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Cosmetic surgery cannot perform miraculous changes in physical appearance or reconstruct basic personality defects such as self-rejection, incurable envy, the "if-only" syndrome, or hopelessly childish notions about beauty and romance. A woman with unrealistic expectations about results is almost certain to be disappointed. A woman with a specific and limited problem, whose livelihood is at stake because of premature wrinkles or bags under the eyes or who feels socially inadequate because she is flat chested or has localized areas of obesity that limit the type of clothes she desires to wear, or who loathes her nose, is likely to be pleased with the solution cosmetic surgery can provide. Her improved self-image results in greater self-confidence, which carries over into her relationship with others.

However, women who are obsessed with looking young and are terrified of aging might benefit more from sustained soul-searching or psychotherapy than from surgery. Any woman who wants to get the best return for a considerable investment of money and time should therefore be as honest with herself as possible about the motives that bring her to the surgeon's office.

Surgery should not be undertaken when the patient's emotional stability has been threatened by a shocking experience. There is no doubt that some women who have experienced an unusually stressful crisis such as a divorce, a sudden death in the family, the unanticipated loss of a job, or the unexpected responsibility of taking care of an invalid child or parent can benefit from the positive effects of a long-postponed improvement in appearance. But psychic stress has an adverse effect on the physiology of the body and in many cases, can slow down the healing process.

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Ideally, a person about to undergo elective surgery should be in the best possible physical and mental condition, always taking into account the fact that if surgery is to be extensive, it will inevitably produce some feelings of anxiety in the patient about the outcome. A reputable surgeon will take a detailed medical history, including past illnesses, present chronic conditions, whether the patient is addicted to alcohol, smoking or any drugs such as tranquilizers or sleeping pills. Surgery may be delayed until she has ceased smoking or using alcohol or drugs for sufficient time so that they no longer affect the body.

Before any woman goes to a cosmetic surgeon, she should attempt an honest assessment of her appearance and know precisely how she wishes it to be changed. Where exactly is the problem? Does the chin need strengthening? Does the nose need altering? Are the ears too outstanding? Does a body contour need to be changed? Take a good look in the mirror. Perfect symmetry of either the face or the figure is usually out of the question. In fact, it is the slight asymmetry of the facial bones that gives most faces interest and individuality.

Over time, the concept of beauty has changed and is associated with the position of women in society and their activities. Today, most females desire to be thin and full breasted. With the development of prostheses and the relative simplicity of the operation, breast augmentation has been requested frequently. Probably the concept of the type of nose that is most desirable has changed most in the last fifty years; again, that is a highly individual matter. Computerized imaging can be helpful in reaching the most desirable and achievable results.

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