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Real Talk From a Plastic Surgeon About Going Under the Knife

Today's Medicine

How do I say this? If you’re 300 pounds and want look like Barbie, I’m not the plastic surgeon for you. In fact, let me know if you find one who can make that happen.

I get it. Cosmetic surgery, more commonly referred to as plastic surgery, is like Nordstrom: It’s a “want” store, not so much a “need” store. People come to me because they want to feel better about themselves. But this kind of surgery won’t turn you into someone you’re not. And as I’m sure you’ve been told before, too much of anything can be a bad thing. Even though it’s what I do for a living, I feel it’s my responsibility as a plastic surgeon to be frank with my patients.

So, here’s what you need to consider if you’re considering going under the knife:

Yes, there’s still a stigma

The stigma tied to plastic and cosmetic surgery isn’t nearly as bad as it was 25 years ago. More and more people are electing to have it done, and they’re also becoming more vocal about it.

But when it comes to certain procedures like breast augmentation or liposuction, there will likely always be some people who pass judgement. Think about your own social circle and how people around you might react if you pursued cosmetic surgery. Would they give you certain looks? Unwanted attention? Would they say things behind your back? You need to be prepared for all of the above.

That said, “going under the knife” is no one else’s decision but your own.

My philosophy? If your thighs have bothered you for 30 years, and you feel liposuction would make you feel better about yourself, resulting in a more engaged and productive you – go get liposuction! If you feel like you lost a part of yourself and your femininity after losing your breasts to cancer, go reclaim what cancer took from you – consider breast reconstruction!

Bottom line: It’s your body, and you have every right to do what’s best for it and you.

And yes, there are risks with cosmetic surgery

Sometimes cosmetic surgery requires the removal of a lot of skin and tissue. This can lead to issues with wound healing or even tissue death.

Other risks and complications include:

  • Infection. It’s one of the more common risks associated with any procedure. Antibacterial soap is used prior to the procedure, and perioperative antibiotics are also administered to help decrease the risk of infection.
  • Scarring. Even the most well-done procedures can result in some scarring, which can be troubling for patients who are particularly concerned with improving their appearance. Prescription creams or gels can often help minimize the appearance of post-operative scarring.
  • Dissatisfaction. I can’t stress this enough: You need to be open and honest with your doctor about your goals and expectations of surgery. Talk to different doctors. Shop around. It’s important that you trust the person performing your procedure. A positive relationship often yields positive results.

Cosmetic surgery health benefits

Again, while I’m not sure most people need cosmetic surgery, it can do a lot for a person’s overall health.


Breast procedures, including breast reductions, make up about 80 percent of my practice. Just as some women may feel more feminine with breasts, others may feel weighed down by them. A breast reduction can reduce or eliminate back, neck or shoulder pain tied to carrying excess weight in the upper body. It can improve posture and make exercise easier.

Even rhinoplasty – often referred to as a “nose job” – can help a person suffering from certain nasal obstructions breathe easier.


Keep in mind that your mental health is just as important as your physical health. If a perceived physical flaw plays a role in any kind of depression, anxiety or stress you may be dealing with, cosmetic surgery may be something to consider. I’m a firm believer that when a person’s self-confidence improves, so does their quality of life.   

The takeaway

As is the case with any procedure, you must be healthy enough for cosmetic surgery.

You may be a candidate if you:

  • Exercise regularly
  • Consume plenty of protein
  • Don’t smoke

All of these things will help ensure proper recovery and healing.

So, is cosmetic surgery right for you? Only you can answer that.

If you’re looking for honest feedback, find a doctor who truly listens to you – someone who views you as a person, not one more procedure.

But if you constantly find yourself wanting “one more procedure,” I encourage you to take a deeper look inside. What is it that you really want? Because no matter how many times you choose to go under the knife, you may never end up finding what it is you’re chasing.

More resources:

Deanna Armstrong

About the Author:

As a plastic surgeon practicing on the campus of Methodist Women’s Hospital, Deanna Armstrong, MD, finds a lot of joy in performing breast reconstruction for breast cancer survivors.

“We both usually walk away with a tear in our eye and a hug,” she said.

She spent time as a medical student and resident at Methodist, and both of her children were born at Methodist.

“It’s probably where I’ve always felt the most comfortable.”

See More Articles by Deanna Armstrong