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Should surgeons interfere when a patient goes too far with cosmetic surgery?

Q:

Should surgeons interfere when a patient goes too far with cosmetic surgery?

A:

Plastic surgeons should always have the best interest of the patient at heart. Goals of plastic surgery are to improve physical characteristics to enhance natural beauty and quality of life. I feel the best plastic surgery is when it doesn't look like you've had a procedure. Too much plastic surgery tends to look unnatural and can make you look older than your stated age, distorting your features. It is our responsibility to say "no" to patients who have unrealistic expectations, or to patients who lose the perception of reality after reaping physical and emotional benefits of previous procedures and "want more".

We have an ethical and moral responsibility to take care of our patients and guide them into making realistic decisions about procedures. We also have to think about long-term consequences of repeated operations and uncorrectable deformities that can occur when too many procedures are performed. So yes, we should always interfere and turn away patients who go too far with cosmetic surgery.

H. A. Brown, MD

A:

This question is more complex than it appears. Obviously, a surgeon should decline to offer surgery if it won't help the patient. Interfere suggests a more active role for the surgeon, and it is an unfortunate fact that the patient I turn down can go down the street and potentially book with another surgeon, and it is not my right or responsibility to interfere in this process. The definition of too far is not always obvious, with a wide spectrum of opinions - some would consider any cosmetic surgery too far!

M. L. Kreidstein, MD

A:

Yes, and no. If a person suffers from body dysmorthic disorder and sees flaws that others do not, a plastic surgeon should not perform plastic surgery on a patient in this state of mind. Likewise if a patient seems addicted to surgical enhancements, ethical plastic surgeons would back away. However, there are some patients who undergo plastic surgery expecting a natural looking result. On occasion people can end up looking very unnatural and nothing like themselves. There are times when I will perform surgery to restore a natural look to patients who have had plastic surgery that results in pulled, stretched skin, hollowness in the eye area and sometimes rounded eyes.

M.M. Law, MD

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