Five things I check before I agree to operate

The consultation is an assessment, not a sales meeting

Most people arrive at a consultation expecting to describe what they want changed. That conversation matters, but it is not the first one I am having in my head.

Before agreeing to operate on anyone, there are five things I need answered. They are worth knowing about in advance - partly so the hour is more useful, and partly because you can ask them of any surgeon you see.

1. Why now?

Not what you want changed. Why this month, after years of living with it.

The answer is genuinely diagnostic. A wedding in six weeks, a divorce, a photograph someone saw - these are not disqualifying, but they tell me whether surgery is the right tool for what is actually going on, and whether the timeline is realistic.

Someone who has considered a procedure steadily for two years is in a different position from someone who decided on Tuesday. Neither is wrong. They need different conversations.

2. Has your weight held?

Stable within roughly five kilograms for three months.

This is not a gatekeeping exercise. Operating on a moving target wastes the operation and wastes your money. Body contouring performed during active weight change produces a result that is obsolete by the time the swelling settles - and swelling takes months.

For liposuction and abdominoplasty especially, a stable starting point is most of what makes a plan meaningful.

3. Does what you expect match what the operation does?

Every procedure has a defined envelope of what it can change. Every patient arrives with a picture in their head.

Where those two overlap, surgery works. Where they do not, no technique closes the gap - and the failure is not technical, it is a mismatch that was there before anyone booked a theatre.

Most disappointment after aesthetic surgery traces back to this question being skipped rather than to anything that happened in the operating room.

4. What are you taking?

Blood thinners, supplements, GLP-1 medications, steroids, hormonal treatment, recreational drugs.

Half of what patients forget to mention changes the anaesthetic plan, the bleeding risk, or the healing. Herbal supplements are the most commonly omitted and among the more relevant - several affect clotting.

There is no version of this where being incomplete helps you. Bring the actual list, including the things you would rather not mention.

5. Would I say no?

This is the one that matters, and it is the one I apply to myself.

If I cannot picture myself declining a case, then I am not assessing it. I am selling it.

Every honest consultation has "not yet" on the table as a real option - and sometimes "not at all," or "this is not the operation for that problem." A surgeon who has never turned down the thing you are asking for is not offering you an assessment.

Ask these of anyone

If you are consulting a surgeon and none of these comes up, that is information.

You are entitled to ask directly: what would make you decline this? What does this operation not fix? What happens if my weight changes afterwards? A good answer will be specific and slightly uncomfortable.

The most useful hour you can spend before surgery is the one where somebody tells you what it cannot do. Preparing for that consultation properly makes the difference between an hour of reassurance and an hour of information.

Five questions. Ask them of anyone.