Cosmetic Surgery

Cosmetic surgery changes the shape or contour of part of the body through an operation. Unlike non-surgical treatment it produces a definite structural change, and it carries the risks, scars and recovery of surgery. Whether it is the right choice depends on what you want changed and whether an operation is the thing that changes it.

Key facts

How we approach it

Surgery is worth doing when there is a clear physical change you want, that change is achievable by operating, and the benefit outweighs the risk for you specifically. When any of those three is missing, the right answer is not to operate — and saying so is part of the job.

That means some consultations end with a recommendation against surgery. Sometimes a non-surgical treatment addresses the concern; sometimes nothing needs doing; occasionally the underlying issue is not one that surgery resolves at all.

What a proper consultation includes

• Examination of the area and a discussion of what is realistically achievable
• Full medical history, medication, smoking status and previous surgery
• The specific operation proposed, and the alternatives including doing nothing
• Where scars will be and what they will look like as they mature
• Recovery in practical terms — time off work, driving, exercise, childcare
• Risks, both common and serious, specific to that operation
• Total cost in writing, including what happens if revision is needed
• Time to go away and reconsider before committing

Things that change the risk

Smoking is the single largest modifiable risk for most of these operations. Nicotine constricts small blood vessels, and the tissues that depend on them can die, which turns a straightforward recovery into a serious complication. For procedures involving skin flaps — tummy tuck, facelift, breast reduction — stopping well in advance is not advisory, it is a condition of proceeding safely.

Uncontrolled diabetes, significant obesity, untreated sleep apnoea, some medications and certain supplements also change the risk profile. This is why the medical history matters as much as the examination.