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Cosmetic Surgery

How do You Choose a Cosmetic Surgeon?
by Mr. Nigel Mercer, BAAPS President- Elect and Consultant Plastic Surgeon

cosmetic_surgery1.jpgThe choice of your surgeon for a cosmetic surgery procedure really is one of the most important decisions that you will make. Not only will you be investing a considerable amount of time and money on correction of the feature, which you wish to change, but you will also be putting your trust and your safety in your surgeon’s hands. You will live with the result for the rest of your life.

So with that in mind, why is it that the public at large in the UK seem to have developed three misconceptions about cosmetic surgery.

The first is the opinion that every surgeon is as skilled as the next and that some procedures are not ‘Specialist’ operations. One of my own patients told me recently that she thought that a breast augmentation was no longer a specialist operation and could be done by any surgeon. That is like saying that any fully trained surgeon can put in a hip replacement. It is just not true.

The second is the belief that, if you go abroad the surgeon will have the same level of training and expertise as one trained in the United Kingdom and, as it is cheaper, there is no increased level of risk. Again, this is completely false. Would the same patients go to Eastern Europe or India to have a hip replacement or cataract removed just because it is cheaper? The answer is “almost certainly not”, so why have surgery that will affect your appearance based largely on cost?

The third misconception is the belief that the only ‘good’ surgeons work in London and more specifically in Harley Street. That is also not correct. Plastic Surgeons in the UK are trained by the NHS in Reconstructive Plastic Surgery, and only part of the training is in aesthetic /cosmetic surgery. At the end of their training, the surgeons are appointed to NHS consultanty position. All NHS positions have a specialist interest, such as burns, skin cancer, breast reconstruction etc and so a newly qualified surgeon applies for the position that best suits their training.  For example, I finished my training in London 15 years ago and the next position which fitted my skills was a consultancy position in west London, but an excellent position came up unexpectedly in Bristol, in the west of England. It was one of the most rewarding positions in the world for treating children with cleft lip and palate. So I left London, moved to Bristol and started to develop both my NHS and cosmetic practice. It does not mean that I am not as good a surgeon as someone who works in central London. A patient recently came to see me about removal of some moles and let slip that she was having a breast augmentation in London at a cost of £2,000 more than she would have paid had I done the operation in the West Country. She genuinely believed that the surgeon, some years my junior, was an expert simply because he worked in London.

Surgeons from all over the world fly in to work in “The Street of Shame”, as Harley Street has been called for decades. The motivation is that the name attracts patients, provides free advertising and potentially rich pickings. It is the case that some UK surgeons now follow the same path as our American colleagues and give up NHS practice to only work privately. ‘More’ does not necessarily mean ‘better’, and ‘less; means ‘unable to say how good the surgeon is’. No matter whom you see, you must ask the correct questions.

So how do you choose a surgeon?
Cosmetic Surgery is not designated as a specialty by the UK Government or by the Colleges of Surgeons. The only designated specialty whose surgeons receive training in all aspects of cosmetic surgery is Plastic Surgery but some surgeons from other specialties are trained in specific procedures and may perform these procedures to a very high standard. Bear in mind in most parts of the countrythat surgeons trained by the NHS now (and in the last 5 years) do not receive cosmetic training. All will know the theory, as it is part of their exit exam and many take it on themselves to get special training but that may be only 3 to 6 months. A newly qualified surgeon in the UK may be very inexperienced in cosmetic procedures, but systems are in place for junior plastic surgeons to perform procedures with senior colleagues while they move along their learning curve. Ask any surgeon you see what their experience is. It must be said that being a “Plastic Surgeon” does not guarantee expertise in cosmetic surgery.

No surgeon should perform cosmetic surgery with out being on the specialist register of the GMC (General Medical Council), which shows that they are fully trained in a recognised specialty. There are surgeons who ‘do a bit’ of cosmetic surgery, but in every surgical specialty designated by the Royal Colleges and the GMC there are recommended numbers of procedures a surgeon must be doing to be able to continue working in that specialty. Cosmetic/aesthetic surgery should be the same, but the UK Government refuses to regulate the business. In other European countries the trade is more closely regulated.

It is a very difficult area for patients and so please take advice and do your research.    

For more information contact BAAPS (The British Association of Aesthetic Plastic Surgeons) -  or the GMC (General Medical Council)


 
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