01.31.2019Expert Perspective

How To Talk To Your Friends and Family About Cosmetic Surgery

Talking about your cosmetic procedures with people close to you can be tricky. You never quite know how they'll react. We spoke to plastic surgeon Dr. Jason Roostaeian, as well as actual patients, for tips on how to make the conversation work for you.

Krista Smith

When I started noticing some early signs of aging around my eyes, I didn’t dash to the doctor right away. I was a little apprehensive about cosmetic treatments, even non-surgical options. I had mixed feelings about modifying myself in the name of beauty. I wanted to still look like myself and not like I'd had "work done." I wondered if I was being vain or succumbing to some perceived pressure from society's standards. After a bit of soul searching, I realized that I’d been letting fear of possible judgment interfere with my own desires. As long as a treatment is safe, both physically and psychologically, I believe people are entitled to self-improvement in all forms, cosmetic procedures included.

Armed with self-confidence, I took the plunge. I did extensive research and met with a board-certified plastic surgeon who treated my wrinkles with BOTOX®️ and my volume loss with a hyaluronic acid-based filler. I was pleased with the results, but not with the idea of periodic upkeep. I eventually opted to undergo surgical fat grafting, a procedure designed to provide more permanent facial volume. I was excited to talk about the surgical procedure with my family and friends. After all, my trusted inner circle would be accepting of anything that made me happy, right?

Not so much. While a few of my friends were genuinely interested and supportive, some others, particularly people related to me, were not as enthusiastic. Most of them didn't say it outright, but their body language, skeptical tone, and relative silence said it all. They didn’t really approve, but they didn’t want to hurt my feelings by admitting it.

While their judgment didn’t lead me to regret my choice, it did make me question being so vocal about it. Should I have kept my cosmetic procedures a secret? I’d made subtle changes, so presumably keeping it under wraps would have been a possibility, but it didn’t feel right to me. I wanted to share my experience, rather than keep it from my loved ones for fear of a negative reaction. Was there a way to educate people about my cosmetic surgery in a way that wouldn’t prompt pessimism? Where was that unfavorable reaction coming from? In search of answers, I sought out plastic surgery professionals and other patients to learn more.

“Good plastic surgery is invisible,” says Jason Roostaeian, M.D., Associate Professor of Plastic Surgery at UCLA. “My goal is always to produce a result that looks as though my patient might've been born with it. Of course, depending upon the area and the extent of what we change, patients may or may not be able to keep their surgery to themselves.”

As plastic surgery procedures become less detectable, it surely impacts is that having on people’s decisions to disclose them. “As technical advances allow for increasingly natural looking results, patients are actually having to face that dilemma more and more frequently," says Dr. Roostaeian. "Fortunately, the popularity of plastic surgery procedures, combined with increased exposure via social media, continues to significantly reduce the stigma associated with aesthetic surgery.”

Understanding that our society is becoming more accepting of plastic surgery made me feel less self-conscious, but I was curious how other patients had navigated talking to family and friends about their cosmetic surgery.

Dr. Sean Saadat is a plastic surgery resident at UCLA who has had two rhinoplasties. The first was at age 19, followed by a revision which he chronicled on social media. Dr. Saadat told me that he didn’t initially disclose his desire to change his nose because he felt admitting his insecurities about his appearance would make his parents nervous. He also worried that he’d be judged as a male seeking plastic surgery, which is stereotypically for females. “When I did bring it up, I said I was having trouble breathing,(and that) when the surgeon suggested fixing the prominent hump on my nose at the same time, I just kinda went along with it," he says.

Dr. Saadat's family turned out to be supportive. “Once I’d made the decision, my family stood behind me," he says. "Having your nose done is quite common in Iranian culture. Many women in my family had undergone rhinoplasties, so I felt like I was surrounded by a rhinoplasty support group.” He wasn’t so confident about his friends, however, so he lied and said he was having his wisdom teeth removed. “In my first couple of days post-operation, with my splint intact and eyes still bruised, I invited them over one by one for a big 'ta-da' moment," he says. "Surprising my friends felt satisfying and prevented them from saying anything negative beforehand. Ultimately, they were happy for me because they knew how insecure I’d been about my nose.”

Aubrey Nolan, co-founder of CrushFit, also felt apprehensive about revealing her cosmetic treatments. “I feel like there’s a huge stigma against getting any kind of work done, especially on your face," she says. "I got my lips done and I was scared to even talk about it on social media. I feared what people would think of me and I considered not telling anyone.” But after giving it some thought, Nolan reconsidered. “I’ve been as transparent as possible with everything that I do. I guess I just don’t see what the big deal is.” When a few followers responded negatively to her choices, she initially felt defensive, but now realizes that “getting work done doesn’t change the heart I have and I no longer feel the need to defend my actions.”

YouTube beauty blogger Elwa Saleh had a different concern surrounding her decision to have plastic surgery to correct her partial nasal collapse. Her family and friends were very supportive from the beginning, so Saleh says she “was not concerned about any judgment or scrutiny. But I was worried about the swelling lasting a long time (since I make my living blogging) about beauty and fashion. Most of my work is on camera and my face is a big part of my job.” After the procedure, “I did get a lot of questions about why I did it from my social media community," she says. "Some jumped to conclusions and thought I had major cosmetic surgery but once I spoke up about what I had done, the judgments dissipated.”

One thing is clear: everyone has an opinion about plastic surgery and the more obvious the change, the stronger people tend to feel. But the degree to which people notice a person’s plastic surgery depends on more than just the procedure and the surgeon’s skill. It’s directly linked to the level of familiarity involved. The better we know someone, the more likely they are to notice a change. This connection was the key to understanding my family’s lackluster response to my own cosmetic surgery. They felt comfortable enough with me to express their uncensored emotions. Strangers risk this behavior, but social media has reframed what we consider familiar. All people are prone to pass judgment. “When you decide to go under the knife, that decision should be made with the understanding that people will judge because of their own insecurities and they may try to hurt your feelings," says Dr. Saadat. "If you do your homework and find a surgeon who will do a very good job, people will be pleasantly surprised to realize that you actually look like an improved version of yourself, and they’ll come to terms with it.”

Here are some tips for talking to your family and friends about cosmetic surgery

Choose Wisely

“You need to be careful about who you tell beforehand," says Dr. Saadat. "They need to be open-minded people who aren’t going to be thinking about their own insecurities.” Although it’s impossible to really predict how a person will react to your decision to seek cosmetic surgery, confide only in those friends or family members who have your best interest, and self esteem, at heart.

Keep Calm and Confident

If you’ve thoroughly considered every aspect of choosing cosmetic surgery, from examining your own psychological motivation to researching your procedure and plastic surgeon, someone else's snarky comments become insignificant. Relay your reasoning without defensiveness or excessive emotion. If you communicate your seriousness about improving your quality of life, your friends and family may be less likely to find fault in your choice.

Look Deeper

Fear or insecurity could be behind someone's negative reaction. The topic of cosmetic surgery is so charged because it can tap into our deep insecurities and can sometimes bring up feelings of inadequacy in someone. Keep in mind, your loved one’s negative response may have very little to do with you.

Don’t Try To Win

Stay focused on your purpose. You're having this conversation to inform your loved one about a decision that you’ve made for yourself, not to try to change their mind about plastic surgery. If things start getting heated, agree to disagree before feelings get hurt.

Be Patient

Sometimes time is all it takes for people to accept their loved one’s decision to undergo a cosmetic procedure. “At the end of the day, it’s the patient who truly has to live with their transformation," says Dr. Roostaeian. "If an aesthetic surgeon does their job well, the results will blend so seamlessly with their existing features that eventually, even their closest friends and family may forget there was ever a change.”

Be Yourself

While there’s no magic formula for talking to your friends and family about plastic surgery, keep these pointers in mind and be prepared for the onslaught of opinions. People who truly care about you will appreciate your honesty, so be as forthcoming as you feel comfortable being. Remember, how we present ourselves is up to us, but how we are perceived by others is beyond our control. Staying true to yourself will keep you feeling beautiful, inside and out.

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