I would like to begin this personal journal on cosmetic (aesthetic) surgery at the beginning. What I mean by this is that we all have a perception of self that is in many instances quite different from how others see us. We are our own harshest critic unless, of course, we are completely delusional. No one views us in the same cold precise light that carries so much emotional trauma as our self perception. As an example we can all relate to the commonplace incident of an office setting where a dozen people work closely together and one day “Sam” arrives without his beard or mustache; half the staff cannot figure out whats different about him! Think about a person you know well, now try to describe their physical, visual appearance. After a very short while you begin to talk about their personality in greater detail than you can ever present their appearance. The perception of presence is more than appearance! The decision to consider cosmetic surgery is a deeply personal one based on how we see ourselves rather than how the world sees us. In the end, cosmetic surgery is to please ourselves. This is not to say that we lack confidence, on the contrary, everyone who enters my office is a rather self-assured individual who sees that critical area that annoys them and wants that change. No wall flowers here!