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Plastic surgeons used to worry about "problem patients" who were getting surgery for the wrong reasons, or who might be psychologically vulnerable. Now problem patients are the ones who might publicly vent their dissatisfaction with a procedure and impact their doctor's practice. Since these days anyone can set up a website or post on cosmetic surgery message boards, allowing forever Googlable mud-slinging, the American Academy of Facial Plastic and Reconstructive Surgery is making videos of "the kind of patients to avoid," an example of whom would be "the cloying patient who butters you up with compliments."

Needless to say, TV shows like The Swan are blamed for creating "wrong ideas about what was possible." Anyway, it's nice to know that plastic surgery ethics permit repeated and inadvisable operations until you look like a freak, but vigilantly police the potential for a patient to question the look of their dome-shaped boobs or joker-smile.

A Face Not Even a Plastic Surgeon Could Love [NYT]