The 3 face surgeries a Harvard-trained plastic surgeon says no to again and again

• Plastic surgeon Dr. Babak Azizzadeh specializes in facial procedures, but he won't say yes to every patient.
• Azizzadeh said he avoids lip and jaw implants because of their high risk of infection and unnatural look.

Some plastic surgery experts have voiced concerns over the facial plastic surgery boom of the past two years, saying people have developed "Zoom dysmorphia" and unrealistic beauty ideals, driven by social media.

It's led some surgeons, including Beverly Hills-based Dr. Babak Azizzadeh, to turn away potential patients who request certain face procedures, or who exhibit signs of body dysmorphic disorder.

Specifically, he rejects requests for lip implantation, jaw implantation, and facial liposuction.

The Harvard-trained surgeon says no to face implants and liposuction

Azizzadeh, who trained at Harvard and now specializes in face reconstruction, says he always goes for the most natural-looking result with the tools he has.

That could mean using a mixture of Botox, filler, and surgical procedures, or refusing certain requests, like for face implants.

Lip implants and implants along the jawline have a higher infection risk, Azizzadeh said, so he prefers to use fillers in these areas. He added that lip filler looks more natural than a lip implant, so he always chooses it over the surgery.

Azizzadeh also told Insider he won't perform facial liposuction, a procedure that involves sucking fat out of the face to remove chin fat or drooping skin. The procedure can lead to nerve damage, infections, scarring, and face deformities, which Azizzadeh said he saw in a recent patient who had come from another surgeon.

He turns away patients with body dysmorphia

Azizzadeh said he also turns away an estimated 10% of patients because they exhibit signs of body dysmorphic disorder, a mental health condition that causes a person to become overly critical and anxious about their body's appearance.

"One of the subtle things we as surgeons have to do, we have to be able to pick up on the patient's mental state, why they're doing it," Azizzadeh told Insider.

He said he looks for patients who point out face details they perceive as flaws "that are too detailed, too esoteric, things that normal people are not going to even notice."

When patients come in citing medical terms related to the procedure they want, it's a red flag for body dysmorphia, Azizzadeh said. He said if a patient seeking a rhinoplasty, or nose job, cites technical terms like "spreader graft," it suggests they're overfixating on their appearance.

"The key thing is really not the procedure. It's more about what does that individual want that they absolutely, 100% don't need," he said.