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This article presents clinical reflections on cosmetic psychiatry. It is the mission of psychiatrists to render assistance to any who seek relief from emotional illness. This noble mission, however, does not currently apply to people who seek only subjective perfection. People seeking subjective perfection are discouraged by physicians wielding the persuasive powers of diagnostic definition, no diagnosis or label, no prescription, no pills. It is the use and not the abuse of psychotropic medication that forms the framework of cosmetic psychiatry.