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ASPS List: Who Shouldn't Have Cosmetic Surgery?

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ASPS List of Inappropriate Candidates for Surgery

Patients in crisis, such as those who are going through divorce, the death of a spouse, or the loss of a job. These patients may be seeking to achieve goals that cannot be met through an appearance change — goals that relate to overcoming crisis through an unrelated change in appearance is not the solution. Rather, a patient must first work through the crisis.

Patients with unrealistic expectations, such as those who insist on having a celebrity's nose, with the hope that they may acquire a celebrity lifestyle; patients who want to be restored to their original "perfection" following a severe accident or a serious illness; or patients who wish to find the youth of many decades past.

Impossible-to-please patients, such as individuals who consult with surgeon after surgeon, seeking the answers they want to hear. These patients hope for a cure to a problem that is not primarily, or at all, physical.

Patients who are obsessed with a very minor defect, and may believe that once their defect is fixed, life will be perfect. Born perfectionists may be suitable candidates for surgery, as long as they are realistic enough to understand that surgical results may not precisely match their goals.

Patients who have a mental illness, and exhibit delusional or paranoid behavior, may also be poor candidates for surgery. Surgery may be appropriate in these cases if it is determined that the patient's goals for surgery are not related to the psychosis. In these cases, a plastic surgeon may work closely with the patient's psychiatrist.

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EmpowHER Guest

Very wise and worthwhile post. With 34 years of experience as a cosmetic facial surgeon, I endorse this good advice.

Remember that the key to a successful outcome for the patient is always the appropriateness of the undertaking. The savvy, highly-specialized surgeon is always an expert in evaluating the patient and her/her request and the wisdom of performing surgery. That surgeon knows when to say " Yes" and when to say " No", or at least, " Let's think about this".

- Robert Kotler, MD, FACS
Clinical Instructor, UCLA

April 7, 2012 - 1:32pm
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