When not to do cosmetic surgery ?

 
Undergoing a cosmetic surgery procedure is a welcome change in a vast majority of the individuals. It is associated with improvement in self-esteem and confidence levels. However, in some cases, as a plastic surgeon, I counsel prospective patients against a cosmetic procedure. This is usually done when there is a good possibility that the benefits of the cosmetic procedure may not be realized. Some of the common reasons to not undergo a procedure include the following: 

Motivation:
Motivation is what causes a person to first consider a procedure and eventually reach plastic surgeon’s office. Motivation to undergo a procedure is variable. Usually, this arises from a desire to ‘fix’ a certain 'deformity'. This desire to improve should come from within. But, in certain situations, a patient is motivated to seek a procedure for someone else. For example, it could be for the sake of an uninterested partner or spouse. Such situations do not constitute an ideal setting for cosmetic surgery. Cosmetic surgery in such an individual may end up with an unhappy patient.   
 
Unrealistic expectations:
The goal of cosmetic surgery is an improvement in appearance. The key word here is ‘improvement’. It is not perfection. We sometimes come across individuals who can be very demanding about the expected outcome of a cosmetic surgery procedure. Medicine is not an exact science. The final outcome is decided by many variables which are beyond our influence. In certain cases, a significant improvement may not be possible because of many patient specific factors. Cosmetic surgery is not a good option when there is a good possibility that the patient may not obtain the desired result. 

Associated co-morbidity:
Some of us have associated illness which may make an otherwise safe procedure risky. For example, obesity is associated with increased wound complications in the abdomen. This may preclude certain procedures because of the increased risk. It is also important, to be honest with the treating physician and inform him or her of any coexisting illness.  

Not sure about surgery:
​Cosmetic surgery procedures are not life saving. They are elective procedures and are not associated with any urgency. If an individual is not sure about a procedure, it best to defer it. Sometimes talking to friends or relatives can help place the motivation to undergo the procedure in a proper perspective. It is also important for the patient to understand the possible outcomes, treatment options and possible complications of any procedure. Only when these are well understood should a person proceed with cosmetic surgery. 

The goal of any procedure is a happy patient. In certain circumstances, the physician may discourage a procedure if he feels that the outcome of a procedure may be less than ideal due to one of the above-mentioned reasons.