Aesthetic Surgery - Choosing a Surgeon

In the UK anyone with a medical degree is licensed by law to perform cosmetic surgery. Many clinics hire doctors with no or incomplete plastic surgery training to operate on patients. The level of skill and experience offered varies widely. Step one is to inform yourself about plastic surgery, about the particular procedure you are considering, and then to find a top quality, fully trained and experienced plastic surgeon. Accessible sources include your own doctor, the articles on this web site and recommendations from another patient.

When choosing your surgeon consider:

  1. Qualifications - Check them.
  2. Experience - Frequency of performing the procedure.
  3. Consultation - Look for comprehensiveness, openness, compassion.
  4. Advertising - Be sceptical.
  5. Professional referrals - Ask doctors.
  6. Testimonials - Can you speak to a previous patient?
  7. Personal referrals - Discuss with knowledgeable friends.
  8. Fees - Expect clarity.
  9. Instinct - Trust your own.

1. Qualifications

In the UK the General Medical Council (GMC) holds up-to-date lists so that you can check a surgeon's credentials (+44(0)20 7580 7642). He should be listed on the Specialist Register in Plastic Surgery. Experienced and successful surgeons will be happy to give you numbers of other professional organisations to which they belong - for example, in the USA, the American Board of Plastic Surgery. If certified by the ABPS, the doctor has graduated from an accredited medical school and completed at least five years of additional residency - at least three years of general surgery (or its equivalent) and two or three years of plastic surgery. He must also have passed comprehensive written and oral exams. Simply call the American Society of Plastic Surgeons' Plastic Surgery Information Service (001-800-635-0635) to check on any ABPS surgeon. Alternatively visit the ASPS web site at www.plasticsurgery.org. You should also check that your surgeon has been granted 'privileges' to operate at an accredited hospital, ideally as a consultant.

2. Experience

Ask the surgeon what his or her experience is with the procedure you have in mind. Ask to see the surgeon's CV. It should show that he is experienced in a wide range of procedures, rather than being an expert in just one, particularly if it is the latest fad. The more experienced the surgeon, the safer you are in his hands. You need to feel confident he will do his utmost to prevent any complications and that he would be competent to handle any unexpected occurrences that may come up during surgery.

Plastic surgery, like all of clinical medicine, is an evolving and improving discipline. Your research has told you what some of the latest significant developments are. Check that the surgeon you are considering is up to speed.

3. Consultation

A short phone conversation or e-mail communication with a clinic is free but, quite rightly, a professional Consultation costs money and may last a whole hour. You may decide to meet and consult two or three surgeons before making your important decision. Make sure you get to meet the surgeon at consultation personally. Beware of unqualified 'advisors' who may be dispensing medical advice without any formal background in plastic surgery. Remarkably, this practice is not illegal in the UK and is quite common. Essentially meet the surgeon or go elsewhere. At the Consultation the surgeon will discuss your problem thoroughly with you; review the options; assess your suitability; make the risks and benefits clear; and finally will recommend the procedure (if any) he judges to be right for you considering effectiveness, safety, cost and appropriateness. You should feel comfortable with his explanations and his recommendation.

4. Advertising

Yellow Pages and women's magazines carry paid-for advertising but be sceptical about extravagant claims. If you see seductive photographs and deals that sound too good to be true, they probably are.

5. Professional Referrals

Your GP or practice nurse or other contacts in the medical profession may be able to recommend a surgeon. High quality private hospitals such as London's Cromwell Hospital and the Harley Street Clinic can provide you with lists of consultant plastic surgeons who have operating privileges - that is those who have been approved by fellow surgeons.

6. Testimonials

Ask to see relevant 'before' and 'after' photographs of patients with a problem like yours. Ask if the doctor can put you in touch with previous patients who would be happy to discuss their experiences frankly.

7. Personal Referrals

A friend or colleague who has had successful plastic surgery of the kind you are considering is an excellent starting point.

8. Fees

Your surgeon should be frank, clear and confident about fees. Ask him to include the operating theatre fee, any fee for an anaesthetist and other relevant costs. Importantly, at the Hurlingham Clinic, the agreed fee is one single payment which includes pre and post-operative advice, hospital and theatre facilities, nursing care, the surgical fees, the anaesthetist's fee, fees for implants or special equipment, and follow-up visits for 6 months.

9. Instinct

Trust your personal feelings about the surgeon and his staff and act on them. Is he or she convincing? A strong character? Someone you would naturally trust and depend on in an emergency? Remember you can always walk away.

Consider the trust a woman must place in her gynaecologist or obstetrician. In some ways she must place even greater faith and trust in her plastic surgeon. A woman who is not ill allows the surgeon to alter her looks permanently. She places in his hands not just her appearance but her self-confidence, her self-image, her sense of self-worth, all of which may affect her happiness, her relationships, her career...

Your plastic surgeon will have to be a master of medical science and surgery, a person sensitive enough to empathise with you, and someone artistic enough to reshape the human body itself - bone, cartilage, muscle, fat and skin - while reassuring and supporting you at every stage.

Take your time. Choose wisely. Don't just go for the lowest cost. Beware of cheap all-in-one cosmetic surgery packages to other countries. You usually get exactly what you pay for. Aesthetic surgery is too important a choice for you not to be fully informed and perfectly comfortable before proceeding.

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