Aesthetic plastic surgery requires particular expertise in determining the patient's potential postoperative satisfaction. As the demand for this surgical specialty increases, so too do the possible psychological hazards associated with patient selection. Because the complaints of patients with minimal defects and their evaluation of the cosmetic results tend to be highly subjective-in contrast to the more objective and realistic complaints of those with marked disfigurement-careful interviewing of candidates is essential. In special need of skillful screening are those patients who, although they may present some correctable imperfection, are not only vague as to what they think they want done and what they expect but also are unaware of the underlying causes of their self-discontent. Such individuals, once accepted for surgery, can present management problems that may lead to outcomes detrimental to themselves, to the surgeon, or to both.