Plastic surgery, particularly aesthetic or cosmetic surgery, lies at the intersection of science, medicine, and art. While technical proficiency, surgical experience and the aesthetic eye are fundamental, the success of a cosmetic procedure is not judged solely by surgical metrics or the absence of complications. For an aesthetic plastic surgeon, an excellent surgical result is a nuanced achievement — one that blends natural appearance, harmony with individual anatomy, and long-term patient satisfaction. And a patient having a beautifully supported aesthetic experience is the cherry on the cake, as Dr DuPéré would say (Dr Marc is also quite the Chef!). Unlike reconstructive surgery, where the goal is often to restore form and function, aesthetic plastic surgery is elective, and its standards of excellence are subjective, dynamic, epoch-guided and culturally influenced.
I want to explore the deeper principles behind what we, plastic surgeons, deem an excellent result, focusing on three central criteria: natural aesthetics and harmony, technical precision and healing, and psychosocial alignment with patient identity and expectations.
I. Natural Aesthetics and Harmony with Individual Features
The cornerstone of an excellent aesthetic outcome is naturalness — the patient should look improved, not altered to the point of being unrecognizable. This is often the surgeon’s highest aim: to enhance without detection. For instance, in rhinoplasty (nose reshaping), success is not measured by a universally “perfect” nose, but by how well the new structure integrates with the patient’s facial proportions, ethnicity, and expressions. A “great” nose on one face may look awkward on another. There is no cookie-cutter aesthetic procedures. Thus, surgeons rely on principles of facial balance, golden ratios, aesthetics and anthropometric analysis, but always adapt these guidelines to individual anatomy.
Moreover, modern aesthetic plastic surgery has moved away from exaggerated results toward subtle refinement. Overly voluminous lips, unnaturally large breast implants, overly large buttocks or overly tight facelifts signal poor aesthetic judgment, even if technically executed well. Dr DuPéré cautions everyone: do not chase trends as trends do go away… and faster than ever. Rather than embarking on the latest trend, it is always best and safest to create results that age well over time and retain anatomical harmony. Surgeons often consider how the outcome will look not only post-recovery, but years later — prioritizing long-term elegance over short-term dramatic change.
Dr DuPéré will often opt for rejuvenation procedures where a patients will go back in time looking like a younger self, not a different person. Yet occasionally, a healthy transformation might be required. Let me explain. An example of true rejuvenating procedures would be repositioning one’s facial tissues with aging. Restoring a woman’s body post-pregnancy or buttock projection post weight loss are other examples. On the other end, a transformative procedure will give someone something she/he never had, even when younger. A lady with poor cheek projection is lacking the beautiful triangulation of the face, something very feminine and elegant. Same for lips; both women and men (to a lesser extent) benefit from some sensual volume in their lips. Exaggeration in volume or tightness is what Dr DuPéré calls is unhealthy transformation.
In summary, the result must blend seamlessly with the patient’s natural features. It should not draw attention to itself but rather enhance the total image in a way that feels both effortless and authentic.
II. Technical Precision, Healing, and Minimal Trace of Surgery
While aesthetic outcomes are subjective, they must be underpinned by surgical excellence. This is when training and years of experience come hand in hand. This includes the invisible aspects: precise incisions, meticulous suturing, careful tissue handling, and appropriate use of technology. Thorough post-surgical education is also essential, along with strict abiding and compliance to the recommendations. An excellent result should heal smoothly, with minimal scarring, no irregularities, and preserved function and sensation.
Plastic surgeons are trained to hide incisions in natural skin creases, hairlines, or body folds. An excellent result often depends as much on what is not visible as on what is. In breast augmentation, for example, the choice of implant type, pocket placement (subglandular, subfascial, dual-plane or submuscular), and incision location (inframammary, periareolar, or transaxillary) all affect both the aesthetic and long-term result. The same is true in facelifts, where scar placement and vector of lift can mean the difference between a natural, rejuvenated face and an over-pulled or mask-like appearance.
Healing is a critical part of the result, but it is not perfectly predictable as many factors are involved in healing. Healing involves techniques, compliance to the rules, abstaining from smoking and other recreations and avoidance of any activities that could compromise the results. A technically-perfect operation marred by infection, asymmetry, tissue ischemia due to nicotine uses or prolonged swelling is not considered excellent. Surgeons also evaluate tissue response: whether the skin redrapes well, whether fat grafts survive predictably, or whether filler or implant placement results in capsular contracture or migration.
Furthermore, consistency across views — frontal, profile, and oblique — is key. A rhinoplasty may look good head-on, but collapse or curve on profile. An excellent surgeon scrutinizes the result from every angle and ensures three-dimensional harmony. Be warned, noses always look better on the ¾ views…so if only those photographic views are shown on a surgeon’s website, one should be concerned.
Thus, technical mastery and soft-tissue judgment — guided by years of anatomical study — are fundamental. But they serve a higher goal: making the surgical intervention invisible to the layperson.
III. Psychological Satisfaction and Respect for Individual Identity
Aesthetic plastic surgery is ultimately performed on living, feeling human beings, not static canvases. No matter how technically or artistically successful a procedure appears to the surgeon, the result is not excellent unless it resonates with the patient’s sense of self. This psychosocial dimension is vital — and requires surgeons to have not only technical expertise but emotional intelligence and empathy.
Preoperative consultations are key: the surgeon must distinguish between realistic expectations and psychological red flags (such as body dysmorphic disorder or external pressure for surgery). An excellent result stems from shared vision — when the surgeon and patient agree on what constitutes improvement and how much change is desirable. It is therefore crucial that the patients be clear about the goals she/he wants to achieve.
Importantly, aesthetic surgery should never erase a person’s ethnic or cultural identity unless explicitly requested. Surgeons today are more sensitive to the need for ethnically appropriate aesthetics, whether in Asian blepharoplasty, African-American rhinoplasty, or facial contouring in transgender patients. The goal is to enhance, not homogenize. In fact, many top surgeons emphasize personalized beauty over conformity to Western ideals. Dr DuPéré strongly supports adapting and personalizing all techniques to each individual.
Additionally, patient satisfaction is not merely about physical outcomes, but emotional transformation. An excellent result often leads to increased confidence, social ease, and improved self-image — not due to superficial vanity, but because the surgical enhancement better aligns outer appearance with inner identity.
In this way, aesthetic surgery is not simply about “fixing” something, but about creating a visual congruence between how a person feels and how they present to the world. That alignment — when achieved — is a hallmark of a truly excellent result.
What constitutes an excellent plastic surgery result is more than skin deep. It involves a complex interplay between natural aesthetics, surgical precision, and psychological alignment with the patient’s sense of self. For the aesthetic plastic surgeon, excellence is not measured by dramatic transformations or social media “likes,” but by the quiet satisfaction of a result that is subtle, harmonious, and enduring. It reflects not only the surgeon’s skill with scalpel and suture, but also their ability to see the human being behind the procedure — their identity, hopes, and vision of beauty. In this sense, aesthetic surgery is both a science and an art — and excellence lies in the balance.
