A Brazilian pediatric surgeon has been offering superhero costumes to patients before surgery for six years—children stopped crying and started laughing in hospital corridors.
• The method is built on two principles: complete transparency about what will happen, and providing a sense of control through costume choice and movement options.
• The approach adapts by age: preschoolers get playful reality transformation, teenagers get respectful dialogue and the right to ask questions.
• Reducing a child's stress affects everyone involved: parents calm down, medical staff engage in the game, and the overall atmosphere shifts from anxious to positive.
• The logic is the same for brands: at the moment of maximum client anxiety, provide process transparency and a control mechanism—a parameter choice that affects comfort.
• Risks include infantilizing an audience expecting seriousness and offering false choice instead of real control—both trigger rejection.
• Reducing client stress is a marketing asset: a person with a positive experience during a difficult situation becomes a brand ambassador and source of word-of-mouth.
• Measure effectiveness through NPS, referral volume, reduced drop-off rates at final stages, and sentiment analysis of reviews.