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Choosing a cosmetic surgeon

Cosmetic surgery is booming. Americans spent more than $12 billion on over 10 million cosmetic surgical and non-surgical procedures such as Botox in 2014 (data from the American Society for Aesthetic Plastic Surgery). In the UK, cosmetic surgical procedures in 2015 were up by 13% from the previous year (data from the British Association of Aesthetic Plastic Surgeons), notably with a rise in liposuction of 20%. While breast augmentation remains the most popular cosmetic surgery in women, men are also going under the knife. In the UK, male surgery numbers increased by 13.5% overall in 2015.

This is big business, so it is not surprising that some clinics use aggressive marketing techniques and advertise persuasively. Therefore you have to be very careful.
What do the words mean?
  • Cosmetic surgery is surgery to improve appearance
  • Aesthetic surgery is another name for cosmetic surgery. It comes from the Greek word for beauty
  • Plastic surgery is surgery to change the shape or form of the surface and sometimes the deeper structures of the body. The word ‘plastic’ comes from the Greek word for moulding. Plastic surgery includes cosmetic surgery, repair operations after burns and other injuries, correction of inherited deformities, breast reconstruction after operations for breast cancer, and removal of skin tumours

Before undergoing any cosmetic procedure, it is essential to do a lot of homework. The following advice is mainly about the UK; if you live elsewhere, find out about surgeons’ qualifications in your country.

Do not rush into anything. Read as much as you can about cosmetic surgery, and note down the names of surgeons who are mentioned or quoted. Remember that all surgery has risks. Think carefully about why you want the procedure done. For example, cosmetic surgery is unlikely to improve a relationship that is going nowhere. If you are going through a life crisis, do not make any decisions about cosmetic surgery.
 
Do not be pressured by anyone else. You will be the one undergoing surgery, so do it only if you want it for yourself.
 
Be very clear what you are hoping to achieve. For example, if you want your breasts enlarged, what size do you want them to be? Having a clear idea is essential for a proper discussion with the surgeon.
 
Find out as much as you can about the procedure itself. Even a simple-sounding procedure such as liposuction requires a lot of skill. Look at the good cosmetic surgery websites (see useful contacts). Various cosmetic procedures are also discussed elsewhere: for example, breast reduction, breast enlargement, thread veins, ageing skin and ears.
 
Locate a good, reputable surgeon. Do not just answer a persuasive advertisement in a magazine or on the web.
 
The best plan is to ask your own doctor for a referral. If you think your doctor would be unsympathetic, contact BAAPS for a list of their members and their different specialities.
  • Check your surgeon’s qualifications in the Medical Directory. The letters MRCS or FRCS mean that that he/she is a Member or Fellow of the Royal College of Surgeons, having had several years experience and passed a stiff exam in general surgery. They do not signify special training in cosmetic surgery. Many cosmetic surgeons now have the ‘FRCS (Plast)’ qualification, which means that the surgeon has additional experience in plastic or reconstructive surgery and passed an extra examination. However, some experienced cosmetic surgeons do not have FRCS (Plast) because they trained before it was introduced.
  • In the UK, most cosmetic surgeons will be members of BAAPS, the main organization responsible for maintaining high standards in cosmetic surgery. However, membership of BAAPS is not an absolute guarantee. To join BAAPS, surgeons have to have had 6 years training in plastic surgery and provide a log book of operations they have done, and other members have to testify to their experience. Once he/she has joined, there is nothing to stop the surgeon doing other cosmetic operations in which he/she is less experienced.
  • Some surgeons are members of the British Association of Cosmetic Surgeons (BACS). This organization represents mainly surgeons in private clinics. To join BACS, they do not need to be qualified plastic surgeons, but have to show they have cosmetic surgery experience. Many BACS surgeons have good experience with certain procedures, but BACS membership is not a guarantee of anything.
  • The General Medical Council has a list of specialist plastic surgeons who are eligible to work as NHS consultants in plastic surgery.

Check that the clinic is registered with the Healthcare Commission. This is the official body responsible for regulating and assessing healthcare in both the independent sector and the NHS in England. All private clinics and hospitals in the independent sector that provide cosmetic surgery and laser and intense pulsed light (IPL) treatment must now be registered and inspected by the Healthcare Commission. If they are not registered, they are practising illegally. The commission checks each provider for quality of treatment and services, safety and cleanliness of premises and equipment, qualifications and skills of staff, and procedures for handling any complaints.

Make sure you have a proper consultation with the actual surgeon who will be operating on you. UK government regulations insist on this. Be suspicious if you are not charged a fee for this consultation – a good surgeon’s time is valuable. A ‘free’ consultation will probably be with a counsellor, nurse or salesperson.
  • Take a good friend with you.
  • Write down a list of questions beforehand. Make sure you ask them all (even if it feels embarrassing). If the answers are not absolutely clear to you, say so and ask for a further explanation. Do not just think you are being stupid. Remember that you are paying for this consultation.
  • Ask about any preparations you will need to make, what aftercare is provided, and what the risks are. Does the clinic have resuscitation equipment and doctors actually in the building 24 hours a day? Who will you be able to contact if you need advice after the operation?
  • Find out about the recovery period. How much pain and bruising should you expect? How long will you need off work? When will you have stitches out? What will the scar be like?
  • Ask how long the results will last.
  • Ask the surgeon how many of these procedures he/she has done before. If you are shown ‘before-and-after’ photographs, ask if the operation was done by your surgeon personally. (You could be shown pictures of operations done at the clinic by a different surgeon.)
  • Make sure you know how much the procedure will cost.

Do not ignore the pitfalls. All surgery has risks. If you are really keen on a procedure, it is tempting to disregard possible problems, but this is a big mistake. Weigh up all the pros and cons carefully before making your decision.

Shop around. Do not just go to the first clinic that you contact. Make a short-list of several surgeons and clinics, and have a consultation with more than one. Although this will cost you, it is money well spent.
 
Consider location. It is tempting to travel overseas for cheaper surgery, but do not do so unless you are sure about follow-up arrangements and what would happen if there were problems.
 
Allow yourself a ‘cooling off ‘period of about 2–3 weeks after the initial consultation, so that you can think clearly about the procedure before making the decision to go ahead. A respectable clinic will encourage this, and will not hassle you into making an immediate decision. UK government regulations from the National Care Standards Commission (set up to regulate private clinics) ban having the surgery within 2 weeks of the consultation, but you could still be pressured into making the decision too quickly. Go ahead only if you feel you can trust the surgeon and that he/she has explained everything properly to you and understands what you are hoping to achieve.
 
Remember you can always change your mind. You can cancel right up to the moment you go to sleep for surgery.
 

Most popular operations

In the UK, 51 140 cosmetic surgical procedures were performed in 2015. The most popular operations requested by women are:
  • breast enlargement (9642 in 2015 – up 12% on 2014)
  • eyelid surgery (7713 – up 12%)
  • face/neck lift (7047 – up 16%)
  • breast reduction (5450 – up 13%).
For men, the most popular procedures are:
  • eyelid surgery (976 in 2015 – up 15% on 2014)
  • rhinoplasty (‘nose job’) (812 – up 14%)
  • breast reduction (796 – up 13%)
  • liposuction (586 – up 20%).
In the USA, the top five cosmetic operations for both men and women in 2014 were:
  • liposuction (342 494 – down 6% on 2013)
  • breast enlargement (286 694 – down 8.5%)
  • eyelid surgery (165 714 – up 2.7%)
  • tummy tuck (164 021 – up 2.5%)
  • nose surgery (145 909 – down 1.4%).
In addition, more than 8.9 million non-surgical cosmetic procedures, including antiwrinkle injections (such as Botox), chemical peels and hair removal were carried out in the USA in the year 2014.
 
Information from the British Association of Aesthetic Plastic Surgeons and the American Society for Aesthetic and Plastic Surgery.
 

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Monday, February 8th 2016

 

Find out more from GP and broadcaster Dr Phil Hammond about the causes of enlarged breasts in boys and men, and what you can do if they are causing you pain or discomfort, in his video on male breast enlargement.

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Comments on this article

Posted by Stretch marks on 01/03/2017 at 03:56

I want to know if there is a cosmetic surgery hospital here in ghana, Am having Stretch marks all over my body and really feel embarrassed. Please I need help

Posted by Jessie Harrison on 09/03/2016 at 11:26

These are all good questions to have in mind when deciding on cosmetic surgery. Because what happens will be permanent. Which is why I like what you mentioned about being clear on what you're hoping to achieve. This is your body we are talking about, and the doctor will take you seriously.

Posted by Cruz on 11/11/2013 at 03:52

I got big ears and I live in Dayton Texas. And i feel embarrassed because people make fun of me and i want it go as soon as possible. I just want them short and don't stick out..... plz help me?

Posted by Karen on 17/10/2012 at 01:13

Hi Hayley. Very few of us look the same after having a baby (or two), so give yourself a break. There's so much more to life than the way we look. Your husband sounds like a great guy - working all those hours for his family - and he must be wondering why you're keeping your distance. You say 'I know he doesn't care about the way I look' so tell him how you feel and use his love and support to rebuild your self-esteem. Be positive, get those cuddles and it WILL get better!! You don't need a tummy tuck.

Posted by Hayley on 14/10/2012 at 11:29

I need some help. I've had 2 kids already (oldest 4, youngest 1) i've been going to the gym, even had a personal trainer, i've brought dvd's to try and tone by belly, but not of it has worked. I feel like an old lady! It's very saggy and wrinkly, i can't stand it. I have to wear baggy clothes to cover it up, i can't have my husband touch or see me. I get undressed in the dark. I sleep on the floor or on the sofa because when my husband is asleep he rolls over and cuddles me, but i can't stand it. I don't want him to feel how disgusting i am. We haven't made love since i had my youngest son, which worries me that he will have an affair or leave me. I want cuddles with him, i want him to see me naked and i want to make love to him, but with my body like this it's never going to happen. I know he doesn't care about the way i look, but that's not going to stop me feeling like this. I love my husband, he's my one and only and i can't lose him over this. I don't know what to do as we struggle to put food on the table for us (we make sure the kids have everything they need) my husband works 13/14 hours 6 days a week and the only day off he has, he goes to college. I don't know how much a tummy tuck costs. Can someone help me please?

Posted by lynda on 13/03/2012 at 12:42

i have a big tummy trunk i dont know what to do..and am thinking of going for tummy surgery..what am i going to do..i feel so shy and am getting big now..omgosh am sad

Posted by ALIDA on 10/10/2011 at 02:08

HI, I HAVE A PROBLEM, I HAVE STRECH MARKS FROM MY BELLY DOWN ONLY IN A LINE GOING DOWN, I DON'T WANT A TUMMY TUCK BUT WANT THESE STRECH MARKS REMOVED WILL IT BE POSSIBLE TO DO THIS, THEY ARE RATHER BIG FAT STRECH MARKS.

Posted by louisa on 19/05/2011 at 01:44

What are the side effects of breast enlargement bcause am planning on getin 1 done

Posted by MaisM on 21/03/2011 at 06:21

Thanks for the great article! With cosmetic surgery becoming so popular these days there is definitely a demand for more plastic surgeons. Make sure you find a good and experienced surgeon, especially for a tummy tuck procedure!

Posted by keeth on 09/10/2010 at 02:10

Can some one change the face completely which will make him unrecognizable?

Posted by Optional on 28/05/2010 at 01:57

cant breath through nose due to a career in boxing followed by years of cocaine abuse . which both ended some years ago now,it has alterd my appearance and would like to be recommened a good surgeon who could perhaps help

Posted by Optional on 16/04/2010 at 10:32

I want the names of a plastic surgeons preferably lady doctors. anywhere in the uk.

Posted by Emily on 11/04/2010 at 03:20

i think plastic surgery should only be used for medical reasons, such as birth defects, injuries, and disease treatments. It should not be used for cosmetics! God made us they way he wants us to be made! you should not change you body. Theres no reason to!!!

Posted by AD on 29/01/2010 at 02:19

Really interesting information. Another good plavce which I found really helpful was goodsurgeonguide.co.uk. It has loads of client testimonials to show a surgeons reputation. Researching is so important for things like this!

Posted by breast on 17/08/2009 at 08:31

i never had breast and cant afford any but if i did i would not have to worry about my husband cheating on me and if iwould have a lot of conferdence an my self those lucky people dont know how lucky they are to have breast.and people to admire them

Posted by emmy on 30/03/2009 at 01:39

I had eye bag surjery.Now it is gone wrong.Do i need again do that.I want die.

Posted by mahmud on 21/01/2009 at 04:41

When i was 8 years old i had a surgery on my face or cheek fo toncil.It created a scar.After 17 years i took a scar rivision surgery but it could hel me at all.Now i have a long scar on tje middle of my face and nek.Do i have any way to cure it?

Posted by stevie amy on 04/01/2009 at 12:25

i have got a tromendouse amount of stretch mark which i am very unhappy about as they are very ugly to look at!!! i have had them for years and yet they have not changed to a white/silver colour they remain PURPLE!!! i have tried everything from creams, oils and oils in the bath. i finally went to my doctors to speak to him about them where he then asked if i have tryed losing weight, insinuating that i was fat! its uncommon to hear that a 17 year old girls is happy the way they look but i am and i love my curvy size 12 body. i am not over weight atall! Why isn't laser treatment on the NHS!?!?!?!?!?!?!? A very unhappy girl. stevie amy

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