The final report of the Competition and Markets Authority (CMA)

The Competition Commission, a predecessor body of the Competition and Markets Authority (CMA), started a market investigation into private healthcare in April 2012, which reported in April 2014, immediately after the establishment of the CMA. The final report was published in September 2016. Click here to read the Report.

Within this document the CMA required publication of performance information on private healthcare facilities and consultants, and the provision of information on the fees charged by consultants.

Mr. Ross charges £100 for initial consultations for aesthetic procedures. For reconstructive consultations, second opinions and revisionary cases the consultation fees range from £100 – £250 depending on the complexity of the referral. Following surgery Mr. Ross does not charge additional consultation fees other than in the case of oncological / reconstructive follow up.  If this is anticipated this will be declared at the time of the initial consultation.

After a consultation Mr. Ross for patients whose expectations are realistic and optimal outcomes achievable Mr. Ross will always give a fixed quote for surgical procedures and patients are informed about the perioperative care and after care package of care.

Mr. Ross has no financial interested in any facility.

Unfortunately in Aesthetic Surgery patients looking to compare prices are rarely aware of the various range of techniques and procedures even for a named procedure. Procedures need to be individualized and can be highly variable depending on the requirements of the individual patient. Complexity of procedures is highly variable and definitive fixed pricing can only be determined after a consultation after discussion about the variety of options and their pros and cons.

In Breast Rejuvenation surgery there are a variety of requests, which are broadly related to increase in size, increase in shape and improvement in symmetry. Breast Aesthetics are altered depending on a number of factors, which include the skin, fat, breast, chest wall and breast/body proportions. In terms of size the volume can be increased or decreased. In terms of shape the skin can be tightened or expanded, the fat / breast can be repositioned / reduced and the chest wall altered.

In terms of increasing volume the commonest procedures to increase volume include breast augmentation using breast implants and/or autologous fat transfer.  One can also use the upper abdomen / back and all these volume enhancement procedures can be combined.

To decrease volume of the skin / breast / fat the commonest procedure is a breast lift (mastopexy) and a breast reduction.  A reduction in volume can be performed by liposuction only, minimal excision through and incision around the areola, an inframammary incision only, a periareola and vertical scar and a periareola scar with both a vertical and a horizontal fold  (inframammary) incision. A reduction can also include the removal of the nipple and replacing it in the form of a graft.

Mastopexy / Reduction can be performed alongside breast augmentation / fat transfer in order to alter appearance those enhancing volume in one part of the breast while decreasing the volume in another. The commonest surgical procedure is the removal of the lower part of the breast through a reduction / mastopexy and simultaneously placing breast implants and/or fat transfer into the upper part of the breast. One can also perform different breast rejuvenation procedures one each side to improve symmetry.

Increasingly breast augmentation revision can involve removal only, removal and skin excision / tightening, lifting, replacement, fat transfer and the use of artificial substitutes.

For all the procedures mentioned there are a huge range of variables that can determine the price. Even for a standard breast augmentation using breast implants, there are a variety of positions in which breast implants can be placed and thousands of breast implants with different shells / textures / contents / shapes.

Although prices are very important to patients a fixed price for all the various combinations of surgery above is impossible. Patients should be given sufficient information and empowered to make a decision to proceed with surgery during a consultation. Patients should be guided in making this decision based on their best interest. This should not be dictated by price. Mr. Ross believes that there should not be a compromise in patient care by offering a suboptimal procedure simply because it is less expensive.

It is Mr. Ross’s opinion that it is better not to perform/offer a procedure that would provide a suboptimal result. Following a consultation with Mr. Ross this may be one potential outcome.

For the sake of transparency in Mr. Ross’s aesthetic practice: =

A simple skin excision / tightening under local anesthetic could cost around £2000, a breast reduction with liposuction under local anesthetic could cost around £3000 compared to a mastopexy / reduction with implants/fat transfer under general anesthetic which could cost around £11,000.

In Mr. Ross’s practice breast augmentation with fat transfer under local anesthetic could cost £3000 whereas breast augmentation with mastopexy / reduction with implants / fat transfer could cost around £11,000.

In Mr. Ross’s the cost of breast rejuvenation surgery is usually around £6,500 – £7,000 halfway between the ranges noted above.

Techniques for breast rejuvenation are continually changing and breast rejuvenation procedures can be combined with body rejuvenation procedures and facial procedures. Patients need to be aware that these prices can change and are not fixed until after a consultation. For some patients Mr. Ross may not be able to offer patients a surgical procedure and if this were to be the case Mr. Ross would offer patients an explanation for the reasons why.