The Enemy of Good is Perfect

When I was a resident in plastic surgery at Columbia Presbyterian Medical Center, I was assisting on a breast reconstruction case. The results were good, but I noticed a little asymmetry. When I suggested redoing the one side to correct it, my attending physician told me “The enemy of good is perfect”. He was trying to make the point that if something looks good, trying too hard to make it perfect carries risks and the danger of going too far and creating a problem. This surprised me, as I thought plastic surgery was about perfection.

Many patients also think that perfection is the goal of cosmetic plastic surgery. These patients are often disappointed by even the best results of the best surgeons. My job as a plastic surgeon consulting with patients is to make sure that they have realistic expectations as to what surgery can deliver in their case. The result depends on your physical appearance, your ability to heal, how you take care of yourself, and the work of your surgeon. My art can only help one of those four items, which is about 25%.

I want to be clear in stating that I have the utmost confidence in my surgical ability and patient selection skills, and I spend a great deal of time educating them as to how to take care of themselves. My results are quite good, as our photo gallery can show.

After being in private practice for 14 years, I now know what my attending was talking about. It is not that you shouldn’t try your best to approach perfection in your results. It is that if you have a good result, do not torture yourself if it is not perfect. Perfection does not exist.

As a prospective plastic surgery patient, this advice is valuable as well. Be realistic in your expectations, and take a moment to compare the before photos to where you are after. Do not listen to others who whisper in your ear with jealousy or bad intentions. Be confident and proud of the improvements that you have made.


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