So what can we do about this. We can discuss the first meeting of a patient with his/her plastic surgeon.
Once they have found one, how do they decide whether to let this surgeon perform a procedure?
Every surgeon has his own philosophy in dealing with patients. There are the "bargain basement" surgeons who might as well be wearing polyester coats. Some present a flowery portrait of the proposed procedure. Others may be a little too cold. I try to strike the middle here. You as the patient should be entitled to having questions answered. Some questions have no right or wrong answer, but are a matter of opinion. If your doctor is a bit hesitant to answer a question plainly, this might be the reason. Don't be shy. Ask!
You can ask to see "Before and After" photographs, but not all surgeons will have lots of them. Some patients are not very good about returning to the doctor after surgery. I have far more "Befores" than "Afters." "Afters" really should be photographed when the result is mature, which usually takes a few months. By this time, patients may feel less compelled to come for follow-up.
The doctor will very likely wish to examine you at consultation. This is a very normal part of your meeting. If we can't see the problem, how can we figure how to fix it? During the exam, feel free to express what exactly bothers you about your present appearance. Try to get him on the same wavelength regarding your desires. How do you wish to look? Some patients consider certain aspects of their appearance to denote their character. Changing these regions is considered a disaster to these patients! The appearance of the nose is a good example. Trying to "get into a patient's head," regarding their nose prior to rhinoplasty may be quite difficult! For this region, delivering a "Patient-specific" result in rhinoplasty is not always easy.
Perhaps most importantly in this first meeting, you as the patient need to decide whether or not you can communicate with the doctor before you. Not every doctor is right for every patient and visa versa.
My philosophy is a High Level of Service. While that doesn't make me the most expensive around, I am not the bargain basement guy either. :)