Will I need DVT prophylaxis for my cosmetic surgery?

For all plastic, reconstructive and aesthetic surgery in patients undergoing a general anaesthetic I will use compression stockings and mechanical DVT prophylaxis. I will discuss the pros and cons of pharmacological venous thromboembolic prophylaxis with you and together make a decision as to whether to give this. If you have co-morbidities or a past history of DVT it is important to highlight these at a consultation as it would be usual to give pharmacological treatment as well as mechanical prevention in these cases. For elective plastic, reconstructive and aesthetic surgery patients should not be smoking, be mobile and have a BMI under 30. Risks of DVT are significantly less if this is the case.

Which Surgeon should I choose?

You should consult with a surgeon that you can trust and whom you would feel comfortable with. Ask what training he/she has completed, how often he or she performs the procedure, whether they are or have been an NHS consultant and whether he/she is on the specialist register of the GMC. Ask whether he/she are full members of professional associations such as the British Association of Aesthetic Plastic Surgeons (BAAPS) and/or the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS). Ask whether he/she has medical indemnity within the UK or the implications to you if they do not. Ask to see examples of his/her work and to meet previous patients that have undergone the procedure you wish to have.

Where should I have plastic, reconstructive and aesthetic surgery?

You should have your surgery performed in a hospital that has acceptable standards of care and regularly performs plastic reconstructive and aesthetic surgery. Ask if this is the case, what the arrangements are should a complication occur and in this scenario whether everything will be provided within the chosen hospital by your chosen surgeon… Do not travel a long distance or overseas for any surgery unless you are comfortable with the aftercare arrangements and the management of any problems or complications that might arise.

I had a tummy tuck many years ago and I have had problems with the scar and the way it sits. Can this be improved?

Often over time tummy tuck scars move and change. The appearance also changes with time and weight fluctuations. Certainly it sounds like things could be improved. The options include scar revision and tissue redistribution, a mini tummy tuck, a full tummy tuck revision and/or liposuction. You should arrange a consultation to go through the pros and cons.

My plastic surgeon is not on the Specialist Registrar of the General Medical Council. Should I be concerned?

It is very important that you check the qualifications of your Surgeon. It is now a requisite that cosmetic surgeons should be on the Specialist Registrar to be able to offer cosmetic surgery. Ask your surgeon what professional organisations he/she belongs to and look for a PS who have full membership to BAAPS and BAPRAS. You must make sure that you are shown results and outcomes and that your PS is open and honest about this data. If you surgeon is not on the Specialist Registrar you should check with both him/her and the GMC to clarify the issue. It may be that you don’t have a correct spelling. The GMC should be able to clarify whether your surgeon has adequate credentials.

Do you offer finance?

Although finance options are available it is important for patients to be aware of all the pros and cons. I always advise patients to consult about a procedure they wish to have and plan in advance. Costs must take into account the cost of the procedure and also any subsequent procedures that may be needed over a life time. This is particularly important for breast augmentation where further revisional surgery will undoubtedly be required. Patients should not look at cosmetic surgery as a short term gain but must consider both the short term and long term pros and cons. I would never discuss costs and finance until patients have decided on what operation they would like to have and understand the pros and cons. If their expectations are realistic and they wish to proceed I will refer them on to discuss finance appropriately. This discussion must be provided by experts in the field and should not form part of the medical consultation and provision of care. Again the pros and cons need to be discussed by someone qualified to give financial advice. If patients wish to go down this route they should perform their own due diligence and make their own empowered decision.

I would like fat transferred from my abdomen transferred into my bum. Am I a good candidate?

It would be necessary to consult with you regarding this. Certainly fat can be transferred from your abdomen and transferred. This can be performed by small incisions and can give an improvement in contour. It is important to be realistic as to what result can be achieved and it depends on the amount of fat you have available. It is important to be weight stable and be at your ideal weight before considering this surgery.

How should patients choose their surgeon?

They should ensure that the surgeon is on the specialist register of the General Medical Council, which ensures quality in medical practice. Look for a surgeon who is a member of the British Association of Aesthetic Plastic Surgeons (BAAPS) or the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) and who regularly performs the type of procedure you are interested in. Always insist on seeing the surgeon who will be performing the procedure and do not pay for any procedures in advance.

Following weight loss I have excess skin – Can i have all of this removed?

The distribution of excess skin is highly variable from each individual and what troubles you also varies. I would recommend a consultation to go through the options. The commonest area that patients choose is the abdomen followed by the breasts and then the arms and legs. For patients wishing to rejuvenate all areas one can remove tissue all the way round the body as a body lift and combine this with an arm lift and at a second operation perform breast rejuvenation and thigh lifting. It certainly is possible but you need to make sure your are weight stable and at your ideal weight before having any surgery.

Do you ever tell patients that they are not suitable for cosmetic surgery?

During every consultation it is important to go through the pros and cons of surgery and go through risks and complications and potential results. Patients may be suitable for either non surgical or surgical treatments or it may be that a patients expectations cannot be met by any cosmetic treatment. It is important that your expectations are realistic and aside not being fit for surgery this is the commonest reason why I would tell a patient they were not suitable for cosmetic surgery.