Principles and Ethics of Cosmetic Surgery
These are principles that guide us.
Make no change that is not an improvement in
Make no change that is not agreed upon by the
Rewards must far outweigh risks.
Normal or natural is more desirable than
attractive or beautiful.
There must be no unnaturalness or abnormality
in the post-surgery appearance.
There must be no visible scars.
The overall aim is to look the best we can
with the least amount of surgery.
The objective of surgery is to obtain the
best possible result with the least ill effects.
If on the fence (undecided), stay on the
More can always be done later.
Less cannot be done once it has been done.
What is done often cannot be undone.
It is better to wish more were done than to
wish less had been done.
It is better to regret not having done it
than regret having done it.
The surgery must be safe.
For safety, local anesthesia is preferred.
The patient should be comfortable at all
There should be no pain with surgery.
There should be no surprises.
The only acceptable surprises are that it was
so easy or that the results are so good.
Recovery should be rapid.
Bruising and swelling should be minimal.
Problems and complications should be kept to
The patient is the most important person to
It is more important to please the patient
than the surgeon.
Cosmetic surgery is a trade of the risks,
discomfort, and the process of having surgery for
Before surgery is done the subject and the
surgeon should know, not only in the mind, but in
the heart and soul, that it is worthwhile.
The goal chosen should be some form of visual
representation such as a drawing, picture or
sculpture of the subjectís face rather than a
description in words.
The more precise and attractive the chosen
goal drawing, the better the result.
Surgery should only be done if there is a
clear goal drawing showing indisputable benefit.
The goal drawings that are to be followed
must be the patientís choice.
The patientís choice and opinion is
of highest priority.
The goal drawings chosen should be of both
front and side views.
The goal drawings represent the after
appearance of the side and front views.
The chosen goal drawing should be so
attractive that it cannot be improved upon.
It should not be possible to improve on the
There should be close to 100% agreement that
the goal is the most attractive possible.
Everyone who sees the goal drawing and all
the alternative drawings should agree that the
chosen goal drawing looks the best.
The choice of goal should be what will be
most pleasing and look the best to all people for
The side-by-side comparison of the before
pictures with the chosen goal drawings should be an
improvement in appearance to all humankind.
There should be almost 100% agreement of all
observers that the goal drawing chosen is clearly,
in every change that is made, an improvement in
appearance over the before.
Only the opinions of observers who are unable
to see, to perceive or may have impairment of
judgment because of drugs, who are in a jesting mood
or who object on a religious or cultural basis
such as the Amish or because of personal envy
should be discounted.
Fads, fashion, the ďin thingĒ, what is in
vogue, chic, or in style are to be avoided.
With cosmetic surgery, the appearance is
usually worse before it is better.
Even when very successful and beautiful, the
area on which work is done may not feel the same as
The beauty of the chosen goal should appeal
to all people of all ages and cultures.
Our chosen goal should be the most pleasing
and the most beautiful possible to the human genes
or human genome.
We want to appeal to the natural appreciation
of beauty with which we are born, just as humans and
many other animals appreciate the beauty of flowers.
The final ethic of all of medicine and
surgery is that everything that is done must be to,
of, and for the benefit of the patient totally and
completely without reservation or compromise.
William Roy Morgan M.D., F.A.C.S.
1419 Superior Avenue, Suite 2
Newport Beach CA 92663