Patient selection is difficult. Modern-day plastic surgeons are becoming increasingly aware that patient selection is an important aspect of a successful surgical practice. Evaluation of the patient as a whole rather than just the deformity is necessary to avoid dissatisfied patients. Surgeons should, during the initial interview, consider the acronym SAFE, asking open-ended questions and evaluating the patient. Patient selection rules for outpatient facilities are an extension of patient selection in general. Either patient or surgeon may have reasons for choosing the hospital over the outpatient facility for the procedure. The importance of patient selection extends to patient management as a whole. Appropriate management is even more important in the office-based setting because the stress may have more of an impact on the patient than for hospitalized procedures. Awareness of the stress state in surgery and the patient's personality style allows for a knowledgeable surgeon and staff to anticipate behaviors and emotions and use appropriately their power and nurturance to lead the patient to the ultimate goal, a feeling of satisfaction with the surgical result.