INITIAL CONSULTATION

An initial consultation lasting approximately half an hour is the first step for a patient requesting cosmetic surgery. A referral letter from the general practitioner is preferred but if this is not available patients must agree to me contacting their general practitioner about the consultation and any planned surgery. In this country the general practitioner is the primary doctor of all patients and surgeons operate with the GP’s 'permission'. This is designed to protect you, the patient, although it is understood that many find the process burdensome.

A fee is charged for the initial consultation, irrespective of whether or not surgery is booked. This policy has been adopted to give independent, unbiased advice, as not all patients are suitable for a surgical operation.

Cosmetic surgery counselling is a time consuming activity and there are many occasions when half an hour is insufficient to cover all aspects of a topic and allow a patient to make an informed decision. In such circumstances I will recommend that a patient return for a further consultation for which there is no extra charge.

It is often possible to show photographs of the sort of results that can be obtained and this may include some of the possible complications of surgery.

Information sheets are available for many of the operations performed routinely.

All consultations are with me, the surgeon who will perform the operation.

ANAESTHETIC ASSESSMENT

The hospitals where I operate hold pre-assessment clinics (PAC), run by nursing staff, for patients undergoing general anaesthesia. You will be given an appointment one or two weeks before your surgery. It is an opportunity for you to meet the nursing staff, see the ward and undergo a basic assessment of your suitability for anaesthesia. Routine tests may be carried out. If you or the nursing staff have any concerns about your health then arrangements will be made for you to see the anaesthetist at this time.

SURGERY

You will be admitted to hospital on the day of surgery and seen by me for a final discussion about the operation. This will give you the opportunity to ask any last minute questions about the operation. You and the surgeon will sign a consent form, and photographs may be taken of the area undergoing surgery.

The anaesthetist will examine you, assess your fitness for anaesthesia and discuss post-operative pain relief. Investigations may be ordered at this time if you have not already attended a pre-assessment clinic.

DISCHARGE

I will see you following surgery and again the next day when wounds and any dressings will be checked. Drains and packs (if present) will be removed and thereafter you are free to leave the hospital. It is best to make arrangements to be picked up rather than travelling alone. You are strongly advised not to drive yourself.

A prescription for strong pain killers can be provided should you need them although most patients find that simple analgesics such as panadol or ibuprofen are adequate.

Remember that you are likely to experience swelling and bruising in addition to pain and so you must restrict you activities accordingly. It is generally advisable to take two or more weeks off work and mothers with dependent children should arrange to have help at home for a fortnight or sometimes longer. The recovery period after major surgery such as abdominoplasty may last for up to three months.

FOLLOW UP

At the time of discharge from hospital your will be given an appointment to see me (not a nurse) in the clinic a few days after the operation. The precise timing varies depending on the procedure and the differing requirements for attention to dressings and stitches. I remove all my own stitches preferring not to delegate this delicate procedure to others.

After this first review appointment, when there are no complications, a patient can expect to be seen again approximately six weeks after surgery and again six months after surgery. These three visits are considered the absolute minimum. More appointments can be made, at the request of you the patient should there be complications or if you have concerns about the surgery.

TELEPHONE ADVICE

Within the limitations of mobile communication and clinical commitments I am very happy to take telephone calls from patients before and after their surgery. It is understood that patients often have concerns after an operation and it is easy to provide reassurance by telephone. Clearly if there is a clinical problem then an arrangement can be made for you to be seen urgently.

SECONDARY SURGERY

There are occasions when further surgery is required to treat complications such as bleeding or infection. This can sometimes happen as an emergency within a short time of the original operation or a few weeks later. The cost of such surgery is covered by the hospital for one year after the original operation.

Cosmetic surgery can be unpredictable and this can lead to both patient and surgeon dissatisfaction with the result. Revision can be performed if this is feasible. There might be a hospital charge for this surgery.

Some operations have a known risk of complications, which will have been discussed with you in advance.

The manufacturer of the breast implants that I routinely use offer a guarantee (in certain circumstances) for all their implants. You will be given written details at the time of surgery.

INHANCE

The BMI group of hospitals now offer 'Inhance' which is designed to give you a package price for the procedure and follow up care. It covers complications and revision surgery for the first year. Full details are available on www.inhance.co.uk