Melanie Berliet, a Vanity Fair writer, went undercover to test her hypothesis that plastic surgeons try to sell additional procedures to patients that they don’t “need.” The 5’9”, 120-pound 27-year-old, who wears a size 34B bra, went into the consultations under the guise of wanting breast augmentation.

Some of the plastic surgeons did not come out looking very good. The three surgeons had different reactions to her physique, but all of them recommended procedures she hadn’t originally asked for.

The one plastic surgeon who did fair pretty well had this exchange with the author:

He goes through the standard health questions, then asks, “How can I help you today?”

“I was just hoping to get a professional opinion about my options in terms of plastic surgery.”

The doctor squints and replies, rather emphatically, “The way it works is: you tell me if something specifically bothers you, and I’ll tell you if I can address it. But I’m not here to sell you services or goods, because there may be something that you don’t see that I see.”

“And you won’t share?,” I ask, somewhat startled.

Dr. Racanelli explains that he has an ethical problem with pointing things out, because he’s heard of cases in which patients felt they were talked into a procedure. He continues, “If there’s a specific area of concern, then you and I can discuss it at length ... I’m not here to, like, pitch you.”

“Is it a legal problem?,” I ask.

“No. Not a legal problem. It’s just the way I like to do things.”

In that case, I tell him, I’d like to talk about my nose and boobs.

Satisfied, the doctor proceeds. Most of what he says is familiar. He says I’m tall enough to carry a full C-cup, and observes that my nose has a “dorsal hump” and a “bulbous tip.”

“Is there a way to image what it might look like?”

“There’s a way to image, and it’s a very successful marketing tool,” he replies. “I do not do it, and the reason is: the only person who knows what your nose is going to look like after surgery is God.” Despite my general discomfort with superfluous references to a higher power, I feel the urge to jump out of my seat and give Dr. Racanelli a standing ovation.