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Considering cosmetic surgery?

  • Last modified date:
    15 May 2007

Introduction

Cosmetic surgery should not be undertaken lightly. Cosmetic surgery can change your appearance in ways that you might consider desirable but it can be expensive in time and money and, although uncommon, it has been known to result in some changes to your appearance which you may not always find pleasing in the future. It is important that you do not feel pressurised or obliged to have it. It should be a decision you take only after a lot of careful thought and questioning.

This page provides some questions to ask yourself about your reasons for wanting cosmetic surgery and your expectations of the results the procedure will bring, as well as providing some alternatives to cosmetic surgery.

If you feel you want to know more, this page will provide you with details of questions to ask to make sure that you can make a properly informed decision about whether to go ahead with the surgery, and which provider to choose.

Your reasons and expectations

As a first step, you need to think long and hard about why you feel you may benefit from cosmetic surgery. For example:-

  • Do you expect it to change your life as well as your appearance, and how do you think your life will be better?
  • Is it reasonable or likely that a change in your appearance will radically change your life?
  • Are you considering surgery for yourself or to please someone else?
  • Do you think that having surgery will improve your relationship or employment prospects?
  • Is it reasonable to expect surgery to achieve the changes to your appearance that you are hoping for?

There are alternatives to cosmetic surgery. If you feel your concerns about your appearance result from anxieties about social situations or from problems with relationships, you might want to discuss with your GP or another professional the possibility of seeing a counsellor or psychologist. If you have been considering cosmetic surgery because of employment issues , you may want to consider alternatives such as career counselling. If you are living with an appearance that you consider looks disfiguring or unusual, the organisation Changing Faces can offer support and information about how to manage others attention and how to enhance your self-esteem and confidence.

Gathering Information

If you do feel that you could benefit from cosmetic surgery, then it is vital to ensure that you are as well informed as possible. The next step is to gather information about the procedure you are interested in and the hospitals or clinics who offer this procedure. However, you should note that it is not advisable to undergo cosmetic surgery if you are pregnant or if you have certain medical conditions, or if you are taking certain medications.

You may be nervous about asking for information, but hospitals and clinics  with your best interests at heart will do everything they can to put you at your ease and will make sure that you get the information you need. You may find it helpful to write all your questions down so you don't forget anything. Or you may prefer to attend consultations with your partner, or a relative or friend, who can remind you to ask for information if you forget.

If you have special needs - for example, if your first language is not English or you have a sensory impairment, then make sure that providers are able to supply information in a way that you can understand.

We also provide a 'questions checklist' which you can print out and use when talking to hospitals, clinics and surgeons.

Talking to your GP

It's a good idea to talk to your GP if you're considering cosmetic surgery. He or she will be able to give you general advice about surgery, and about any particular health issues you should mention to your surgeon.

Talking to surgery providers

All companies who provide cosmetic surgery MUST be registered with the Healthcare Commission. You should ask to see a hospital or clinic's registration and it is vitally important that you do not agree to have cosmetic surgery from any hospital or clinic who cannot provide details of their annual registration. The Healthcare Commission inspects all cosmetic surgery providers and prepares a report giving details of their findings. You can get Healthcare Commission inspection reports from the Healthcare Commission's website. A link to this website is on the useful links page.

When you first approach providers you may meet or speak to a patient adviser. The Department of Health believes that patients should receive advice about surgery ONLY from doctors and nurses, as they have the qualifications and expertise to give you high-quality advice. Check whether your adviser is a doctor or nurse, and whether they are registered with the General Medical Council or Nursing and Midwifery Council.

If you wish to go ahead you should be offered an appointment to talk to a surgeon. It is important to be honest when you meet the surgeon. Being clear about your expectations of the procedure will make sure that the surgeon can give you the correct advice about whether the procedure will achieve the results you want. Be truthful about any health or lifestyle issues that the surgeon may ask you about, as these could affect the results of your procedure. You should make sure that you tell the surgeon about all existing medical conditions, including pregnancy, and all medications you are taking so that the surgeon can determine whether or not there are any additional risks associated with those conditions and/or medications. Certain medical conditions may preclude your having surgery. The surgeon should discuss this with you if it is relevant.

Make sure that you feel confident about the surgeon's ability to perform the operation. Ask him or her about the qualifications they hold, how many procedures they have carried out, and how many patients needed revision surgery. Asking for 'before' and 'after' photographs of other patients who have had your chosen procedure will also give you information about the surgeon's work.

The surgeon should provide full details of the procedure itself, including what will happen, how long it will take, what anaesthesia will be used, whether you will require an overnight stay, the level of pain you may experience, how long the results of the procedure will last, whether there will be any scars and any risks the procedure may carry. ALL surgery contains a certain element of risk - including risks associated with anaesthesia, infection and scarring. The surgeon should provide a full explanation of the general risks of surgery and any particular risks associated with your procedure. For those procedures requiring a general anaesthetic your anaesthetist should discuss with you, before your surgery, any issues that relate to the anaesthetic and your wellbeing and safety. Your anaesthetist should also discuss your preferences regarding anaesthesia and help you decide what would be best for you.

In common with all surgical procedures that involve an incision in the skin, cosmetic surgery procedures involving incisions will leave scars.  These will be permanent and may be quite pronounced and inflamed at first but usually the scar tissue will subside and the redness will fade over time.  This may happen over a period of weeks or it may take several months or even a year or so, depending on the location and extent of the incision(s).

The surgeon should also talk to you about any special regime you need to follow before surgery, the recovery time and the aftercare procedures. The success of your procedure may depend on following the pre-surgery regime and the aftercare advice, so you must make sure that you understand the advice and that you are prepared and able to follow it. For example, if the surgeon says that you would need to be away from work for two weeks following your operation, then you will need to make sure that you will be able to take sufficient time off work.

Your hospital, clinics or surgeon should give you written information to take away with you after the consultation so that you can refer back to it if you need to.

Arranging for surgery

After talking to the surgeon you may decide to go ahead with the procedure. But you should not feel that you have been pressured into a decision - you should be able to take as much time as you need, and you should avoid any provider who you feel is putting pressure on you to agree to surgery.

If you are asked to sign an agreement to go ahead with surgery then you must make sure that you understand and are happy with the agreement you sign. This agreement should include a written statement for you to sign, saying that you give your consent to the treatment.

The agreement should also include details of the cost of your procedure. Make sure that you understand what the price of your procedure covers, particularly in terms of aftercare and any revision surgery which may be necessary. Also, the agreement may include details of any financial penalties you may incur if you subsequently decide to cancel the agreement, so you will need to make sure you understand these penalties.

Even after deciding to have surgery it is important to have a 'cooling off' period for you to come to a final decision, so check whether the agreement allows you to do this. If a provider offers you a “special deal” or a “discount” make sure that the offer allows you adequate time to make a decision to go ahead without you feeling under time pressure.

Your records

The provider will retain a record of your treatment, which may include 'before' and 'after' photographs of you. You will need to think about whether you are prepared to let the provider show these photographs to other potential patients. The provider should ask you to give your consent if they wish to show photographs or any other part of your records to other patients.

Getting cosmetic surgery abroad

Cosmetic surgery abroad often costs less than in the UK. But this doesn't mean that you can treat it any less seriously. Any savings in the cost of the procedure abroad should be weighed against the cost of travel and accommodation, as well as the cost of any follow-up care or revision surgery which may be needed.

Ask the same questions as you would for cosmetic surgery in the UK. It's worthwhile checking what the regulations are in the country you intend to have surgery in, as well as qualifications for surgeons, doctors, nurses and other practitioners who may be involved with your care. Also, remember to ask about what happens about how any complications during your procedure will be handled, about aftercare, and about any revision surgery that you might need after your original procedure. How will this be provided once you have returned to Britain?

In addition, you will need to make sure that you are able to communicate with the your doctor and others involved in your care in order to ask questions and understand the answers, and you may need a translator. You should also check whether the doctor, hospital or clinic have insurance which covers your procedure and whether it takes into consideration that you are from another country.

It is also important to know that not all countries have the same regulatory framework as England so standards may vary considerably. Remember that the Healthcare Commission, which is responsible for regulating and checking private cosmetic surgery in England, does not cover procedures carried out abroad. Unfortunately, it will not be able to help you if you have any problems while overseas.

If you cannot obtain satisfactory answers to your questions then you should think very carefully about whether to go ahead. Cosmetic surgery abroad may be cheaper than in the UK. But it if you are not able to be confident about whether it is safe, then it could end up being much more expensive in terms of risk, revision surgery and pain.

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