Seeking Advice - Finding a Surgeon

The British Association of Cosmetic Surgeons (BACS) suggests that patients can find a surgeon by:

1.Contacting the British Association of Cosmetic Surgeons directly.

2.Seeking a referral from their General Practitioner.

3.Getting a recommendation from another patient.

4.Contacting a clinic that advertises to the public.

Contacting the British Association of Cosmetic Surgeons

A list of recommended cosmetic surgeons can be found on the BACS website: www.b-a-c-s.co.uk. These surgeons will all be members or associate members of the BACS.

Most surgeons also have their own websites, which can be accessed from the Association's website. Prospective patients are thus able to find out more about a particular surgeon and/or procedure before making contact.

The General Practitioner

This is the system of referral advocated by the General Medical Council (GMC). It dates back from well before the inception of the NHS, when it was considered unethical for a consultant to accept private patients unless they were directly referred by their GE This was designed to stop unscrupulous consultants touting for patients and treating them inappropriately. However, many patients wishing to undergo cosmetic surgery prefer that their GP is not informed or aware of their intentions. There are many reasons for this.

Many patients are simply too shy or embarrassed to approach their GP for fear of being ridiculed or discouraged from treatment. Some do not wish to burden their overworked GP with a problem involving an element of vanity when he is already so busy with more essential medical problems. Same patients may have already seen their GP, who told them not to have any treatment, and so they would like a second opinion. Others may have been referred by their GP to a surgeon with whom they did not have a rapport and they would like to see someone else.

Many fear that their intentions will be made public because of the nature of the referral system. This necessarily involves the GP's staff who they fear may divulge their secret to others in their community.

Some patients admit to not knowing their GP and would prefer to bypass him altogether. Others are not registered with a GP. Some have openly admitted that they have little trust or faith in their GP and would not contemplate approaching him with such a delicate, personal and private problem.

Although more and more GPs are aware of the benefits that cosmetic surgery can offer and are entirely sympathetic and helpful, there are still a number who are less enthusiastic and who strongly try to dissuade any prospective patients.

Most cosmetic surgeons get very few referrals from GPs.

Recommendation from Another Patient

This is arguably the best and surest way of being referred to a surgeon who has at least proved that he/she is competent at performing the procedure. Most surgeons who do not advertise get the majority of their new patients by referrals from their old patients.

The drawback here is that most patients will not openly or freely admit to undergoing cosmetic surgery, so a prospective patient may not know whether any of their friends and acquaintances has had any surgery.

Clinics that Advertise to the Public

In recent years there has been a huge increase in the number of clinics, establishments and so-called advisory centres offering cosmetic surgery to the public. Many such places are run by non-medically qualified persons who regard it as a quick way of making easy money.

The reason why these establishments have increased in number over the years is that, until quite recently, it was an offence for medical practitioners to advertise their services and expertise to the general public. This could result in the practitioner being struck off the medical register.

It was, however, perfectly legal for a non-medically qualified person to set up a limited company offering cosmetic surgery services. This company could employ the services of a surgeon and anaesthetist as long as their names were not made public.

Thankfully, with the changes in GMC guidelines, the public is now able to get direct access to the surgeons, and therefore have a greater choice in selecting the one they wish to perform their surgery or treatment.

The BACS advises anyone approaching a clinic that advertises to the public to make sure they see the operating surgeon at a pre-operative consultation well in advance of the day of surgery. If the surgeon is not a BACS member, they should make sure they are treated according to, or along similar lines to, the BACS Code of Practice. In addition, it is important to find out about the surgeon's experience, qualifications, and proof of previous procedures performed (eg. pre and post-operative photographs of the surgeon's work, although it would be extremely difficult to prove beyond doubt that these were in fact photographs of his/her work), and to see as many testimonials from previous patients as possible.

It should be recommended that patients only be seen by the operating surgeon and not by any other party. Many clinics employ so-called 'counsellors' — often non-medically qualified sales people — to entice people into undergoing surgery. We strongly feel that such a practice is dangerous and can easily lead to patients being given misleading information, which can cause problems later on. Cosmetic surgery is a very personal and private undertaking and depends on a good patient-doctor relationship, without the involvement of any other party. Some commercial clinics are indeed well run and employ competent surgeons who successfully carry out a large number of cosmetic operations.

The BACS Code of Practice

Before admission to the Association each member must agree to abide by the Association's Code of Practice at all times. The Code does not purport to be a complete Code of Ethics of conduct and the Council of the Association specifically reserves the right to amend the code as and when it deems appropriate.

1.All patients seeking cosmetic surgery will receive thorough and meticulous pre-operative counselling with full information both verbal and written as is necessary for a full understanding of the procedure and its complications. In addition, patients will be asked to confirm in writing that they have received and understood such information.

2.The surgeons must use their best endeavours to make sure that if non-medically trained counsellors (or any other counsellors who are not members of the medical profession) are imparting advice to patients, then that advice must not interfere/conflict with the advice that has or may be imparted to the patient by the surgeon. The regulation applies to all pre-operative advice, post-operative advice and treatment. Where the surgeon becomes aware that there has been any interference/conflicting advice, then he/she must take immediate steps to re-affirm his/her advice to the patient.

3.Adequate time should be allowed between pre-operative consultation and the operation in order to give the patient every opportunity to consider carefully all the facts pertaining to treatment.

4.The Association recognises that adequate time may vary depending upon the type of surgery requested. The Association recognises that some patients may wish to have the operation on the same day as the consultation and, if this is the case, then the patient shall be asked to sign a form stating that the Surgeon has recommended that there should be an adequate lapse of time between the consultation and the operation, that the patient has understood the advice and has instructed the Surgeon to proceed on the same day as the consultation.

5.In circumstances whereby the Surgeon becomes aware that a patient may require an operation on the same day as the consultation then he/she must use his/her best endeavours to send to the patient all relevant information and literature pertaining to his/her operation/ treatment, some time before the consultation.

6.Surgery must only be performed in places that are properly equipped and staffed for such surgery. There are some clinics and organisations recommended by BACS, and Members must not carry out cosmetic surgery in clinics or organisations that are not on the recommended list. The list is constantly reviewed and updated and a Member may approach the Council at any stage and ask for a particular organisation/clinic to be placed on the recommended list. Provided three Members of the Council approve then that organisation/clinic will be added to the recommended list.

7.All members must ensure that any literature/documentation that he/she would normally impart to his/her patients relating to the Surgeon's speciality is constantly reviewed and, where appropriate, updated. All members will, pursuant to a written request from the Council, produce copies of the aforementioned literature/documentation for inspection by the Council within 14 days of a written request.

8.All members must only perform cosmetic surgery in the approved module(s) for which they have been admitted as Members of the Association. If a member wishes to extend his Membership to cover any other approved cosmetic surgery module in respect of which he/she has not been admitted as a Member then he/she must make the appropriate application to the Membership Committee to extend his/her category of Membership.

The British Association of Cosmetic Surgeons (BACS)

Cosmetic surgery is a relatively new surgical speciality in the UK and is not readily available in the National Health Service (NHS). Up until quite recently there was relatively little interest in this speciality. It was even frowned upon by many medical practitioners who regarded cosmetic surgery as unnecessary and frivolous.

Because there was little to offer in the way of surgical expertise in cosmetic surgery in the late 1970s and early 1980s in the UK, a group of surgeons, from various surgical specialities, inaugurated the British Association of Cosmetic Surgeons (BACS) in 1980. What united them was their interest in cosmetic surgery as a speciality in its own right.

The British Association of Cosmetic Surgeons was established to promote the study and practice of cosmetic surgery, to act as a forum for the exchange of information and ideas among its members and to promote and maintain the highest standards in this speciality. The Association has a defined Constitution as well as a strict Code of Practice, which all members must abide by at all times.

The Association has grown over the years but has never lost sight of its initial aims. The entry criteria, which have to be satisfied by all new members, are strict, and membership is an honour. Full membership is only granted to those who are Fellows of one of the Royal Colleges of Surgeons (FRCS), or hold the equivalent European qualification and have proven competence in cosmetic surgery. Competence is assessed by already established members of the Association who report their findings and opinions to the membership for final approval before admission to the Association.

In recent years the Association has opened its membership to include Associate Members. Associate Members are qualified medical practitioners but do not necessarily hold the same qualifications as Full Members. These practitioners engage in the regular practice of cosmetic procedures, but often those less complex than those performed by full members eg. hair transplantation, laser skin surgery or thread vein treatment.

The Association holds regular clinical meetings and encourages members to travel widely to attend seminars and conferences to keep up to date with progress in this speciality. All surgeons have to audit their work and undergo regular revalidation under the auspices of the General Medical Council and Royal Colleges.

We would stress that the British Association of Cosmetic Surgeons is not the only association or group of medical practitioners that practice cosmetic surgery in the UK. The British Association of Cosmetic Surgeons was however the first group of surgeons to be established in the UK, whose main dedication was to enhance the practice of cosmetic surgery and whose members performed cosmetic surgery full-time. There are other groups of surgeons and doctors, generally drawn from narrow fields, such as Ear, Nose and Throat (ENT), Maxillofacial and Plastic Surgery.

The Pre-Operative Consultation

The results of cosmetic surgery can be very gratifying to both the patient and the surgeon. Before you have any treatment, a consultation with the surgeon should take place, involving a full discussion without any obligation. All your questions should be answered satisfactorily and you should be given time to think over what has been said and what has been proposed.

In an ideal world, cosmetic surgery should consist of two parties only: you and the surgeon. After all, it is the surgeon who has the task of determining your expectations, performing the operation or procedure, looking after you post-operatively and taking full responsibility for all post-operative problems, complications or unfavourable consequences.

Without doubt, the single most important stage in any cosmetic surgical procedure is the pre-operative consultation. It is at this stage that all the necessary parameters are laid down. In addition, both you and the surgeon should form an amicable relationship based on honesty, integrity and trust. If such a relationship is not formed at this stage it is better in the long term for you to seek help elsewhere or for the surgeon to decline treatment because the likelihood of an outcome unsatisfactory to you is very much increased.

A consultation is essential because the surgeon also has to ask you about your past medical history in order to find out if there are any details that might influence an operation. When the surgeon knows more about you he is then in a better position to operate effectively and safely. The surgeon will normally communicate with your GP after the consultation, as long as you have given him permission to do so.

At the initial consultation the surgeon has a duty to decide if you have a problem that can be improved by an operation. Sometimes your feelings about what you look like are very different from what other people see. The best results in cosmetic surgery are obtained when the surgeon and the patient agree about the problem in the first instance. Then the surgeon has to ask himself whether there is an appropriate treatment that will improve it. It is obviously pointless to undertake a treatment that might not work or might even make things worse. In order to be successful, an operation has to be performed on the right person using the right technique.

Once the surgeon has decided that there is a treatment that will work, he should inform you fully about the operation and the post-operative course of events, such as when the stitches are removed and when you can expect to be 'presentable' again after the operation.

Cosmetic surgery is not invisible. But, by careful operative technique and the accurate positioning of the incisions, the scars can be almost invisible and only detectable on the closest examination. Patients on their part should realise that some skin heals better than others. This, of course, should be fully discussed in the initial consultation – as should all likely complications.

The more you know about the operation because everything has been carefully explained to you, the more likely you are to be pleased with the result. This initial consultation can take up to an hour, in order for the surgeon to tell you enough about the operation for you to be able to make a valid decision. The initial consultation is a mutual process: both you and the surgeon will be trying to assess each other. You will be trying to decide whether to allow the surgeon to treat you. Most surgeons these days hand out printed information sheets that can be studied carefully later.

There are three criteria that are important in this assessment process:

1. Does the surgeon understand the problem? Did he make the appropriate responses when you explained the problem? Understanding the patient's problem is vital, because if the surgeon never quite empathised with the patient, a successful outcome would be a fluke. You need to consider whether the treatment proposed by the surgeon is actually what you are seeking and whether it is relevant to your problem.
2. Did the surgeon prove to you that he can do something about it successfully? At consultation, most surgeons show photographs of previous patients, which should give you a good idea of what the surgeon is likely to achieve. You should ensure that the photographs are relevant to your own case If you are unconvinced by the photographs of the surgeon's previous patients, you should not go ahead.
3. Has anything put you off from wanting to be a patient of this particular surgeon? Sometimes the photographs reveal that the surgeon's and your ideas of what would be a successful result are radically different. Your judgement should not be solely determined by the reputation and qualifications of the surgeon. Not all surgeons are right for all patients and vice versa. To have a cosmetic operation performed by any particular surgeon is a very personal choice. It is important to establish a good rapport. If you are put off for any reason you should seek another surgeon.

The surgeon's job at the pre-operative interview is simpler. There is only one criterion: whether he thinks you are going to be pleased if you have the proposed treatment. If the surgeon feels that there is a significant risk of disappointment then he would be unlikely to offer it.

Of course, you may decide not to go ahead after hearing all about the operation. The consultation will still have been very valuable and saved you a lot of stress and worry — and money! There should be no pressure to come to a decision at the consultation itself. On the contrary, difficult decisions, such as deciding whether to have an operation or not, must not be rushed.

Most surgeons will offer you several consultations, anticipating that you will often only think of important questions that you wish you had asked after you have given the matter a good deal of thought. Some patients may wish to book their surgery at the initial consultation in a wave of enthusiasm, only to regret it later. Commercial clinics and greedy surgeons have certainly put pressure on patients to decide quickly and have offered inducements to do so. This is extremely unprofessional practice.

The surgeon himself should of course carry out the initial consultation, the surgery and all the post-operative care, and should be available to you at all times during the treatment process.

Some surgeons use computer imaging to illustrate or emphasise possible results or outcomes of surgery. This technique may work well and be successful for some surgeons and patients. Neither of us adopt this practice routinely, because we are only too aware that it is not always possible to accurately match the final long-term post-operative appearance of a part of the body by simply editing features on a computer screen. The human body does not always comply with the before and after pictures illustrated by computer graphics for reasons already explained. We therefore urge extreme caution to all patients who have experienced a consultation where computer imaging was used — the result shown may not necessarily match the result achieved by surgery.

It is a sensible idea to see a number of surgeons before going ahead with an operation. This makes it much easier to assess individual surgeons against each other, and to decide which surgeon would be most appropriate for you.

It cannot be stressed enough that the pre-operative consultation appointment is perhaps the most important part of the whole process of undergoing a cosmetic surgical procedure. The relationship between the patient and surgeon is of the utmost importance. To make the point again: beware of establishments that offer the services of such people, and no other adviser, so-called counsellor or any other party should interfere or be involved in the counselling stage.

Cosmetic Surgery Advice

Looking for cosmetic surgery advice about cosmetic surgery treatments? Then you've definitely come to the right place.

Cosmetic surgery treatments or procedures are capable of achieving almost totally unbelievable outcomes. Cosmetic procedures have certainly never been so sought-after and widely available as it is now, possibly because celebrity recommendation and endorsement has put the concept at the top of the wish list for everyone, not merely the rich and famous, but for average men and women also.

Nevertheless, regardless of whether you might be considering a straightforward Botox® procedure in order to iron out facial lines and wrinkles, a liposuction procedure to help alleviate problematic areas of excess fatty tissue, or possibly a much more significant procedure on your breasts or your face, a cosmetic surgery treatment should for no reason, ever, be undertaken lightly.

When an individual's anticipations are unrealistically high or maybe when an inexperienced cosmetic surgeon, employed by a less respected treatment clinic, is allowed to operate on an a naive member of the public, disappointment or maybe even a problem may occur.

It is crucial that the appropriate surgical treatment is performed for the best reason, on a suitable patient, by the perfect cosmetic surgeon. It is also essential that adequate time is dedicated to pre-operative counselling, in order that knowledgeable permission is granted in order that the patient is completely mindful of what to expect.

Cosmetic surgery advice is important to receive a thorough review of everything any individual considering a cosmetic surgery treatment or procedure will ever need to know; not only a fundamental comprehension of the benefits and dangers, but an in depth explanation - in simple English - of the specific procedures themselves.

We, all of us, inhabit a world whereby the majority of media coverage on the subject matter is usually either journalistic hype, business advertising or even outright scare-mongering and it is not easy to determine what to believe.

Discovercosmeticsurgery.com is a unique website. It is the website you can most certainly believe, which is a fundamental read for every woman or man considering cosmetic or plastic surgery treatments, and who needs accurate advice.

Discover more:

1. Cosmetic surgery advice

2. Internal bra system

Where is Breast Implants Surgery Performed?

Breast implants surgery can be carried out in a variety of different places.

Numerous diagnostic surgical treatments can be performed within an outpatient environment, as can breast enhancements, breast augmentations, lumpectomy, breast lifts, plus some breast reductions. Significant breast reductions as well as any form of breast reconstruction should be carried out in a medical center or ambulatory surgical facility that has suitable accommodation where one can spend the night time recuperating.

The Breast Cancer Patient Protection Act of 2004 demands insurance companies to pay for a minimum forty-eight hour hospital stay for patients undergoing a mastectomy.

Whether your own breast implants surgery procedure is going to be in a hospital setting, ambulatory surgical facility, or medical center, make certain the facility where breast implants surgical treatment is performed is actually fully accredited by a nationally recognized organization and/or is actually state licensed. This is necessary to ensure your safety.

In the year 2003,the American Society of Plastic Surgeons documented that sixty percent of aesthetic procedures were carried out in office--based medical facilities, twenty-eight percent had been done in a hospital environment, and sixteen percent within free-standing medical facilities. This included breast implants surgery along with other plastic surgery procedures.

Accreditation means an out-patient setting or hospital or surgical facility that has passed state regulations or national regulated requirements, not only for medical equipment, but also for architecture, procedural protocols and inspection. It must also strictly adhere to national, state and local regulations for sanitation, building codes and fire safety.