No facial plastic surgeon wants an unhappy patient. When you seek facial cosmetic procedures to improve or correct an aspect of your appearance, you’re banking on the expectation that you’ll get the best possible result and will look fabulous after. Your surgeon wants that very much as well. So how do cosmetic practitioners ensure that they match up the right patient with the correct procedure and that everyone is happy once all is said and done?

Well, there’s a lot more that goes into screening, planning, and nurturing excellent outcomes than you may realize. We’ll explain when facial plastic surgeons say no and why it’s a good thing.

Sometimes when clients visit a cosmetic clinic in pursuit of a particular treatment, the facial plastic surgeon tells them that they shouldn’t proceed. Let’s look at a few of the critical reasons why a surgeon may say “no” and why that’s essential to ethical, expert practice.

When top facial plastic surgeons should turn patients away

Most experienced medical professionals know that reducing the number of unsatisfactory or complicated outcomes starts long before the procedure. Patients may be aware that they have the freedom to choose whom they want to work with and that they reserve the right to say “no thank you” to one or more practitioners when they attend consultations. They have an essential role as their own advocate, but the surgeons have major responsibilities too. Both for their personal protection and for yours, a surgeon may deny you an operation. Let’s look at the matter of patient protection first.

  • The patient demonstrates that they have unrealistic expectations or do not understand the process, procedure, or possible outcomes.
  • After having the procedure explained to them, they cannot repeat the information.
  • They have been over-treated.
  • They have compromised tissue or ability to heal.
  • They are argumentative, antagonistic, or difficult to communicate with.
  • They’ve left multiple surgeons due to being consistently unhappy with outcomes.
  • They don’t have a realistic budget to pay for the treatment they want.
  • They are medically unstable or have other health issues that would preclude an elective cosmetic surgery.

The above can be mental or physical safety issues. For some, such as finances, there are workable solutions like medical financing that help people offset costs, so these can be suggested, but they don’t always solve the problem. Many of the scenarios above would prompt in-depth, follow-up discussions, but some represent a real danger to the client.

For instance, body dysmorphic disorder (BDD)

This disorder must be handled with extreme empathy and caution, and facial plastic surgeons often find themselves in a pivotal position to address it.

BDD is characterized by an obsessive personal view of the body or facial appearance flaws that other people don’t see. The perception of a “large nose”, for instance, could be very different for the person suffering than those around them. Developing compulsive routines such as a restrictive diet or exercise, extreme skincare/product application, mirror checking, and picking at the skin are some of the ways these concerns present. Other indications of unrealistic perception show up when very young, smooth-skinned individuals ask for facelifts or similar inappropriate surgeries.

Though the percentage of people who have this mental illness is relatively low for the general population, the prevalence becomes much higher in cosmetic and facial cosmetic surgery settings.

Generally, someone suffering from BDD will benefit from psychiatric support, but not surgery. A facial plastic surgeon who suspects that BDD is the underlying issue must push “pause” and put their patient’s best interests first.

In some cases, providing in-depth explanations and details will help paint a realistic picture. In other cases, prospective patients may continue to hold out hope for a result that the surgeon knows they can’t deliver. To avoid deep disappointment, doctors may explain that the improvement in question can’t be achieved in their hands or that it can’t at all.

Can facial cosmetic surgery make you look “perfect”?

If a person indicates that they seek perfection, that’s a problem. Choosing a highly skilled surgeon goes a long way to ensuring beautiful results, but the very nature of cosmetic surgery means that elements of the process and healing can’t be predicted. This type of surgery is designed to improve and enhance, not to perfect. Other examples of problematic expectations are if a client wishes to look like a completely different person or if they expect to look 30 or 40 years younger.

Your surgeon must be confident that your tissue will heal well

A practical and safety-related example would be when too much scar tissue has developed as a result of past procedures or if critical, structural support tissues are missing. The complexity and risk of complications increase while the options decrease. Issues of blood supply are understood by the surgeon, but less often by the patient. Your facial plastic surgeon will tell you why a procedure may be unsafe and not worth the risk.

Facial plastic surgeons want to ensure that what you want is really what you want

You may be internally or externally motivated to make a change in your appearance. Fantastic reasons to go for it and revitalize your look include:

  • Improving a specific feature that bothers you
  • Combating the signs of aging
  • Restoring something you lost (like facial volume or hair)

External motivations might consist of:

  • Wanting a job promotion
  • Hoping to save a relationship
  • Responding to pressure from a friend or significant other

The expectation of a secondary gain from cosmetic surgery is an expectation that your surgeon will want to remove for you. It’s true that confidence can be improved when a perceived flaw is changed. If the motivation was an uncontrollable and unrelated benefit like career advancement, the patient stands highly likely to be disappointed with results, as other factors prevent the gains they wanted. Surgery can’t change your life or affect someone else. It can help you feel better about how you look.

For ethical and legal reasons, sometimes “no” is the right answer

From the facial plastic surgeon’s perspective, their medical licence and reputation are valuable assets. Any action that could jeopardize those will be avoided. That means saying no if they believe a procedure will be unnecessarily unsafe, if it will not deliver the desired outcome, or if the client is not ready.

So, what can you do if a surgeon says no to you? First, try not to be offended. Cosmetic surgeons are people too, and they must make decisions that feel right to them based on the information they have. They’ll likely err on the side of caution because so much is at stake. For the person hearing disappointing news, it can feel unfair or confusing.

Here’s what we recommend:

Ask lots of questions. Most medical professionals are pleased to explain the rationale for a decision and ensure patients feel at ease and well informed. They’ll be able to present possible risks honestly and clearly to you.

Get a second opinion. You can certainly choose another top facial plastic surgeon and present your goals and questions. In many cases, we recommend having more than one consultation, because it allows you to compare advice, facilities, prices, and more. You have no obligation to proceed with a specific practitioner after you’ve met with them. Be smart for yourself, however. If one surgeon tells you something is unsafe or extra risky for you and another says the opposite, you’ll need detailed and convincing reasons. Don’t dismiss concerns that could potentially affect you permanently. After you let another surgeon know what feedback you’ve gathered and they tell you more or less the same thing, you can probably trust what you’re hearing.

Keep hopeful

It may be hard at first, but be grateful if you’ve been prevented from making a costly mistake. Moreover, keep in mind that there are lots of other options. Surgically and non-surgically, medical aesthetic science is expanding rapidly. What’s possible each new day is impressive and inspiring. There may be minimally invasive facial enhancement treatments that you can have or other ways to improve the way you feel about how you look.

If the procedure you thought you wanted is not an option, keep an open mind and consider approaching treatment from different angles. Our inner messaging about how we look, the way we dress and present ourselves, and beautifying ourselves inside and out can have a dazzling impact on our appearance.

If you’d like to schedule a consultation with Dr. Cory Torgerson to talk about possible facial improvements, he’d be pleased to meet with you. Dr. Torgerson believes that each patient should be able to meet him pressure-free and free of charge for their consultation. That allows you to have an honest discussion and gather all the information you need without it costing you anything. Dr. Torgerson is passionate about helping each client develop an entirely personalized treatment plan and feel their absolute best, no matter which procedure they choose. He’ll give you his honest, expert opinion based on over 17 years operating in facial plastic surgery and head and neck procedures. He has an extensive education and a high level of skill in both surgical and non-surgical modalities. That means he can genuinely offer each client a broad spectrum of complementary methods to ensure that they receive what they want and what they need. We’d love to hear from you. Contact us today!

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Dr. Cory Torgerson
Dr. Cory Torgerson
Dr. Cory Torgerson is one of Canada’s most talented and prominent facial plastic surgeons, focusing on head & neck facial surgery. Dr. Torgerson has been frequently invited to teach and lecture on these topics across North America. He has hospital privileges at Sunnybrook Hospital, one of the premier hospitals in the University of Toronto Health Network.
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