Photographs of other people's results are the worst possible planning tool — your anatomy sets the ceiling.
Bone structure, skin thickness, healing tendency and existing asymmetry all determine what is achievable. A nose that suits one face on a different skull will not translate — and thick skin simply cannot show a refined tip.
Every face and body is asymmetric. Surgery improves symmetry; it does not create perfect symmetry, and pointing out pre-existing differences before surgery is a sign of a careful surgeon, not a pessimistic one.
Most satisfying results are changes nobody can name. Friends say you look well, not that you look different. Patients seeking a change everyone will notice are usually the ones who return unhappy.
If the result were 80% of what you imagine, would you still be glad you did it? If the answer is no, the expectation gap is too wide, and a good surgeon will say so.
Yes — for unrealistic goals, unstable body image concerns, or when the risk-benefit does not favour surgery. That refusal is part of the service.