Are You a Good Candidate For
Plastic Surgery?

The SixSurgery team turned down over 340 patients in 2019. Although we get tons of incoming requests for a consultation and would love to welcome everybody, we are not able to offer our services to all. Not commonly talked about, there are many reasons why you might not be a great candidate for surgery.

The following are conditions the SixSurgery team does not accept:

Procedure Specific Limitations

Certain procedures will have added requirements and/or limitations. Individually focused, we design a plan for you in which certain techniques or procedures that could work for others may not work for you. Examples can range from some people having more unusable internal fat than external fat, to certain patients not having the skin quality adequate for a facelift. All our recommendations and measures are put in place for your safety and to achieve your desired result. See procedure-specific limitations on individual procedure pages.

Revisions and touch ups of previous work done elsewhere

Certain unique cases are done by Dr. Constantine, Dr. Rose or Dr. Haywood only, at our clinic. Dr. Jugenburg will still be involved but one of our three other qualified surgeons will be your primary surgeon.

  • If you had surgery/treatment done by another surgeon and are hoping we can revise the procedure
  • If you had previous surgery on a body part and would like additional surgery. Example is if you had tummy liposuction and now want a tummy tuck, or had breast implants and now want a breast lift

Body Weight or Obesity

Certain unique cases are done by Dr. Constantine, Dr. Rose or Dr. Haywood only, at our clinic. Dr. Jugenburg will still be involved but one of our three other qualified surgeons will be your primary surgeon

  • Please note that even with BMI under 30, the SixSurgery team may require you to lose additional weight before agreeing to perform your surgery
  • Gaining weight for a procedure (such as a fat transfer procedure) when you are not underweight is not typically recommended.

Adult BMI Calculator




Your BMI:


Severe Thinness < 16
Moderate 16 – 17
Mild Thinness 17 – 18.5
Normal 18.5 – 25
Overweight 25 – 30
Obese Class I 30 – 35
Obese Class II 35 – 40
Obese Class III > 40

Although the SixSurgery team sympathizes with the emotional pain and any potential embarrassment such patients feel; we put your health and safety first. In addition, the results will be better when within the recommended range. Surgery is not a substitute for weight loss or weight control, but is there to help you achieve your results.


If you require Insulin to manage your diabetes, we are unable to perform cosmetic surgery on you in our outpatient facility. You will be referred to our hospital based colleague.

Immune suppression

If you are taking immunosuppression medication (ex autoimmune disorders requiring immunosuppression), you are at increased risk of infection after surgery and are not eligible for surgery at our clinic.

  • Patients with severe Arthritis, Crohn’s, or previous transplant patients

Malignant Hyperthermia

If you have Malignant Hyperthermia, you cannot have your surgery performed at our private facility.

Overall Good Health

You will be asked about your lifestyle, health, any conditions, medications or supplements you take. This is important to mitigate any risks or concerns.

If you have or have had any medical conditions that require you to see a medical specialist (not just your family doctor), you will likely require a letter from such specialist clearing you for surgery and/or providing us with post-surgery care recommendations. Lab tests may be requested on a case by case basis. All current and past illnesses, especially cardiac or pulmonary issues, surgeries, and medications must be disclosed.

Psychological Screening

Although there is no formal psychological test to assess patient readiness and motives, the SixSurgery team takes extra precautions to ensure a patient is prepared physically and mentally. Body dysmorphic disorder, plastic surgery addiction, exaggerated worry over a minor problem, or having surgery for someone other than yourself -are all some of the many immediate red flags.

Unrealistic Expectations

Most importantly, you should have realistic expectations about your goals for surgery. Ideally, you want to look like a revitalized and refreshed version of yourself.

It is important to do your own research and due diligence while exploring viable options with a trusted medical professional. The best way to determine if you’re a candidate for a cosmetic procedure is to schedule a consultation with us.

Frequently Asked Questions

What if my BMI is just a little over?

The SixSurgery team has very strict BMI requirements for health and safety purposes. You must have a BMI of 30 or below (and sometimes 25 or below for certain procedures) before we can schedule a consultation.

Can I gain weight for a BBL?

We want to stress that we do not recommend gaining weight for a BBL as patients cannot guarantee that they will gain fat in the right places to transfer.

In addition to gaining weight under the skin, you will also gain weight around the organs or under the muscle (intra-abdominal fat). This intra-abdominal fat will not be accessible to liposuction and will detract from the appearance of your waistline, which will persist even after the BBL.

If you do this in hopes to lose weight after the surgery, we do not lose fat cells in one specific area when we lose weight. Instead, fat cells all over our bodies actually shrink. This may include your results. Example: Suppose you weigh 110lbs and gain 20lbs getting up to 130 before surgery. If you get back down to 119lbs after your BBL, fat cells all over your body, including your butt, will shrink and your new buttocks will lose volume.

How much fat is safe to remove during liposuction?

Typically, 4 to 6 litres is considered safe. The limit can be pushed higher for someone with a larger amount of fat. Somebody who has a lot more fat is typically able to tolerate more liposuction than someone who is more petite. The limiting factor is blood loss and fluid shift. Excessive liposuction can cause hemodynamic distress, cardiac events, severe blood loss, hyper coagulation and DIC (Disseminated intravascular coagulation). This is why we will always remain within the recommended safety limits during any liposuction procedure.

Are all cosmetic surgeons plastic surgeons?

Not all cosmetic surgeons are plastic surgeons. Cosmetic surgery is not a an official specialty and the term essentially describes any surgery performed to enhance one’s appearance. Technically, anyone who performs cosmetic treatments can call themselves a cosmetic doctor or cosmetic surgeon. For that reason, when someone calls themselves a cosmetic surgeon, you may not know what kind of training background they really have, and whether they have any formal training at all. Your cosmetic surgeon could in fact be a pediatrician or an anesthesiologist or a cardiac specialist. These are not medical specialties where doctors truly learn how to be cosmetic surgeons. This is why it is important to do your research and ensure that your cosmetic surgeon is board certified with all the required credentials, training and certifications.


Confidential Consultation