Patients seeking cosmetic surgery increasingly have diverse expectations. Some want to combine several procedures in one operation, from facial and breast surgery to body contouring. The desire to address multiple concerns at once, shorten recovery time or undergo anesthesia only once is understandable. However, meeting a patient’s wishes does not mean every requested procedure should be performed.

For Dr. Tuan, one of the more difficult professional decisions is sometimes not choosing a surgical technique, but deciding not to operate, reducing the number of procedures or dividing a complex plan into several stages.

When a doctor’s decision differs from a patient’s wishes

Dr. Tuan received a Master’s degree in Surgery from the University of Medicine and Pharmacy at Ho Chi Minh City in 2018 and completed Level I Specialist training in plastic surgery at Can Tho University of Medicine and Pharmacy in 2024. In 2025, he became involved in teaching at Hanoi Medical University and joined the Vietnam Association of Plastic and Aesthetic Surgery.

His practice focuses on facial plastic surgery, breast procedures and body contouring. He said patients often ask to combine multiple procedures in one operation, particularly those traveling from other parts of Vietnam or from abroad who want to minimize surgeries and shorten their stay.

Yet a convenient schedule is not necessarily medically appropriate. As the scope of surgery increases, doctors must consider the patient’s health, surgical history, operating time, potential blood loss, anesthesia requirements and ability to recover.

“Some patients have carefully arranged their schedules and want everything done in a single operation. But if the assessment shows that the procedure would become too extensive, the doctor has to explain why it should be reduced or divided into two stages. In some cases, the safest decision is not to operate yet,” Dr. Tuan said.

He noted that saying “no” can be more difficult than agreeing to surgery because the doctor must explain that the procedure may be technically possible, but not necessarily appropriate in the circumstances. The key is balancing the desired result with the safety limits of the operation.

Safety goes beyond surgical technique

Surgical safety involves more than the skills of an individual surgeon. Through its Safe Surgery Saves Lives initiative, the World Health Organization (WHO) highlights infection prevention, safe anesthesia, effective surgical teamwork and postoperative monitoring. Its 19-item Surgical Safety Checklist is designed to improve coordination and reduce preventable errors and adverse events.

This means the decision to proceed with surgery also depends on the medical facility, anesthesia and critical-care support, the surgical team and postoperative care.

In an August 2026 article on liposuction and body contouring, VnExpress International cited Dr. Tuan as saying that the amount of fat removed is not the sole measure of an outcome. A patient’s health, body size, number of treatment areas and the physiological impact of surgery must also be considered. For extensive procedures, staged surgery may be more appropriate than addressing everything in one session.

A patient seeking breast surgery combined with contouring in several body areas may therefore be advised to reduce the number of treatment areas or undergo surgery in two stages. If health conditions or preoperative tests indicate additional risks, surgery may need to be postponed.

When expectations also need to be assessed

Not every decision to decline surgery is related to a health problem. Another issue is the gap between patient expectations and what surgery can realistically achieve.

The popularity of before-and-after images on social media can make cosmetic results appear easily transferable from one person to another. In reality, anatomical structure, skin quality, previous procedures and individual recovery capacity create different limitations for each patient.

For Dr. Tuan, consultation is therefore not simply about determining what techniques can be performed. It also means clarifying what can be done, what should not be done and what degree of change is appropriate for each individual.

This is particularly relevant to cosmetic surgery, where most procedures are elective rather than emergency interventions. Patients have the right to make choices, while doctors have a professional responsibility to determine the limits of appropriate medical indications.

Knowing when to stop

Dividing surgery into several stages may prolong treatment, require additional time and increase costs. It may not be the most convenient option for patients.

However, Dr. Tuan believes convenience should not be a reason to extend an operation beyond what is medically appropriate. WHO also emphasizes that surgical safety must cover the preoperative, intraoperative and postoperative periods.

For Dr. Tuan, the boundary between meeting aesthetic expectations and ensuring safety is not always easy to define. Saying no may disappoint a patient, while reducing procedures or dividing surgery into multiple sessions may significantly change the original plan.

Yet in a field where doctors are often asked, “Can it be done?”, the more important question may sometimes be, “Should it be done?”

Knowing when surgery should proceed, when it should be postponed and when a doctor needs to say “no” is also part of professional responsibility.