“Liposuction is my least favorite procedure. It’s boring. I hate it.” These are the words of a plastic surgeon reporting anonymously to New York Magazine on January 8, 2012. Further, he says, “It’s also totally oversold. It’s not a cure for obesity…..it’s an operation for people who have pockets of fat that are stubborn and don’t go away.”

He advises 50 percent of people who come in for liposuction that they do not need it. But if you’re determined to get lipo, you will find it. Many practitioners out there, who are not plastic-surgery trained, are eager for customers. Some are overaggressive, creating rippled or wavy-looking skin, which is very difficult to correct.

His favorite surgery to perform is a nose job because it is closest to sculpting and is such a challenge to do well. “A millimeter or two millimeters more or less is a vast, vast difference.” But, he advises, if you were to actually see a rhinoplasty performed, you would hesitate to undergo it. “You fracture the nose with your hand, and you’ll hear it when you’re in the OR – I mean, it cracks just as if you punch someone in the face. You use all the primitive tools like a hammer a chisel and a rasp. And you can completely botch it.” There are surgeons who specialize solely in redoing rhinoplasties.

As far as breast augmentation, he says, “it’s a relatively quick and simple operation,” but most people don’t know that breast implants are not a lifetime device and will need replacement. The thing about doing breast augmentation that can make a surgeon sweat is when the patient is unhappy with her implant size. For example, when you make somebody a C-cup, “…and they’re like, I’m a small C. I wanted to be a large C.”

On the subject of who’s to blame, doctor or patient, in cases when patients like Michael Jackson and others like him keep coming back for more surgeries until it becomes clear that the results look like a disaster, he says, “You’re in a gray area. My personal opinion is, it’s always on you. You did it.”

He admits that when he walks down the street and looks at people, he often thinks, “I can do this, I can do that. You become hypercritical.” That becomes a problem at home. Sometimes when he looks at his wife too long without saying anything, she’s sure he’s thinking about the procedures he can do improve her looks. Although he tells her, “No, I’m not,” he secretly is.