The article examines the issue of refusal to perform plastic surgery from the perspective of medical law and professional ethics. Based on the analysis of Russian legislation, judicial practice, and international experience, it is demonstrated that a motivated refusal constitutes a legitimate instrument for protecting both patients’ rights and physicians’ professional responsibility. The conclusion emphasizes the need for regulatory clarification of the grounds and procedures for refusal, as well as the development of specific ethical and clinical standards in the field of aesthetic surgery.