Cosmetic plastic surgery is unique in the field of medicine. By definition, the procedure does not need to be performed, it is purely elective. This central tenet means that the safety, quality and results associated with the procedure are of the highest standards and all pain minimized. Another unique aspect of cosmetic plastic surgery is often underappreciated. For a patient to undergo a surgical procedure with significant cost and some pain involved, they must perceive some benefit. In the case of a patient undergoing a cancer operation the benefit is clear, the surgery will save your life. In the case of a patient undergoing a procedure to repair a broken nose, the surgery will allow the patient to breathe. In the case of a cosmetic patient the benefit of surgery is more abstract. Cosmetic surgical patients are willing to undergo the cost, pain and time involved for a procedure because they hope to feel better after the procedure. The patient hopes to undergo a change in their state of mind based on altering their physical appearance. This is similar to when a patient goes to the gym to exercise or begins a diet regimen. The cosmetic surgeon is using surgical tools to affect a psychological state. A state of well being, improved self esteem, and confidence can all occur from cosmetic surgery. However, because cosmetic surgery in its essence changes a state of psychological being, patient selection is important. Certain patients may have psychological challenges that make cosmetic surgery not the best choice to address these concerns. How can the patient identify if they are probably not suited for a cosmetic procedure. All human beings are imperfect. It is natural to want to improve a flaw, but we all understand that we cannot change everything, we cannot improve everything. If you are spending a great deal of time looking and thinking about a certain imperfection or body part flaw this is a sign to pay attention to. If this perceived imperfection is changing the way you dress to conceal the flaw or the way you live your life, this is a warning sign. Patients should be very careful to consider the impetus for the cosmetic surgery. The best cosmetic surgeon is not going to help you save a failing marriage or revitalize a flagging career. The patient and surgeon should be honest about what the surgery can, and more importantly cannot achieve. The best way to address your concerns is to visit the surgeon and freely express your doubts and fears. The experienced cosmetic surgeon will be able to determine if cosmetic surgery is right for you or whether you may be best helped by other interventions. The surgeon’s primary concern is your psychological well being, if that is improved by surgery or some other means the surgeon will happily refer you to the most appropriate person.