Why Would a Plastic Surgeon Say No?

Let's talk about honesty. Honest with ourselves and honest with our patients. We have to be. When they come in and see us, they're coming to look better, to feel better, to improve their self-confidence, but we have to be honest with them. And to do that, we have to know things. We have to have knowledge. How can you have a nice consultation with somebody and tell them the truth if you don't know all the options?

Part of being honest is being able to tell patients, no, you don't need that. Don't do it. Another part of it is being able to tell them, here we don't have this option for you, but another place may have it. Just because you have that laser doesn't mean you have to use it on everybody. Just because you have that procedure doesn't mean that everybody needs to get that procedure.

And just because somebody came and saw you doesn't mean that they must open their wallet and pay you for a treatment that they don't necessarily need. Now, paying you for your time, for your advice, is a different story. You deserve that. But you don't need to put a syringe in their face if they don't need that.

I had a patient come in and see me for a rhinoplasty today. Very nice nose. She wanted to do rhinoplasty, wanted to do it her whole life. And I said, no, you don't need it. This is my job as a facial plastic surgeon, to tell my patients what's going to make them look the best, what's going to give them the biggest bang for the buck. And for her, it was going to be skincare. Starting with skincare, going up to a CO2 or erbium laser resurfacing eventually. That's going to be the thing for her to make it look amazing. So I said no to the rhinoplasty, but think about these things.

Then two other patients came and saw me today. Both were significantly overweight and they wanted me to fill or do something to contour their lower face. That's not going to happen. I see a lot of videos, a lot of posts on Instagram, showing contouring. It's just not going to happen. If you have a flat cheek, you can inject it to lift it, to create contouring. But if you have a significantly heavy lower face and you need to lose 50 pounds, 100 pounds, 150 pounds, then putting fillers here is a complete waste of money. I'm not going to do it. You should not do it.

We should be able to say no. No, you don't need it. Even if it disappoints the patient, maybe you don't have another option for them. But you have to be honest. We don't always have to do something. Sometimes doing nothing is best, because now you save the person a few thousand at least. They may go home disappointed, but they're not losing a few thousand dollars out of their bank account.

So being honest is super important. Being knowledgeable is just as important, because you have to know what you're talking about and not treat everybody the same way. Just because you just learned how to do cheek injections doesn't mean everybody needs cheek injections. Just because I'm the nose guy doesn't mean everybody needs rhinoplasty. This is what we should do.