Do you ever reject a patient for plastic surgery?
I have seen a small number of patients who seemed dissatisfied with so many of their features (inappropriately), that I’ve recommended self-evaluation and/or psychotherapy instead of cosmetic surgery. Some of these patient admit to being harshly criticized by a parent during childhood, and may have severe self-esteem issues that will not be addressed by the cosmetic surgery process. It is important for patients to be mentally sound, able to understand what cosmetic surgery will and will not do for you. I try to probe the person behind the request to understand if what I can do will truly meet the objectives of the patient. This is a difficult process for the plastic surgeon because each patient does not undergo an extensive psychological analysis, so I have to trust the instincts I have developed over the years. I do reject patients who do not have realistic expectations or those who are psychologically imbalanced.
This question was answered in conjunction with Jon Perlman, M.D.