No one goes in for cosmetic surgery for fun – so read the hard facts first, and only then make a decision.
We’ve seen wonderful results from cosmetic surgery, and we’ve seen dreadful ones. We’ve heard stories from patients who are delighted and we’ve talked to those whose lives have been put in jeopardy. On the positive side, one recent British study revealed that cosmetic surgery improved the lives of a majority of those who had psychological problems, large or small, as a result of their appearance.

The most important factor you must bear in mind is this: whether you are contemplating skin peeling, a face lift, liposuction or having your teeth crowned, surgery is an invasive procedure which carries risks – some potentially life-threatening. No one will embark on it as if it were a hairdo, but do read our guidelines on choosing a surgeon, and when you go for an initial consultation, remember it’s your face, your body, your life you are entrusting to this person. What’s more, you are paying the piper – usually a lot since cosmetic surgery is almost always private – so make sure you call the tune: be thorough but not aggressive with the surgeon. Establishing a good rapport with him/her is essential.

There are three principal ways to find a surgeon:

1. Ask your doctor, but be aware that many won’t know either the best person to go to or the most appropriate procedure.

2. Ask friends for recommendations.

3. Ask your doctor to get a list of consultant plastic surgeons from the British Association of Plastic Surgeons (BAPRAS). Or apply yourself to the British Association of Aesthetic Plastic Surgeons (BAAPS), which provides lists of members to the general public, and then make an appointment for an initial consultation. If you are not happy with the first surgeon, consult another surgeon before making a decision.

Make sure that whoever you choose is a fully accredited plastic surgeon and that they have experience and interest in cosmetic (as well as reconstructive) surgery. We do not recommend you approach the clinics who advertise in the back of magazines. However impressive they sound – and many may be – some have been exposed as having unqualified staff and/or poor facilities, which have had life-threatening consequences for some patients.

When you meet a surgeon, he or she will be interviewing you to see that you are in the right state of mind – too anxious and they may consider you unsuitable for surgery. It is also important for you to interview him or her, to see whether you get on, whether they listen and if they seem to understand you and your hopes. Find out your surgeon’s qualifications and training, how long they have been practising and where, and exactly what can be done for you. Many surgeons say that the most important attribute is the ability to draw and model in clay. Groups of dedicated surgeons actually spend their spare time in art galleries and museums, studying the human face and body.

A surgeon may try to impress you with computer video-sculpting, showing what you could look like by computer mock-ups. It looks flashy but it’s really only useful for the surgeon to play around on. Most condemn it as a selling technique when shown to patients. Some patients like to see before and after pictures of previous patients. These are fine as a point of comparison, but bear in mind that you will never be shown the ones that have gone wrong.

Although there are worthwhile new techniques, such as the endoscopic brow lift (see opposite), complex and/or innovative procedures are not necessarily the best. You want the surgeon to do what he/she is experienced at and what is appropriate for you, not something he/she is longing to try out. Remember that no wise surgeon can or should guarantee a specific result.

A thorough initial consultation (make sure to check the fee for this when you book) should include counselling to ensure you are really ready to go through surgery, and detailed information on the procedures, possible complications, pain relief and recovery times. Many surgeons now prefer to operate without a general anaesthetic, using instead deep sedation or local anaesthesia so that patients don’t suffer grogginess or hangovers. In this way, you can be in and out in a day for some procedures.

Always confirm costs at this stage and see how many follow-up visits are included (some surgeons see you up to 12 months later; some even longer). If you decide to go ahead, you will be asked to sign an informed consent form; read it carefully. Make sure your chosen surgeon is comprehensively insured. (Roughly one in a thousand patients sue their surgeons, a BAPS source revealed.) The two leading UK insurers are the Medical Defence Union (MDUand the Medical Protection Society (MPS).