Here’s Why a Cosmetic Surgeon Might Refuse to Perform a Procedure
Cosmetic surgery is a deeply personal decision—and choosing the right surgeon is just as important as choosing the right procedure. While many patients come to their consultation ready to move forward, a top cosmetic surgeon like Dr. Alex Sobel may say something unexpected: “I don’t recommend surgery right now.”
This might sound surprising, but it’s actually a sign of a compassionate, ethical, and experienced surgeon. Dr. Sobel prioritizes your safety, long-term satisfaction, and emotional well-being above all else. Below, we’ll explain the most common reasons a cosmetic surgeon may refuse to perform a procedure—and why that decision is often in your best interest.
1. You have unrealistic expectations
Cosmetic surgery can enhance your appearance, boost confidence, and align your outer self with how you feel inside. But it’s not a cure-all—and every body has its own unique limits. Sometimes, patients request extreme changes that would compromise the balance and harmony of their body, bring in heavily filtered or edited inspo photos, or want to replicate another person’s appearance. In these cases, your surgeon may recommend against moving forward.
Part of Dr. Sobel’s expertise lies in knowing which techniques will deliver optimal results; “refusing” one procedure isn’t a rejection, it’s a redirection toward a safer, more effective solution.
Dr. Sobel will always be honest about what a procedure can and can’t do. For example, if a patient comes in seeking liposuction to remove unwanted fat from their waistline, Dr. Sobel may recommend a tummy tuck if liposuction alone would not be enough to achieve a smooth, firm midsection. Removing the unwanted fat without addressing skin laxity can leave you with loose skin post-liposuction.
If your desired outcome is unlikely to look natural, hold up well over time, or deliver the satisfaction you’re hoping for, he’ll guide you toward more suitable options—or recommend holding off altogether.
2. You smoke, vape, or use nicotine
Carbon monoxide, nicotine and surgery don’t mix. These substances compete with oxygen to be carried by hemoglobin on your red blood cells and restrict blood flow, thus impairing healing. That means a much higher risk of surgical complications, including infection, skin loss, delayed healing, and exaggerated scarring for those who smoke cigarettes, vape, or use nicotine patches or gum. Nicotine consumption will give any credible surgeon pause.
Because your safety comes first, Dr. Sobel may decline to perform your surgery if you’re using nicotine and you are not prepared to stop. However, many patients successfully move forward with their procedure after remaining nicotine-free for the recommended period of time. You’ll receive clear and supportive guidance if this applies to you.
3. You don’t have time for a safe recovery
Surgery is only one part of your cosmetic journey—the recovery period is equally important!
A rushed recovery puts your results, and your health, at risk. Every surgical procedure requires downtime, and the body needs adequate rest to heal properly. Not taking enough time off work or returning to strenuous activity too soon could compromise your results and increase your risk of complications. Your surgeon should consider your lifestyle before scheduling your procedure.
Dr. Sobel will help you understand the realistic recovery timeline for your chosen procedure and ask about your schedule and support system to ensure your healing goes smoothly. If you have upcoming travel, work obligations, or caregiving responsibilities that will prevent you from following post-op instructions, he may recommend postponing surgery until you’re in a better place to heal fully and comfortably.
“I had rhinoplasty from Dr Sobel in October, 2024. Dr Sobel was kind, gentle, always jovial and full of positive energy. He was great at tempering my expectations and explaining the outcome of my surgery. I am so very happy how it turned out! My surgery was pretty easy, as was the recovery. Dr Sobel kept me informed and positive the whole way. He did exceptional work and I couldn’t be happier with the results! Highly recommend him!”
4. Your body needs more time
Sometimes, the issue isn’t if you should have surgery—it’s when you should have surgery. If your body is still adjusting after a major change, surgery could disrupt the healing process or interfere with your final results. In these cases, pressing pause on a cosmetic procedure can prevent complications and help you experience the best results possible when the time is right.
To recover from a previous surgery
If you’ve recently had another cosmetic or medical surgery, your body may still be healing—even if you feel mentally ready. Performing procedures too close together can compromise your healing ability and aesthetic outcome. Dr. Sobel can help you plan enough time between medical or cosmetic procedures to give your body the time it needs to recover fully and safely.
For example, procedures like fat transfer breast augmentation sometimes require a secondary surgery to achieve the desired breast size. It’s important that your body has enough time to heal from the initial surgery and for the transferred fat to integrate with the breast tissue before you consider additional fat grafting. Being fully healed helps ensure that the second procedure doesn’t overtax the body and helps the results appear more predictable and better meet your expectations.
To recover post-partum
After pregnancy, your body goes through enormous changes. Even if you’re eager for a “snapback” procedure, it’s best to wait at least six months after giving birth (and often longer if you’re breastfeeding) before pursuing surgery. This allows your hormones to normalize, your weight to stabilize, and your tissues to recover naturally so that your results are optimal and aren’t impacted by post-partum changes.
Dr. Sobel is especially thoughtful when helping his patients feel more like themselves after pregnancy and breastfeeding and supports patients with compassionate, expert care—timing included.
To adjust to recent weight loss
If you’ve recently lost a significant amount of weight—either through lifestyle changes, GLP-1 medications, or bariatric surgery—your body is likely still in transition. Fat distribution, skin elasticity, and body proportions all take time to settle, and jumping into surgery too soon can result in underwhelming or short-lived results.
Waiting until your weight has been stable for several months allows Dr. Sobel to accurately assess your anatomy and recommend the ideal procedure to achieve your goals.
A surgeon who says “no” is prioritizing you
At our Bellevue cosmetic surgery practice, we believe patient-centered care starts with honesty. Saying “no” to a procedure doesn’t mean your goals aren’t valid. It means we want you to reach them safely, successfully, and in a way that makes sense for your body, lifestyle, and emotional well-being.
If you’re considering cosmetic surgery and want trusted, transparent guidance from a board-certified cosmetic surgeon who puts your health and satisfaction first, schedule a consultation with Dr. Alex Sobel. Our Bellevue office can be reached at (425) 453-9060 or you can fill out our patient contact form online and we will be in touch.