When Less Is More: The Importance of Saying “No” in Medical Aesthetics

At Dr. Olga Zilberstein Medical Aesthetics, our mission isn’t just to provide treatments, it’s to deliver results that are safe, natural, and truly in your best interest. That’s why there are times when we intentionally turn patients away or suggest a different approach. In a world where overfilling and over-treating have become too common, saying “no” is part of what sets us apart.

Here are some of the most common reasons we may decline treatment, and why it ultimately protects you: 

1. It’s Too Early for Botox

We don’t believe in injecting just for the sake of it. Preventative Botox is not something we strongly believe in. We recommend starting Botox once you develop static lines (wrinkles that remain even when your face is resting). If you happen to be younger and develop these lines, we suggest coming in every 6–12 months for a conservative approach. 

2. You’re Already Overfilled

We often see patients who have been overtreated elsewhere, whether it’s overly filled lips, pillow face cheeks, or a jawline that’s starting to look unnatural and masculinized. In these cases, adding more filler isn’t just unnecessary, it can worsen facial proportions and disrupt natural balance.

This is where “perception drift” comes in,  a phenomenon where patients (and even some injectors) slowly get used to an overfilled look and start to see it as the new normal. Over time, they lose sight of what looks natural and proportional, chasing more volume when what’s needed is less.

At our practice, we prioritize long-term facial harmony and structure. If we feel that you’ve reached, or surpassed, the limit of what looks good, we’ll recommend dissolving or simply waiting. We’re not here to create exaggerated results. Our goal is to enhance your features, not distort them.

3. What You’re Asking For Won’t Help

Not every concern can be solved with non-surgical procedures. Some issues—like excess skin, heavy tissue, or deep fat—require surgical referral. In certain cases, liposuction is needed to remove fat; when there’s too much loose skin, it must be cut away; and sometimes, heavy tissue needs to be repositioned to achieve the best result.

4. You Seem Nervous or Not Ready for Treatment

We understand that deciding to get an aesthetic treatment can be a big step. If a patient seems anxious, unsure, or overly hesitant during the consultation, we may recommend taking more time before moving forward. Feeling fully confident and informed is essential, and we want you to be excited about your decision, not stressed or second-guessing it.

5. It’s Not The Time of Year For That Treatment

When we say no, it’s because we care about your results and your trust.