Every patient that comes to the clinic comes with a wish picture on what is his or her expectation after surgery. I believe the wish picture is the most negative factor affecting the patient’s happiness after surgery. There is this perception in society that plastic surgeons can essentially perform any procedure and turn anybody into whatever they want. Although we can do marvels and change your body in such a way that is going to look different, it is very unrealistic to expect a plastic surgeon to change your body to look like your favorite celebrity. Think about beautiful women with a hourglass shape like Jennifer Lopez. If plastic surgeons can perform consistently that type of body, you will see a lot of Jennifer Lopez walking around. Wish pictures are useful in my practice for three reasons. To determine what shape you want. To determine how full you want your buttock. To determine if you have realistic expectations on what the procedure can do for you. Remember many of the pictures that you show your plastic surgeon of these beautiful women on Instagram and other social media has been significantly Photoshopped. How wide your hip will get, how big your buttock will get cannot be reprocessed with a wish picture. Performing a real physical exam to determine your anatomy, your skin tone, and elasticity is more important than a wish picture when it comes to determine the results that you are going to have. My goal with surgery is to make your hourglass and if you want an A-shaped buttock, I will determine if you are a candidate for that, but I just cannot make an hourglass shape similar to a picture. I can make an hourglass shape on you and you are going to be better you, but ultimately I do not put a picture on the wall when I am doing surgery and keep injecting fat until I achieve what you expect from the surgery. If you have those unrealistic expectations before surgery or you have a wish picture that is not what I think you are going to get I can guarantee you that I am not going to do your surgery. In my practice, we perform more than a thousand procedures a year and you will be shocked on how many patients I had to turn down patients, which is close to 50% because of unrealistic expectations of things that I cannot do. In other words, I am not going to put my name on a bad job or and I am not going to do a surgery on somebody whose expectations are way beyond of what I can humanly do. I can do a very good job and I can guarantee you one thing, I will do the best that I can with your body but if you expect to look like a picture, I recommend you do not do the surgery because even before surgery I can guarantee you will be upset after surgery because your expectations are not going to be met by your plastic surgeon.