🗓️ Dr. Heather Rogers POSTED TO THE GROUP CHAT July 2, 2026

Beauty Industry | Women’s Health & Longevity | Wellness

One of the reasons I am so popular as a procedural dermatologist is that I tell patients no all the time.

Patients come to my office convinced they need to be doing something. Their friend had filler. Social media says they should start Botox at twenty-five. They are worried about a wrinkle, a jawline, a neck, or simply the general fear that aging is somehow preventable if they can just find the right procedure.

Most cosmetic providers are happy to oblige. If a patient wants something done, why not do it? You're giving them what they want and making money doing it. I play the long game with my patients.

I want them to look great today and twenty years from now with as few complications as possible. That requires restraint, forethought, and the time to understand not only their skin but their goals. Sometimes the right answer is Botox. Sometimes it's a laser. Sometimes it's surgery. And sometimes the right answer is, "You don't need it, it won't help, it won't look good, or I don't think you'll tolerate it well."

Procedures can make a significant difference in slowing the signs of aging. I love performing them and I get many myself. But for all the good cosmetic procedures can do, there is real risk. Botox can drop an eyebrow. Filler can migrate. Lasers performed at the wrong setting or on the wrong patient can cause unwanted pigmentation or even scarring. Surgery can heal unpredictably. Faces can become overfilled.

I am not telling you this to scare you. I am sharing what twenty years as a practicing dermatologist has taught me so you can enter this journey with your eyes open.

If you decide cosmetic procedures are right for you, here is my advice:

Start at home.

There is no reason to spend money on cosmetic procedures if you are not taking care of your skin every day. Fortunately, taking care of your skin is remarkably simple. In the morning, use a vitamin C serum, moisturizer, and sunscreen. At night, wash your face, use a product that promotes cell turnover, whether that's tretinoin, retinol, bakuchiol, or an alpha hydroxy acid, and follow with a moisturizer. You don't need fifteen products. You do need consistency.

When you are ready for cosmetic procedures, pick a provider whose aesthetic you admire. I say this all the time and I stand by it. If you do not like the aesthetic your dermatologist, injector, or plastic surgeon has chosen for themselves, do not let them choose yours. Cosmetic medicine is an art, and you need to find someone whose philosophy matches your own.

Do not rush in.

Don't buy a Groupon or see the person with the next available appointment because you simply can't wait. Wait. This is your face. Never seek the deal. There are deals because a provider isn't busy enough, and you should ask yourself why. You are not paying for a syringe of filler or a laser treatment. You are paying for judgment, experience, and technical skill.

Start slowly.

Do as little as you can to achieve an outcome that makes you happy. You can always do more next time. More is not always better, and one of the biggest mistakes I see in cosmetic medicine is patients chasing perfection instead of improvement.

Never have a procedure that makes you more nervous than excited.

Cosmetic medicine is elective. There are very few procedures that cannot wait six months or even six years. If your instincts are telling you to slow down, listen to them. The same goes for money. Never have a cosmetic procedure you cannot comfortably afford. Looking better should not come at the expense of sleeping well at night. Financial pressure puts too much stress on you and the procedure and often leads to disappointment.

Never have a procedure until you understand the possible complications.

Before anything is done, ask your doctor two questions: What could go wrong? And how would you help me through it if it happens?

Complications happen, even to the best of us. You need to understand those risks and feel comfortable accepting them before moving forward.

I tell patients to think about cosmetic procedures the same way they think about remodeling a house. Even with the best architect and contractor, things do not go perfectly. Eighty percent of the project will be exactly what you imagined. Some of it will be slightly different than expected, and occasionally something will go wrong that requires time, money, and patience to fix. The same is true for medicine, even cosmetic medicine. People heal differently. Swelling lasts longer than expected. Bruises happen. Scars mature unpredictably. Fillers migrate. Surgery occasionally requires revision. Even when everything is done correctly, biology and life still have a say in the outcome.

None of this means you can’t have cosmetic procedures. I see everyday the confidence and joy they bring. But it does mean do not have them unless you understand the risks as well as the benefits and can accept that things may not go exactly as planned.

There are many talented, ethical cosmetic providers out there. Find one whose aesthetic you admire, whose judgment you trust, and build a long-term relationship with them. And remember, the best cosmetic provider isn't the one who always says yes. It's the one who knows when to say no, because that means they are thinking about what is best for you.

Good luck.

Here to help,

Heather D. Rogers, MD