You’ve saved the cash, had a consult, and scheduled your treatment.

Now, who do you tell? 

It’s not an easy decision, and there’s certainly no right answer. From Botox to breast augmentation, the fear of judgment from friends, family, and co-workers is very real. 

The good news is that the stigma around cosmetic treatments and plastic surgery is definitely changing for the better.

“We have found that the social stigma that used to be associated with plastic surgery is no longer really an issue,” said Dr. Peyman Solieman, a Beverly Hills plastic surgeon, in a RealSelf Q&A. “In general, when our patients discuss their reasons for wanting to pursue surgery, their families and friends are much more supportive throughout the process than you may otherwise expect.”

Part of the reason is understanding why people decide to have a cosmetic or elective treatment. When we asked 700 men and women who had contacted a doctor to schedule a consultation, 76% said they wanted to feel confident.

[TWEETBLOCK text=”Tweet this”]Nearly 2x as many people picked confident over sexy when describing how they want to feel after plastic surgery.[/TWEETBLOCK]

“This is not something to be ashamed of or embarrassed about,” said Dr. Talmage J. Raine, a Chicago plastic surgeon, in this RealSelf Q&A. “Making a positive choice about your body image is a healthy thing and should be addressed with confidence and excitement.”

 

Related: Silicone or saline? 5 things you need to know about picking breast implants.

 

Even so, some people may ask you hard questions.

“You should expect some negative feedback such as, ‘Why would you do something like that?’ or ‘You looked great before. Why would you change?’ ” Dr. Raine continued. “Share your change first with those who support and love you.”

One person on RealSelf shared some valuable advice in a forum on this topic.

“I think the best thing to do is have a beaming smile and dress up, oozing confidence and positivity,” wrote one person on RealSelf. “If anyone mentions it, just say how great it has been. The worst thing to do is to look embarrassed.”

Honesty can often be the best policy if you know you are in a supportive environment.

“Initially, I wasn’t going to tell my boss,” wrote another woman in this forum. “I just put in a request for medical leave and wrote ‘surgery.’ But after a day or two, I figured this is going to be noticeable. So I went into his office and was like, ‘Well, I’m getting a breast augmentation. Just thought you should know so we can eliminate any awkwardness after.’ He kind of chuckled, and that was all that was said.

“Before I went in for surgery, he pulled me into his office and even made sure I wasn’t scared and that I didn’t need any assistance with anything,” she continued. “I took a total of 12 days off. I only asked for four, but my boss told me to take the full next week off and play it by ear. Even said I’d be able to take more time off if necessary.”

But, not everyone wants to—or should—tell all. 

“I usually advise telling as little as possible to as few people as possible,” said Dr. Alan M. Engler, a New York City plastic surgeon, in a RealSelf Q&A. “In the end, it is your personal and private information, and you are not obligated to discuss it with anyone you choose not to.”

“One approach is to avoid the issue. Tell people you’re going on a vacation with some friends, taking a trip or something that avoids the issue of surgery altogether,“ Dr. Engler added. “Most other choices risk additional questions. If you say it’s ‘personal,’ ‘private,’ or a ‘female problem,’ you may stop the immediate question, but people may also wonder, ask, or start imagining.”

You may want to tell only close family. Often, people find that when they do undergo a treatment, others might not even notice, or think they made a lifestyle change that’s giving them a new glow. 

“No one will know what you have done if you see them three weeks later,” said Dr. Howard T. Bellin, a New York City plastic surgeon, in this RealSelf Q&A. “The people you see after will recognize that something is different about you, but they will not realize what it is, i.e. you lost weight, have a new dress, shaved your mustache. I sometimes bet patients a dollar that their own parents will not realize what caused the change, and I have never lost the bet!”

 

Related: Questions plastic surgeons wish you’d ask, but you don’t.

 

Even plastic surgeons count on that for their own procedures. When Dr. Mats Hagstrom, a San Francisco plastic surgeon, got a facelift he did something that might seem counterintuitive—he grew a beard.

“It kind of throws people off when they realize you look different,” he said. He tells his patients to do the same. Change your cut, color, or facial hair so people can’t quite put their finger on what’s different.

What about how to talk to someone you think may have had some work done? Is it ever OK to ask?

“The proper etiquette to discussing plastic surgery is to say, ‘You look good,’ ” said Dr. Robert M. Freund, a New York City plastic surgeon, in this RealSelf Q&A. “Never let someone know that you think that they have had plastic surgery, because if they did not, then you are accusing them of looking unnatural.

“If they want you to know about their surgery, then they will spill the beans after you compliment them on looking better.”

Have a question? Ask a doctor on RealSelf.