There are a number of reasons why you may be disqualified from having plastic surgery. These include unrealistic expectations, health concerns, previous surgical complications, coercion by others etc. Let’s explore this in more depth.
It goes without having to be said, that by definition, cosmetic surgery is elective surgery. No one must have a breast augmentation or a tummy tuck etc. It is surgery that we choose for ourselves. All surgery entails some risk. However, for elective cosmetic surgery, we want the risk/benefit balance to be heavily skewed towards the benefit with a small risk. It behooves the patient to be in as good health as is feasible and realistic. All of my patients undergoing general anesthesia will need pre-op clearances from their primary care physicians and this will entail a physical exam, blood work and a cardiogram. Ideally this is done well enough in advance of surgery, so that there will be time to either correct or further investigate any abnormalities that show up. Depending on personal circumstances, a specialist may also need to see the patient. There is no definitive statement that can be made here except that all patients should be in reasonable health before contemplating elective plastic surgery.
LIPOSUCTION AND AN APPROPRIATE WEIGHT
I am somewhat in the minority here but I believe patients should have BMI less than 30-32 to have liposuction. Any honest plastic surgeon will tell you that no type of liposuction is a weight loss technique. It can certainly improve your shape and appearance. However, I feel if your BMI is high, the effect on your appearance is very limited. It is also important to make a serious effort to change your lifestyle. There is no question that losing weight after liposuction (or before) will enhance your final result.
I know they are the new rage, but I am extremely weary of the new GLP agonists (drugs approved for type 2 diabetics but are also being used for weight loss). They definitely help lose weight but as far as I know ( and would expect), once you stop these medications, then the weight will come back unless you make serious lifestyle changes. This means that many people will try and stay on these for life!!! I am virtually certain that with time, more and more side effects will surface.
There are no long term effective short cuts. You need to eat healthy if you want to lose weight and keep it off.
It is important to not make blanket statements since the particular circumstances may affect the decision whether to proceed with surgery. A great example of this is SMOKING. I will not operate on active smokers (or any person actively using nicotine) for facelifts, tummy tucks or breast reductions. If they want to have these surgeries with me, they have to be off nicotine for 6 weeks before surgery and 3 weeks after surgery (then they should just quit:)) Why specifically these 3 operations? It is because these 3 surgeries require undermining large areas of skin, decreasing the blood flow to the skin. Nicotine is a powerful vasoconstrictor and further decreases blood supply. Studies show that the complication for these procedures is increased in smokers. There are other surgeons, who I know, will still operate on these patients but in my personal opinion, I don’t think this is a good idea and their judgment is being swayed by fear of losing out on a surgery. For other procedures such as a breast augmentation or liposuction, the blood supply is compromised much less and smoking is less of a risk factor (still always better to quit nicotine but less important for these procedures).
This is huge and has become more important with the rise of social media. Sadly many patients (and unfortunately less ethical doctors) will enhance final results by photoshopping the final results. It is possible to buy very good software for doing this for little money. It used to be expensive but with technological advancements, it is readily affordable.
There are a lot of things that can be said about this topic. However, I think the most important thing is that it is critical to get your board certified plastic surgeon’s idea on a realistic result. This does not mean you may not get even better results than what the surgeon described, but it is important to realize you will most likely have an improved appearance but it is also human nature to wish you were even better. This personality trait keeps us striving to improve. However, it is vital that you take time to appreciate the positive changes that have been made.
It is important to realize that we are all unique. There are a lot of factors that will influence the final result. Oftentimes, there are factors influencing the final result that a patient may not realize. To illustrate: you may look at a picture of someone else or see your girlfriend and to your untrained eye, you both look like you would benefit from a tummy tuck. You are both about the same height and weight. Post-operatively, both of you improve, but one much more than the other. Why? Of course, there can be a lot of reasons but one woman may have had a lot of her fat in the subcutaneous position (under the skin and above the muscle) and the other woman may have had most of her fat behind the muscle (visceral). There are countless examples. Just because someone in IG shows off her sculpted jawline, does not mean that anyone regardless of build, can get the same result.
I always try to tell my patients that they will likely improve but there will rarely be perfect.
COERCION BY OTHERS/ OR TRYING TO ACHIEVE AN ULTERIOR GOAL
This in some ways overlaps with unrealistic expectations. Occasionally, I encounter (though not commonly) someone who is exploring doing a cosmetic procedure to please either a partner or a parent. Both are terrible reasons for doing this surgery. I will not operate on a person if I can discern that this is the reason. It is your body and you have to want the changes to your body!!
Related to the above, I have encountered a few consultations, who wanted an end result and felt that by having cosmetic surgery, they would more likely achieve this goal. I had one consultation with a woman who was very upset that her husband was having an affair with a younger woman with large breasts. During the consultation it became clear that she was quite content with her breast size and was only doing the breast augmentation with the hopes that she would win him back. I told her that I would not do the surgery and suggested that she explore marriage counseling etc. I also told her that if she shopped around, some other surgeon would likely do the procedure but almost certainly she would be dissatisfied with the final result because it would not truly achieve what she was after.
Along a similar vein, someone who truly does not like themselves, needs therapy and not plastic surgery. It is one thing to not like a particular feature about yourself that can be improved through plastic surgery. This is very different from someone who does not like (hates) themselves!!
PREVIOUS SURGICAL COMPLICATIONS OR PREVIOUS SURGERY IN THE SAME AREA.
This really needs to be individualized. It is important to look carefully at what has been done before and why things did not turn out as hoped. Sometimes you can try a different approach and realistically hope for a different outcome. Sometimes you have to accept that this person has received good treatment and sometimes things do not turn out as hoped. In this case, the plastic surgeon has to say that it is unlikely they will be able to improve the situation and decline to re-operate, even if the patient insists that you give it a try.
DON’T UNDERESTIMATE WHAT YOU CAN DO
We tend to see our flaws and we magnify them in our own minds. However, when we look at someone else, we take in their entire gestalt and then later may notice some less than ideal features. Eating healthy, exercising, getting enough sleep, being happy with your life and dealing with stress well – will not only lead to better health but will almost certainly make you look better. These are totally in your control:)