Choosing a cosmetic surgeon

For any member of the public, the array of surgeons and clinics offering cosmetic treatment is dazzling and often baffling. Yet the choice of a surgeon and hospital is the single most important decision for someone contemplating surgery.  It is worth considering the qualities one seeks in a surgeon, and clinic and then considering how best to find them. BAPRAS believes that at the heart of all these decisions should be safety and reliability.

A good starting point for any choice is your general practitioner.  He or she will have insights into local services and ofer impartial advice about surgery and surgeons.  Some patients are understandably reluctant to bother their GP with such requests, whilst others feel anxious their GP may be judgemental or regard their aims as frivolous.  This sort of attitude is very rare nowadays and the GP remains the patient’s best source of impartial advice as well as their advocate.

Personal recommendation is also important.  If the patient knows someone who has had a good experience with a particular surgeon that can be invaluable as a starting point, but be careful about comparing yourself too closely: like surgeons, all patients are individuals and all cosmetic solutions are particular to that patient at that time.  Personal recommendations should always be followed up with the checks below on the surgeon and the clinic.

As we have seen, all surgeons are individuals, and in this most artistic branch of surgery that is not a bad thing. But even so, your surgeon should conform to certain standards in order that you may feel confident that he or she will be well informed, up to date, well trained and, above all, put your safety and care as the first priority.  Many surgeons have these qualities, but in the UK not all offering plastic or cosmetic surgery are obliged to be comprehensively trained in the subject.  The General Medical Council (GMC) holds a register of such specialists and a good starting point is to check that your surgeon is on the GMC register as a specialist in plastic surgery (in which case his or her training will be comprehensive in terms of this surgery) or in a field of surgery directly related to your proposed procedure.  This can either be checked directly at the GMC website, or by direct questioning of the surgeon or clinic.  Most, but not all, such surgeons will have NHS consultant posts in the appropriate surgical area: the qualifications needed to get such a post are reassuringly rigorous

In addition, many plastic surgeons will display their membership of specialty organisations, one of which is BAPRAS This specialty organisation only accepts members fully trained in plastic surgery, and you may see the logo of the Association displayed on notepaper or other materia

Further checks can be done at the first appointment. It is perfectly acceptable and sensible to ask your surgeon about qualifications, and especially whether they are on the GMC specialist register.  Ask if they are members of a specialty organisation such as BAPRAS, and ask whether the surgery you seek is a normal and common part of their practice. They should notify your GP of the content of your consultation (unless you specifically ask them not to) and the intended course of treatment, and you may request a copy of that letter be sent to you, so that you can consider again the points covered and if appropriate, discuss them with family, friend or GP. In this respect it is often a good idea to have a friend or relative present at the consultation so that you can compare notes afterwards and share impressions before making a final decision

Next you must take a good look at the clinic.  Is it local to you or will someone propose you be operated on many miles away? Does it have other branches of surgery under the same roof: this is always reassuring as it implies  high standards of care and that the facilities will be more comprehensive than in clinics offering cosmetic surgery alone. Medical safety in cosmetic surgery is paramount: it is never essential or life saving surgery and so all risks must be reduced to the absolute minimum. For this reason comprehensive hospitals with experience in caring for a wide range of medical conditions are probably the safest available environments in which to have cosmetic surgery

You should also ensure that aftercare is readily available locally so that if you are unfortunate enough to have a complication after surgery,  your surgeon and their team are not far away

All good clinics will be happy to show you around their facility, and explain the aftercare arrangements, and the Independent Health Care Commission website will give informative data about performance and quality (see below).

Having followed the advice above, summarised in the text box below, of course the most important thing is that you feel confident personally with the surgeon in front of you and with the clinic you intend to be treated in. There is a wide choice of surgeons and clinics and if you are at all uncertain it is always worth seeking a further opinion and meeting another surgeon, before committing to a particular course. Again your GP may advise you in this.

Identifying a surgeon to consult
•  Word of mouth
•  GP recommendation

Checking the surgeon – what to look for:
•  Is he/she on the GMC specialist register? (click 'check a doctor's registration status' on the right hand side of the home page)
•  Member of Specialty Organisation, such as BAPRAS?
•  Experience in field? (ask)
•  NHS post in appropriate specialty? (ask)

Checking the clinic – what to look for:
•  Does it have a wide range of surgical specialties?
•  Does it have resident doctors tonight?
•  Does it have an intensive care unit?
•  Is there a high rate of infection with MRSA or other resistant “superbugs”?
•  Ask to see round the facility
•  Is aftercare provided locally?
•  Is there an Independent Care Quality Commission report available on the web?

Simon Kay