I was at a Swimming Meet this weekend and one of my friends asked me if I perform Abdominoplasty at the same time as Breast Augmentation. My reply came in the form of explaining the concept of the “Hot Topic” of Mommy Make-overs and what they involve. She next told me that she knew a couple of friends (from the same grammar school) who had undergone these procedures. Strangely, both of them had gone in initially for Breast Enhancement and were strongly encouraged to add the Tummy Tuck. This was because that “would make the Breasts look even better.” I was visibly taken aback.

This brought up the discussion of “needing” versus “wanting” Aesthetic Surgery. Now let’s be honest. Although writing this may be blasphemy to the Priests of Nip Tuck, in reality no one “needs” Cosmetic Surgery. They “want” Cosmetic Surgery to improve their appearance. It is elective. I personally would find it appalling if I went to a Plastic Surgeon with one concern and they talked me into something additional.

This brings up the concept of vanity. We’re all familiar with the criticisms that Cosmetic Surgery is all about vanity. Well, frankly, it is. However, let’s put this into perspective. Since the dawn of time human beings have been altering their appearance to reflect the values of their culture. Consider the tattoos, piercings and scarification that are customary in some societies. Whether or not we want to accept it, the truth is that how we appear has an impact on how we feel about ourselves and how others perceive us. However, like most things, intelligent moderation is the key to success. A healthy amount of vanity may aid in maintaining our sense of self worth and positively impact our interpersonal relationships. In contrast, extreme vanity can emotionally cripple someone and turn them into a nightmarish Hollywood Cliché’.

It is true that when someone visits a Plastic Surgeon, they are looking for expert advice about their concerns. However, it is also true that this person is probably somewhat insecure and vulnerable. In my opinion, encouraging someone to have additional surgery when the advice was not specifically sought out is unethical. It is really easy to manipulate an insecure and vulnerable person into doing what you want them to do. As physicians, we have a much higher moral obligation to our patients. We are not selling cars and adding on an extended warrantee. Unfortunately, especially in our challenging times, patients need to beware of practitioners that insist on “the extreme makeover.”

As a Plastic Surgeon, it is a great privilege and humbling to have someone entrust their safety and well being to you while attempting to improve their life with surgery. However, the patient is the only one who has the right to decide what will work for them. I always tell my patients “There are a lot of things I know how to do that are great for my kid’s college funds. Not all of them are good for you.” When considering Aesthetic Surgery, be clear on what you are trying to accomplish and keep that in perspective. If you are curious, get options and get educated. Beware of grandiose artistic surgeons who “have a plan to make you better than you ever were before.” Getting more than one opinion is always prudent. As statistics of patient satisfaction will tell you, if done safely and well, Aesthetic Surgery can enhance your life. However, don’t let any interested party influence what you believe is right for you.