Dr. Raghu Athré, a facial plastic surgeon based in Texas, estimates that he turns away prospective patients around 10% of the time because they’re not in the right place mentally or emotionally. “I’ll say, ‘Hey, listen. I don’t think that a facelift is probably the appropriate procedure for you at this time, and we can probably talk about this in the future.’ And I’d say probably of those patients, about 50% come back later and go, ‘You know what? You’re right. That was probably a bad time for me to do that,’” he says. “When you have that level of honesty, you’re able to kind of really pick the patients that you want to do and you get great results.”

In the consultation stage, honesty is vital, Dr. Athré adds. “If they come in and show you an Instagram picture, saying, ‘I want this,’ it is the surgeon’s moral and ethical responsibility to go, ‘Listen, first of all, that ain’t going to happen, okay?’ Or, ‘That’s a fad,’” he says. “We have to learn to address this and not work for just the concept of getting a paycheck.”

Then comes the procedure itself, and after that, the initial post-op period, which typically lasts around two weeks. Even patients who are overjoyed with the final result sometimes struggle with depression or anxiety in the initial days after surgery, due to pain, discomfort, isolation, and difficulty sleeping. Plastic surgeons say they can help alleviate this risk by preparing patients for what the post-op period will realistically look like, both physically and emotionally.

“I tell my patients you will be depressed on post-op day three to four, end of story,” says Dr. Athré. “You need to prep for this.”

Dr. Michelle Lee, founder of PERK Plastic Surgery in California, advises patients to make sure they either have a loved one to stay with or hire a private nurse during the recovery process, but aren’t alone. “Nobody should be going through a procedure like this completely by themselves,” she says. “It’s like anything in life. You want a community to go through this with you. You don’t have to broadcast it on social media, but you should have a trusted friend to support you.” She also tells patients to avoid mirrors for the first few days, when bruising is at its worst, and to get out of the house and into nature—“with a big hat on, of course.”