When to Say No: Understanding Limits of Plastic Surgery

I had a longstanding patient in whom I had done 5 rounds of micro silicone injections into her lips.  Her results were stunning, natural, and feminine.  She came back a year afterward wanting more.  I humbly tried to talk her out of it, begged her not to ask for more, but to no avail.  She wanted more.  I declined.  She threatened to go to another plastic surgeon.   I told her that would be a good idea since we could not meet on the same aesthetic turf.  She called my staff the next day saying that she was involved in a car accident because of my refusal to work on her.  Fortunately, I recently saw her again for fillers in areas that I thought she would benefit from it (not the lips) and she was ecstatically happy with my results.

Saying No in Plastic Surgery

Sometimes you must learn to say no to a patient because saying yes will contravene what makes good sense to you as a surgeon and violate your inner aesthetic principles.  I say no all the time. The hardest time to say no to a patient is after you have already established a relationship.  It is far easier to tell someone no before you start to work on him or her during the initial consultation.  In today’s world of the Internet, you have to be careful even how you say no to him or her because people just starting posting a bad review even if you refuse them service.  I always tell my patients, the reason I say no is not because I am interested in losing money but because I cannot stand doing the wrong thing for someone that would destroy my artistic sensibilities.

Samuel M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. To learn more about Dr Lam’s plastic surgery procedures please call (972) 312-8188 to schedule a consultation. If you would like to ask Dr Lam a question about facial plastic surgery please visit our Plastic Surgery Forum.