4 Times Doctors Have to Say No to a Cosmetic Procedure

You’ve seen it on reality shows and sometimes even on your favorite celebrities—cosmetic procedures that go too far or patients that go under the knife (or needle) one too many times. When faced with the results of too much pinching, tweaking or filling, one has to wonder, "Why would a doctor allow that?” But many doctors do say no and have no problem doing so. Perhaps the 400-cc breast implant your friend got won’t work for your body, or your frown lines are better treated with a filler than a facelift. There are many instances when a doctor can and will say no in order to achieve the best possible outcome. We talked to a few top doctors to find out how and when they know they won’t be able to fulfill a patient’s wishes.

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There’s Nothing Left to Fill
Injectable fillers can do wonders for your face; they can plump up lips, smooth out marionette lines and restore youthful cheeks. But as fillers become increasingly popular, doctors continue to educate patients on what they can and cannot do. “The most common procedure I need to say no to is fillers,” says New York dermatologist Jody Levine, MD. “Sometimes patients come in and hold up the skin on each outer cheek and say they want their results to look like that. I explain that filler, in my hands, will give a natural and beautiful lift, but that it will not lift to the extent at which they are pulling their skin. It is not surgery.”

The Copycats
Part of setting realistic expectations is understanding that a doctor can only do so much to enhance your existing beauty. Aiming to emulate the appearance of someone with completely different features and proportions will most likely result in an unfavorable result. 

“For me, bringing in a picture of a celebrity and expecting me to recreate that exact look is a major red flag,” says Santa Monica, CA, dermatologist Ava Shamban, MD. “My goal is to reverse father time without ever tampering with mother nature. Everyone has something very beautiful about their face that can be enhanced. So I advise patients who come in wanting to look like someone else that their expectation is completely unrealistic.”

Hopping From Doctor to Doctor
Another red flag for medical professionals is hopping from one doctor to the next in order to get various treatments and procedures that may not normally be allowed by one doctor. In aesthetic medicine, doctor hopping can be a sign of an addiction to cosmetic surgery. “One thing I look out for are patients who have been to five or six other well-respected dermatologists and have been unsatisfied with their care and results,” explains Dr. Levine. “Such a patient may be looking for a transformation that is not possible, safe or will look unappealing.”

If You Fit the Profile
Some plastic surgeons use an acronym to describes a certain type of patient that may have a predisposition for unrealistic expectations. “In plastic surgery there is an acronym called SIMON (Single, Immature, Male, Overconfident and Narcissistic), which is commonly recognized as a red flag for failure,” says El Paso, TX, plastic surgeon Humberto Palladino, MD. “Also patients who had numerous other procedures before and are continually unhappy despite having an acceptable outcome is another warning sign to take into consideration."

So what do you do if your doctor says no to a procedure that you have your heart set on? First, ask your doctor to explain the reasons behind their decision and ask for alternative options for the procedure of your choice. Getting a second opinion is also good idea as long as you seek another medical professional with similar credentials. “I always tell patients that the best investment they can make is to ensure that the professional taking care of them is a good fit,” adds Dr. Palladino. “Second and third opinions are always a good idea if they are not 100 percent happy with their doctor, but board-certification is a must. Look at before-and-after images or other evidence showing beforehand what your doctor is able to deliver.”

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