NO ONE ever really wants to undergo a surgical procedure. Conversely, when the right operation is performed for the right reasons, accurately and expeditiously, on the right patient at the right time, the results are formidably gratifying to both patient and surgeon. The problem is the latter. As surgeons, we believe in our profession; we also believe in ourselves, and some of us believe in miracles, while others rely on them. We combat aging and disease with inspirationally effective tools. Ultimately, aging and disease will win. We must, therefore, consciously and honestly balance the physiological, psychological, social, and financial insults of surgery against the anticipated benefits. In this balancing act, we are not unique among our medical colleagues—just the most conspicuous.