When it comes to plastic surgery, celebrities live in a constant state of denial. But thumb through any tabloid magazine and you’ll spot grainy, paparazzi images of starlets trying to hide bruised, recently plumped lips, swollen, just-chiseled noses, or even too-tight, newly lifted faces. While this alone pretty much confirms that celebrities are fans physical alteration, it’s pretty rare for a celebrity to blatantly admit to having work done. Therefore, none of us actually know for sure if they’ve been cosmetically enhanced—unless you’re their doctor, of course.

So, how exactly do the men and women behind those perfectly symmetrical, Hollywood faces pull off these top secret appointments? Well, it’s just as complicated as you may have guessed. While celebrity doctors have obviously been sworn to secrecy (and required by law) to never reveal confidential patient information, we found a few physicians who were willing to tell us their process for coordinating secret celebrity procedures, as well as which treatments their elite clientele are coming in for most often. Read on!