Quality Plastic Surgery – Is there such a thing?

12 April 2016/0 Comments/in General /by admin@staiano

A Quality Provider?

I believe there is a need for a provider of plastic surgery in this country that stands for quality.
There are many Plastic Surgeons who are doing good work, but most of them are working alone as sole traders.
There are only a few hundred full members of BAAPS (the British Association of Aesthetic Plastic Surgeons) in the country and the majority work in the NHS.
Whilst being a Consultant in the NHS is a marker for quality and one that I encourage patients to look out for in their Surgeons, the NHS work takes a lot of time and this means that many Plastic Surgeons cannot dedicate their time and energy to the private practice.
This has led to an increase in the number of commercial clinics and non-Plastic Surgeons who are providing plastic and cosmetic surgery to patients.
I left the NHS to focus not only on delivering excellent service, but on showing that I am delivering excellent service.
My clinic is a place that people can come and that they all know they will be treated at the highest level of expertise and ethics.

Unfortunately…

…the image of plastic surgery clinics is of glamorous sale assistants who will give you a sales pitch and then make it difficult for you to say no.
The perception is that a lot of clinics put profits before patients.
The ethos of the Staiano Clinic is simple – we are doctors first and because the clinic is run by a doctor (me), this culture is instilled from the top down.
We see patients who have a problem and we see if we can help with that problem.
The first step is to find out what that problem is.
There is always a physical complaint, but there is usually an emotional and psychological effect too and we need to make sure that by improving the physical we will also be helping the emotional and psychological side.
Occasionally, the psychological effects are more important than the physical effects, which is why we work with psychological counsellors to help us address these problems if they are present.
This is an important aspect as we cannot get away from the fact that cosmetic surgery is a very emotional issue and while we are not saying that there isn’t a physical problem, we must all recognise that the physical and emotional elements are firmly linked.

The next step is to see if we can help with the problem.

We make no promises that your life will be transformed or you will be able to get a footballer for a husband (as was recently suggested to me in a radio interview), but we will show you realistically what can be achieved and we will also talk to you about the limitations and complications of having surgery.
We are not trying to sell anything, we are trying to treat patients and give all of the risks and benefits so that they can weigh it up and make an informed decision.
When I am training junior doctors, I always tell them that you will never regret not operating on a patient and if we can make you think twice about having a procedure then maybe it is the right thing that you go away and take time to consider it.
We are all about getting happy patients and this is our number one priority.
We are not interested in sales. I am touched and moved by the positive feedback and reviews that we get and I am convinced this is because we always try to do the right thing and do what is best for you, even if that might mean not having surgery.
I really believe that we, as Plastic Surgeons, are doing the country a disservice by not raising our profiles and by allowing commercial clinics and non-Plastic Surgeons to dominate the market and give the industry a bad reputation.
It is a great atmosphere to work at my clinic because it is full of so many happy patients and advocates in this digital age with on-line reviews and reputations being so important.
I believe that once we get our message out there, we can help to turn things around and take away the guilt and stigma associated with plastic surgery and give it the reputation of something that can enhance, improves people’s lives and self-esteem and not something that is unnecessary, vain and unimportant.
If you would like any further information please feel free to contact us though our website, Facebook or Twitter. If you would like to subscribe to our quarterly newsletter, please click here.

New Year, Newsletter

4 January 2016/0 Comments/in General /by admin@staiano

The Staiano Clinic Newsletter is out

I am very proud to announce that the first Staiano Clinic newsletter is now out. I must say a huge thank you to Nicola who has put a great deal of work into making this idea a reality and well done for meeting the deadline for getting it out before Christmas.
My vision has always been to change the perception of plastic surgery as I feel that it is often misunderstood. There is a view that it is unnecessary surgery and I see many patients who have guilt over considering it as they feel it is somehow not worthy.

Would I ever have plastic surgery?

People sometimes ask me (in fact I was asked this afternoon) whether I would consider having plastic surgery. I understand why they ask the question and I always answer that I would consider it if I needed it in the same way that I would consider having orthopaedic surgery, heart surgery or any other sort of surgery, if I needed it.

Plastic surgery is not unnecessary surgery!

No one would have surgery if they did not need it and the concept that plastic surgery is sometimes not necessary is not one that I subscribe to. Medicine is all about improving quality of life and the operations that we perform in plastic and cosmetic surgery can have a dramatic effect on patient’s quality of life and self-esteem.

First class service and experience at The Staiano Clinic

I opened my own clinic two years ago with the goal of creating an environment where I could put my patients first and control the whole experience to give a first class quality of service with an ethical approach to the delivery of care. My focus has always been on making sure that each one of our patients gets the best possible result that we can give and this includes the support that we provide after surgery. In fact, we focus more on this than we do on looking for new patients. I have found that word of mouth marketing is the most effective way to build the business and I am always touched when patients come to me through recommendation.
The newsletter is a way for us to keep in touch with you and foster the environment where we can connect with you throughout the year so that you know that we are here for you if you have any questions or concerns at any time after your operation.

Would you like a copy?

If you would like to receive a copy of our newsletter, simply fill in this form and we will put you on our mailing list. Alternatively, you can email us at: info@staianoplasticsurgery.co.uk with your name and address. We plan to send out the newsletter four times a year to keep you updated with what is going on at The Staiano Clinic.
Things are moving fast here and we have expanded over the last two years and we are looking to expand further with our nonsurgical treatments such as Botox and fillers as well as a hair transplant surgery service and we are bringing in specialists in facial plastic surgery to complement the expertise in breast and body contouring that we already have.
There will also be news from the clinic with the spotlight on a member of staff in each edition as well as testimonial a month for which we will be giving away a luxury hamper.
We hope you enjoy the newsletter and watch this space for developments.
As ever, we would love to hear from you, so please feel free to get in touch and connect with us!

The Wild West

3 July 2015/0 Comments/in General /by admin@staiano

How to Avoid the Cowboys

I was talking to a journalist yesterday at BBC Hereford & Worcester and I realised that there are things that we as plastic surgeons take for granted but the general public are amazed to hear.
You can listen to my piece on the radio:
BBC Hereford & Worcester “ Elliott and Toni at Breakfast, 02072015
Unfortunately, the world of plastic and cosmetic surgery is still the wild west of surgery! There is no other branch of medicine which has been infiltrated by other doctors and practitioners who are not fully trained in the speciality.
If you needed a hip replacement, you would go to a orthopaedic surgeon.
If you needed a heart bypass, you would go to a cardiothoracic surgeon.
So why is the majority of plastic surgery in this country not done by plastic surgeons?
The reason is that you tend to look for a plastic surgeon by looking on the internet, which means that companies can spend money on glossy advertising which looks impressive but can hide the credentials of the surgeon or practitioner.
This means that the surgeons are often either not qualified or are not trained to the highest levels.

I was asked does your association campaign for regulation?

BAAPS (the British Association of Aesthetic Plastic Surgeons) have been campaigning for some time for tighter regulation in the cosmetic industry, and in particular reference to this story “ for regulation on who can purchase and administer dermal fillers.
The journalist at BBC Hereford & Worcester bought some dermal fillers from the internet and went to Worcester town centre and within an hour had the details of 3 people who were interested in having treatment.
This is a journalist without any medical training or qualifications at all. No one asked for her qualifications and there is no legislation that protects people from this.
You can hear the interview here.
BBC Hereford & Worcester “ Elliott and Toni at Breakfast, 02072015
We have been calling for tighter regulation on the qualifications of cosmetic practitioners and more stringent controls on who is able to give out these qualifications.
However at the moment, the industry remains largely unregulated with many self-proclaimed experts with little or no formal training or experience.
We would like dermal fillers to be classified as medicines rather than devices, which would mean that they would be restrictions on who could purchase and who could administer them.
We would also like there to be more regulation on who can perform cosmetic procedures including cosmetic surgery.
However, until there is more legislation, it is important that we educate the public in order to ‘avoid the cowboys’!

So what should I look out for?

If you are considering plastic surgery “ then it is important to look for the letters FRCS(Plast) after your surgeon’s name. You can find a list of fully qualified plastic surgeons on the websites of the British Association of Aesthetic Plastic Surgeons –www.baaps.org.uk or British Association of Plastic, Reconstructive and Aesthetic Surgeons –www.bapras.org.uk
I have written a book called ‘Never Accept a Lift from Strangers “ how to choose the best plastic surgeon for your cosmetic breast surgery’ which will be available later on in the year, so watch this space.

If you are considering a cosmetic treatment “ the majority of these are not performed by plastic surgeons.
Your practitioner should be a doctor or a senior nurse with the ability to prescribe medications (a nurse prescriber).
It is always best if you have a personal recommendation, but failing that, there should be evidence of positive testimonials or reviews and you should be able to speak to a past patient if you like.
They should be able to show you examples of before and after cases that they have performed and they should be able to go through all of the limitations and complications associated with the procedure (all procedures have potential limitations and complications). If you feel pressurised, or if things don’t feel right “ walk away.
You should be given enough time and space to consider whether treatment is right for you without feeling forced in to making a decision.
Please spread the word and feel free to share this on social media or amongst your friends and social circles.
Legislation may be some way away, so until then it is education that is the key to making sure that the public is protected and the industry can move away from the reputation of ‘cowboy practitioners’ who do not have your best interests at heart.

Never Accept A Lift From Strangers

25 January 2015/0 Comments/in General /by admin@staiano

Cosmetic Surgeons Should Work Within Their Scope of Practice

I am delighted to hear that the Royal College of Surgeons is highlighting the need to ensure that only fully accredited surgeons should perform cosmetic surgery. Unfortunately, cosmetic surgery is an area that people embark upon without considering the qualifications and experience of their surgeon. Cosmetic surgery is the only area of surgery where this applies.
There is a link to my radio appearance on my website here
No one would consider having a hip replacement with anyone other than an orthopaedic surgeon, or a heart bypass with anyone other than a cardiothoracic surgeon. However, plastic surgery is performed by general surgeons, GPs, dentists, dermatologists and surgeons who are not fully trained in any speciality at all!
Surgical training involves many years of working as a junior doctor before you are allowed to sit an exit exam which are designed to test whether you are capable of working without supervision. Only when you have passed these exams are you eligible to apply for a Consultant Post and start training other surgeons. You can tell if a plastic surgeon has passed this exam by whether they have FRCS(Plast) after their name. There are many surgeons who have not passed this exam and would not be eligible to perform surgery without supervision in the NHS, but who are operating without supervision in the private sector. There is no regulation to prevent this.
Even amongst plastic surgeons, there are subspecialities and we all have certain areas that we regularly treat “ some specialise in the head and neck, others may do burns or cleft lip and others specialise in the breast. However, many plastic surgeons tend to operate on all areas of the body in the private sector.
This is something that I feel particularly strongly about and I am writing a book about it entitled:

Never Accept a Lift from Strangers “

How to Choose the Best Plastic Surgeon for your Cosmetic Breast Surgery

I also have an Ebook that you can download with the 5 Questions that you should ask your surgeon to ensure that he or she is a fully trained plastic surgeon. You can download it here
For the last 7 years or so, I have specialised in breast surgery and body contouring. I do not do facelifts, nose jobs, botox or fillers. I do not work outside my scope of training and this gives me a depth of experience that could not be achieved if were to offer a wide range of treatments. I believe that facial cosmetic procedures should be left to people who have an interest and expertise in that area “ it is not something to dabble in.
This is exactly what the Royal College Surgeons are calling for “ that surgeons should only operate within the field they have been trained in. Listen to it here
Staiano Plastic Surgery is my clinic and I own and run it. My special interest is the breast and body, but I have other specialists that work with me with their own scope of practice including facial plastic surgeons, skin specialists and non-surgical experts. Until we have regulation to prevent untrained doctors from performing surgery, it is up to us to continue to educate the public about what to look out for so that you can know the qualifications and experience of your surgeon.

The benefits of Botox

29 September 2014/0 Comments/in General /by admin@staiano

Botox has increased in popularity in recent years and has become a safe and convenient way to reverse some of the effects of ageing. Botox relaxes the muscles in the face where frown lines can occur and it is most commonly used in the area between the eyes “ known as the glabellar. Botox is also commonly used to remove the lines which appear at the sides of your eyes, known as crows feet.

If you are thinking about having botox, here are the three top benefits to having this kind of cosmetic treatment.

1. It’s quick and convenient
Botox is administered through a syringe and is therefore a non-surgical procedure. It can be administered on the day of your consultation and the positive effects can be seen within a few days. A medical will be done on the day of the treatment to check you are suitable. If you are a suitable candidate, the treatment can be applied immediately.

2. Anaesthetic is not needed
Anaesthetic is not needed because the needles that are used are very small and most botox users report minimal to no pain. If you are particularly sensitive to needles, then an anaesthetic cream can be administered to numb the area before, although this is rarely necessary.

3. You will have an instantly youthful appearance!
None of us can escape the natural process of ageing, but if you have spent a lot of time in the sun, or perhaps you are a smoker, then the lines on your face may be appearing quicker and more prominently than you would wish. One of the reasons botox is so popular is because it has remarkably quick and noticeable results. The effects also usually last from 3 to 6 months.

Staiano Plastic Surgery is delighted to announce we are offering botox and other cosmetic treatments as part of our non-surgical procedures, please read here to find out more about our new services or call us on 0121-454 3680.

Free Consultations or No Free Consultations?

15 March 2013/0 Comments/in General /by admin@staiano

Should We Offer Free Consultations?

This is a question that has divided plastic surgeons.

The argument for free consultations

On the one hand, patients may feel that they may not strike up a rapport with the surgeon or the surgeon may not be able or willing to give them the result that they are aiming to achieve and so they do not want to risk paying a consultation fee if they are not going to go ahead with surgery at that facility. It is important to get a feel for the place where you are going to be treated and to make sure that the staff are polite, attentive and professional “ this applies not only to the surgeon, but also to the rest of the outpatient and hospital staff.
First impressions are important, and if you don’t get a good one, you may regret paying £100 or more for the privilege, which is why we offer a ‘satisfaction guarantee’ which means that we will refund your consultation fee in full if you feel that your consultation has been unhelpful or if you are not suitable for surgery.

The argument against free consultations

On the other hand, many surgeons feel that they should be paid for their professional opinion and we have costs such as secretarial fees, consulting room rental and medical indemnity that have to be covered. Furthermore, there is the concern that patients are less likely to attend the appointment if it is free as the value is cheapened when patients are not paying. There is also a concern on the wider scale, that some clinics may be offering free consultations in order to attract patients and then using ‘hard sell’ tactics to encourage patients to undergo procedures. There should never be any pressure or incentives given to make patients feel that they have only a limited time to make a decision on what is often a life-changing event.

Why we charge for the initial consultation

I can see both sides of the argument. They say that there is no such thing as a free lunch, and so if clinics are going to offer free consultations, then they will presumable expect a significant proportion of patients to go ahead with a procedure. This is something that we really try to avoid. I think that it is important to see every patient and give them the best advice. We are doctors first and there must be no suggestion that any decision that we make, or advice that we give, has been given with any pressure or agenda, other than the patient’s best interest. A good consultation is one where the patient has left feeling supported, informed and educated, whether or not they choose to have surgery.
We do charge for consultations and will give you our professional opinion and as much time as you need. We only charge for the initial consultation, and so you can come back and go over things as often as you need if you have questions or queries. In fact I encourage you to come back for a second consultation to go over things. We do not charge for follow-up consultations. We also give patients our email address if they have any questions or concerns that we can answer by email. You can ask us about our qualifications and experience and we can talk about your expectations and whether surgery might be able to fulfil your goals. You will only see your surgeon, there will be no sales people or patient advisors and there will be absolutely no pressure to proceed with anything. If you think that surgery might be right for you and you would like to go over things again, then you can come back and see us as often as you need for no extra charge. We also offer a cosmetic surgery counselling service which allows you the opportunity to talk to someone about your feelings and your goals who can give emotional support with, what is often, a life changing decision.
Our initial consultation fee is from £100 and consultations are held in our boutique plastic surgery clinic in Edgbaston.
You can book an appointment online or get in touch with us here or by calling 0121-454 3680. We would love to hear from you.

How to choose a plastic surgeon

17 February 2013/0 Comments/in General /by admin@staiano

When choosing a plastic surgeon and deciding where you are going to have your procedure undertaken there are important points to bear in mind.

Believe it or not, there are surgeons out there performing plastic surgery who are not fully trained in plastic surgery. There are currently no laws against anyone performing your surgery and so your dog has better protection that you have! Get a copy of my book to find out the facts.

Ask yourself these questions while you do your research:

Is the plastic surgeon fully trained?
Do I trust this surgeon?
Do I like the hospital?
Are the staff friendly?
Will the plastic surgeon look after me if I suffer any complications or have an unfavourable result?

Is the plastic surgeon fully trained?

This information can be easily obtained over the internet. A fully trained plastic surgeon is one who has done a period of recognised training leading to the award of a Certificate of Specialist Training (CCT). In order to apply for a CCT, surgeons will have had to have passed the intercollegiate specialty examination in plastic surgery at the Royal College of Surgeons. Once surgeons have passed this examination, they are entitled to use the letters FRCS(Plast) after their name.

Note, there is a big difference between FRCS and FRCS(Plast). FRCS (more recently MRCS) is a basic surgical qualification and is achieved after undertaking a period of general surgical training and passing general surgical exams. In order to become a fully trained surgeon, then you must undergo a further period of specialist training in your chosen speciality. For plastic surgeons, this involves a further 6 years in higher specialist training and it is only after that that surgeons can apply to take the exit exam and hope to be awarded FRCS(Plast).

Other surgical specialities have different letters after their name eg (Gen) for general surgery, (ORL) for ENT surgery, (Orth) for orthopaedic surgery and so on.

What are the differences between plastic surgeons?

All plastic surgeons tend to sub-specialise. Some will concentrate on facial reconstruction, others will operate on burns patients and some will focus on hand surgery. It is not unusual for a plastic surgeon who mainly performs hand surgery in the NHS, to perform some breast surgery in the private sector, as all plastic surgeons have received broad training.

In 2007, Mr Staiano chose to concentrate on breast surgery and so no longer performs any hand surgery or facial work, which allows him to keep up-to-date with the latest techniques and gives him the benefit of a broader and more extensive experience than those who focus on different areas.

What is the difference between a breast surgeon and breast plastic surgeon?

The two should not be confused as the same thing. Breast surgeons are surgeons that have been trained in general surgery and then sub-specialised in breast surgery. They deal with the investigation and treatment of breast disease and breast cancer. Plastic surgeons who specialise in breast surgery, tend not to be involved in the treatment of breast cancer, although many do work with breast surgeons and perform breast reconstruction following mastectomy or wide local excision. There are a group of breast surgeons, who have undertaken extra training in reconstruction and may offer breast reconstruction as well as treatment of breast cancers, these are known as ‘oncoplastic’ breast surgeons.

Breast plastic surgeons are dedicated entirely to breast plastic surgery.

What about surgeons who have trained in other countries?

It is not uncommon for doctors from overseas to come to the UK to work and gain experience. This can benefit both the overseas surgeon and the health service in the UK as it can bring a diversity of experience. However, training schemes abroad can differ to ours in the UK as the hierarchy can differ. In some countries, the health service is run by a professor with other consultants working under him. In the UK, once you become a consultant, you are expected to be in charge of your own patients and so UK consultants are trained to a very high standard and are capable of independent practice. It is difficult to assess the level of training of an overseas surgeon and so more research or caution may be required.

What about surgeons who are NOT registered?

It can be difficult to find your way through all of the qualifications that doctors possess. A doctor may say that he or she is registered with the GMC, but this is a basic prerequisite to practice medicine in this country and is no guarantee of training. A doctor may say that he or she is a member or fellow of the Royal College of Surgeons (MRCS or FRCS), but this just means they have completed basic surgical training.

If you want to make sure that your surgeon is fully trained in plastic surgery, then look for the letters FRCS(Plast) after their name or go to the BAPRAS (http://www.bapras.org.uk/find_a_member) or BAAPS (http://www.baaps.org.uk/component/surgeon/search/120/init/1) websites for a full list of doctors registered with these organisations. Membership of BAPRAS and BAAPS is only open to fully trained plastic surgeons.

Do I trust this surgeon?

Once you are happy with their qualifications, it is important to look at your surgeon’s portfolio. In your initial consultation ask to see photos of recent work including before and after photos. Also ask to speak to one of your surgeon’s former patients and ask them about their experience and how they feel about the outcome. Another way to find out about your surgeon is to look them up on forums. A good place to start would be the following forums:

www.realself.com/breast-augmentation/forum
http://www.sofeminine.co.uk/beauty/cosmetic-surgery-sr14.html

More than anything though, it’s how you feel about your surgeon once you have met him/her. You will know after your first consultation if you can get along together. It’s very important that your surgeon takes time to listen to you and treats you as an individual. Breast plastic surgery is a major decision and there is no one procedure that fits all. It’s an operation with associated risks and you must be sure that you are in safe hands.

It’s also a good idea to take a family member or friend with you when you first meet your plastic surgeon. A second opinion is very important. Also give yourself time to think about it. A professional surgeon will never force you into signing anything or encourage you to make rash decisions. Shop around, do your research and always give yourself time to think things through.

Do I like the hospital?

Unfortunately some plastic surgery organisations will do the consultation in one hospital or clinic but then carry out your procedure in another hospital. It’s really important that you try and visit where your treatment is going to take place. Ask yourself these questions: Is it clean? Are the reception staff friendly? Are they organised and on time? Do they have all your paper work in order? These will be good initial indicators that a hospital is organised and will ensure that your patient journey with them runs smoothly.

Are the staff friendly?

This is so important. You need to feel at ease throughout your treatment and it’s important that you have empathetic, friendly staff helping you along. Ask to meet some of the nurses and staff at your initial consultation. Ask them a few questions about what their role in your procedure will be. It’s easy to see if staff are friendly or not in the first meeting and initial conversations with them. Remember, you are paying them a lot of money and good customer service is the least you deserve.

Will the plastic surgeon look after me if I suffer any complications or have an unfavourable result?

This is extremely important. As we have seen with the latest PIP controversy, many cosmetic surgery organisations do not have a patient focussed aftercare plans. There has also been a lot of press about companies offering cut-price cosmetic surgery at home and abroad and not dealing with adverse or unfavourable outcomes, leaving the patient having to seek help from their GP and the NHS.

Whilst major complications are rare, there can be minor imperfections and it is important that your surgeon will see you through these and offer you revisions if necessary.

Make sure the after care plan ensures that your surgeon will look after you if anything goes wrong. Also ensure there are no hidden clauses about extra payments and find out how much your surgeon charges for follow ups. It can become very expensive if your surgeon charges you for every meeting after the surgery. Again, do your research thoroughly and take your time. You need to make sure that you are in safe, experienced hands and that you are with a practice that will not charge the earth if something goes wrong.