Every empty airplane seat, hotel bed and restaurant table represents lost revenue, never to be recaptured. When you think about it, surgical practice is no different in that regard. We sell time and space in the operating room. When a patient, especially a private-pay cosmetic surgery patient, cancels or postpones elective surgery at the last minute, you can't re-utilize operative time you've committed to her in an equally productive way. Just like many airlines, hotels and restaurants, I penalize patients who cancel surgery my staff and I scheduled on their behalf and at their request.