Cosmetic surgery operations are procedures with psychological significance involving the patient’s body and body image. We propose one type of pathological personality as a contraindication for cosmetic surgery procedures: perfectionism. The stringent self-evaluations, propensity for other derogation, intense fear of scrutiny, excessive sense of entitlement, and extreme need for others’ approval that characterize perfectionism make satisfied perfectionists a rarity and dissatisfied perfectionists an inevitability. This chronic predisposition toward dissatisfaction is why we assert that pathological levels of perfectionism should preclude cosmetic surgery procedures.