And almost all Aesthetic surgical procedures, there are only two variables that really matter. The first variable is the candidacy of the patient. This generally means having a clear understanding of what the primary problem is and having a surgical treatment that address is the primary problem. Sometimes there are secondary and tertiary issues. The best treatments always address the primary problem. Understanding what the problem is requires getting an accurate assessment or diagnosis. For example, individuals who are seeking chin augmentation may also have other issues in regards to facial, skeletal imbalance, and the lack of projection of the mentalis may not be the only issue at hand. Having a clear understanding of what a primary and secondary issues are is the first step, and getting a clear understanding of what the correct procedure is and if that procedure has inherent, limitation or not. The second variable is the skill and experience of the surgeon. There are major differences when it comes to scaling experience of providers. Facial aesthetics is a large part of very subjective field. Not everybody has the inherent skill to understand facial aesthetics or make the correct evaluation for Treatment decisions. Experience generally helps, but there are those who also have inherently better skill or trading than others. In the end, what you want is someone who has both inherent skill and lots of experience. I do not recommend patients travel long distances to have elective surgical procedures, and I do not recommend patients have surgery based on virtual consultations. To maximize the chance of high-quality outcomes I recommend patients have multiple in person, consultations whenever possible. I recognize that sometimes travel may be necessary because of inherent lack of local talent. When that’s the case in person, consultations while in advance of scheduling surgery, or still better, as is having multiple consultations to get a chance to vet providers and compare outcomes. Recognize the providers generally do not make all of their results available on the website or in the email communications. Providers are generally only showing preselected images, representing the best work of their career. This is completely insufficient to get a clear understanding of what average results look like or how many procedures, each provider has actually done. To get a better understanding of what average results look like you need to ask providers to open up their portfolio and show you their entire collection of before and after pictures of previous patients, who had similar characteristics to what you do. ask providers to show you varieties of outcome, including excellent outcomes, average outcomes, and outcomes that did not turn out, as well as they had hoped, or outcomes that require revision surgery. Riders may be willing to do this, but others will not. I because candidacy has a lot to do with how results turn out it is very important. You don’t confuse quality outcomes based on patients who are a different set of facial characteristics that you do. In other words, understand your own candidacy for the procedure and understand candidacy average patient when you’re looking at before and after pictures. I can tell you that there is major differences, depending on what surgeon you choose for all aesthetic procedures. I issues to consider her not only aesthetic outcomes, but also the avoidance complications, such as permanent, numbness, or changes in facial dynamics. I recommend patience, be more cautious than they think necessary and when, in doubt, I simply schedule more consultations. For most patients they can cosmetic surgery. I recommend patient start by having at least five in person consultations. They should give you a good sense of variety, understanding, different providers, and how they approach things differently even if they’re surgical outcomes are similar. Typically the most talented and experience providers will be the most comfortable, showing you a variety of outcomes, and will have collections of before and after pictures that seem endless. During consultations, you should take notes regarding both the quantity and quality of before and after pictures. Always make sure the patients in the before pictures of similar facial profiles to your own. When, in doubt, slow down and schedule more consultations. I don’t know where you live, but I suggest you start by talking to local providers in your community. For most medical procedures, there are generally talented providers in the most areas. Rural areas tend to have less providers, so there may be less providers to choose from. In the end, the decisions you make are your own. When in doubt, slow down and schedule bar consultations. Nobody has to have cosmetic surgery. Best, Mats Hagstrom, MD