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Plastic surgery
Margaret,
Not all people who have had plastic surgery look dented where they shouldn't and rounded where they shouldn't. The denting happens when the surgeon has been too aggressive in one particular area that was suctioned. The problems in plastic surgery arise most frequently when the patient has been overcorrected, ie. Michael Jackson. On the other hand, I've seen some beautifully reconstructed noses and faces and even breasts reconstructed following cancer surgery where they looked perfectly natural.
Plastic surgery gets a bad rap because the "not so good jobs" are easily detected. The good jobs are not easily detected, the person just looks better, more rested and youthful.
I think Chris Sapers advice is very good. Talk to your client about what they like and don't like about themselves. An overly Botoxed face loses expression around the eyes, but unless the client mentions it in conversation regarding the portrait, I would paint them as they are.
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