Why does breast reduction cost so much?

If you think that breast reduction costs a lot then it is important to put it into perspective.

Some patients put breast reduction into the category of cosmetic breast surgery and think of it in the same way as other operations like breast augmentation.

Any cosmetic surgery is a major undertaking both physically and psychologically because you are changing the way you look.

However when it comes to the extent of surgery, breast reduction can be a significantly bigger procedure than breast augmentation.

When taking in to account breast reduction cost, you have to realise what is involved.

Breast augmentation surgery takes about an hour in theatre whereas breast reduction takes three hours in theatre.

If you have ever seen the inside of an operating theatre (check out my video), you will see that there are 5 to 10 members of staff at all times all of whom have specific areas of training and expertise.
Not to mention what goes on in the background to keep a hospital running with all the administrative costs and overheads.

There is usually at least a one night stay in hospital and this will all be covered in the one-off cost that you pay.

I sometimes notice that my colleagues think that we as plastic surgeons get paid a lot because they see the headline rate that we receive when doing surgery.
However there is a big difference when working in the self-pay market compare to the insured market.

Whilst the cost of breast reduction is significant, it is a one off payment and all aftercare, outpatient visits and follow-up appointments are included in the price.

My colleagues who do insured work get paid for every intervention.

If they see you in the clinic, if they perform an x-ray or other tests, or if they have to perform any other procedures “ they will be paid at every stage.

After performing a breast reduction, we will see you in the clinic on a regular basis to ensure that your wounds heal, your scars soften and the shape of your breasts settles.

We want to make sure that you are happy with everything.

Furthermore, we will continue to see you in the clinic if you ever have any problems or concerns at any time.

There may be some patients who need very little input from us but there are others for whom this will be invaluable.

It comes down to how much value you get from a procedure as to whether it is worth the cost.

Breast reduction can be life changing on several levels:

  • on a physical level by removing the weight from your chest, reducing back and neck strain and not having your bra straps digging in.
  • on a practical level by allowing you to shop on the High Street for bras and be able to wear the clothes that you want to wear.
  • and on a emotional level by feeling in proportion and more comfortable with your body and improving self esteem and self-confidence.


It is hard to put a price on this.

I understand that breast reduction cost is a major determinant when someone is choosing surgery but I don’t think it should be the only one.

Here at The STAIANO Clinic, we are very aware that many other clinics offer the same procedures and we need to be competitive.

I have built the clinic so that we can compete on a worldwide scale when it comes to the qualifications of us as plastic surgeons, the level of care and treatment that we give and the time and space that we give you as an individual patient.

Not to mention the aftercare that we offer.

It is hard to do this and still be able to compete on price and so I realise that if you shop around, you will be able to find surgery cheaper elsewhere.

Whilst we can’t always compete on price, I know that we can compete on quality.

If you want to find out more you can download our guide with some frequently asked questions here or call us on (0121) 454 3680

You can also read more by visiting our Breast Reduction page.

If you want to know what a breast reduction costs at The STAIANO Clinic, then click here and we will send you not only how much it costs but also what we offer for that cost.

As always feel free to comment and if you have any questions you can find me on Facebook with a live Q&A every Tuesday at 7 pm


How to treat Breast Asymmetry

We specialise in breast reshaping here at the STAIANO Clinic and can perform breast lifts, breast reductions, breast implants and breast lift with implants.

There are many cosmetic clinics which offer breast implants but not all will treat patients with more complicated problems.
Patients with breast asymmetry will often present for surgery.

The first question we would ask is:

Are you happy with either of your breasts or do you want them both changed?

If we can just operate on one side then this will lower the risk of complications and be beneficial for all.

It may not always be possible to just operate on one side, particularly if one breast is sitting lower than the other one with uneven heights of the nipples.

It is possible to lift the nipple, but it is not possible to lower a nipple (at least not without leaving a scar where the nipple was). So we can raise the low one, but is extremely difficult to lower the high one.

The next question to ask is:

Is there a problem with the shape, the volume or both?

In general terms, problems with the shape involve a breast lift and problems with the volume involve breast implants or breast reduction, (depending whether you want them bigger or smaller).

Surgery for breast asymmetry usually involves a combination of breast implants, breast lift and sometimes breast reduction.

Different things need to be done to each breast and so there is always a risk that they will settle differently and you may have to accept some degree of asymmetry.

Everybody is born with a degree of asymmetry and this is quite natural.

What we aim to do with surgery for breast asymmetry is to bring your breasts and your frame back into balance and make it easier for you to wear clothes and bras without needing to use a chicken fillet or external prosthesis in one side.

If you have different size breasts with one sitting lower than the other (usually the bigger one), you could have them made the same size by using different size implants.

The implants come in set volumes and so we would be unlikely to make them identical and would usually need to use a sizer in theatre to work out the best match.

The implants would not do anything about the shape of your breasts and so one would still be sitting lower than the other.

This would probably not be in issue when wearing clothes but may be an issue out of clothes.

In order to correct this you would need a lift of the breast that was sitting lower, which is usually the bigger one and so it would also be possible to perform a reduction at the same time as the lift to balance out the volume.

Then we could use the same size implant in each side.

This is something that we could discuss in the clinic and there is no right or wrong answer.

Some patients would prefer not to have breast tissue removed and then replaced with an implant and would prefer different sized implants.

Others would rather have a reduction to match the size and the same size implants so as you age or undergo weight fluctuations, it is more likely to have a symmetrical change in your breasts.

Treatment of breast asymmetry is complicated and requires a bespoke approach and a partnership between the surgeon and the patient so that a plan can be made that can produce a realistic expectation with acceptable risks and an acknowledgement of the limitations of what we can do.

If you have a breast asymmetry and have any specific questions then I do a live Q&A every Tuesday at 7pm on Facebook and I would be happy to give my opinion.
If you want to come to the clinic for a consultation then you can contact us here or phone (0121) 454 3680. We would love to see you.

You can download my breast implant guide here.

You can download my breast reduction and breast lift guides.


Cosmetic surgery is never just cosmetic

It’s good to see the news article about Simona Halep who has just won the ladies Wimbledon singles final.

She credits a breast reduction to be part of her success.

This was featured in an article in the Daily Mail in 2014 where one of my patients spoke about here experience – you can read it here.

You see, while she never liked the size of her breasts, it was also interfering with her ability to play tennis.

You see cosmetic surgery is never purely cosmetic, or at least not very often.

¦when it is done well.

We see patients who enjoy horse riding, running and we have a haute couture fashion model

¦but we also have mothers and wives who just feel uncomfortable or unhappy with their body shape.

Contrary to popular opinion most people don’t want to walk into a room and attract unwelcome stares and attention.

They just want to feel comfortable in their body physically and psychologically and that is what cosmetic surgery can do.

It brings psychological benefits as well as physical benefits.

You don’t have to be championship tennis player to understand the benefit of having 2kg of breast tissue removed from your chest or 3kg of an abdominal apron removed from your tummy.

It is good to see cosmetic surgery reported with a positive light because all too often, the media portrays cosmetic surgery as creating some freakish caricature of a body.

Most people who come to our clinic, walk out of the clinic looking the same or similar to how they looked when they walked in.

Perhaps they are not needing to wear ‘chicken fillets’ in their bra, or they don’t have to wear baggy jumpers anymore

¦or maybe they just look a bit less tired and more refreshed.

Their friends might think they have had their hair done or changed their make-up, when in fact they have had a blepharoplasty or botox.

It is about making people feel more comfortable, whether they are playing championship tennis or going out for lunch.

¦and that can only be a good thing, right?

If you have any questions about cosmetic surgery, I am available every Tuesday night at 7 pm for a live Q&A on Facebook.

Click here to Download our guide with Frequently Asked Questions about Breast Reduction

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When can I go back to work after surgery?

 The major surgery which we do at the Staiano Clinic, such as breast augmentation, breast reduction, breast lifts, gynaecomastia and tummy tucks have a dramatic effect on your body both physically and mentally and you should allow enough time to recover from them.

Surgery often involves tightening or stretching the skin, so it can feel tense and swollen for some time and you should avoid exerting yourself.
Not only does this run the risk of putting tension on the wound and the possibility of the wound not healing up as well as we would like, but it will also increase the swelling and the swelling can take some time to subside.

If you overdo it in the early stages then it can be a false economy in the long run and you would have been better off giving yourself more time to let things settle to start off with, and although cosmetic surgery has an image of a lunchtime procedure with no downtime, if you are seeking a dramatic change in the shape of your body then you should expect and plan for a period of rest and recuperation.

The First Week

The first week after surgery is always uncomfortable.

Everything feels tight and tender and you will not feel like doing much.

You will be able to potter around the house and look after yourself, but you should plan for little more.

After the first week you will come back to have the dressings removed and you usually do not need any dressings after this time.

However, everything will still be quite fragile and you should continue to take things easy in the second week, although you may be able to work from home for short periods.

Depending on the procedure you have had done and how you are feeling, you should be able to drive after two to three weeks although occasionally you are able to drive after one week.

You should always check with your car insurance company to make sure you are insured and talk to us as we will be able to guide you.

Every individual is different and you should listen to your body, so that if things are uncomfortable or start to swell, then you should ease off and rest.

It is important not to be too immobile and we always encourage you to keep your legs and arms moving, either by walking around or gently exercising while sitting, as well as taking deep breaths to expand up your lungs.

We encourage you to cough if you feel like you have anything on your chest.

After Two Weeks

After two weeks you may be able to resume gentle activities and you may be able to go back to work as long as it is not too strenuous.
If you have had surgery to your upper body, now is the time you can start exercising your lower body on the exercise bike or the stepper at the gym, but you should avoid too much activity with your arms.

Two To Four Weeks

Between two and four weeks you will start to feel better, although the scars will still be quite fragile and the tissues will still be quite swollen.
We normally advise people to wait at least four weeks before starting to massage their scars with cream, as they might be quite red and firm at this stage.

Four To Six Weeks

After around four to six weeks you can start engaging in more strenuous activities including heavy lifting or upper body exercises at the gym.  I would stress that this is the time to start these activities which does not mean that you should go straight in, doing the same level that you were pre-operatively.  It is merely that you can start to gently see how you feel and gradually build up.  If it is uncomfortable or the tissues swell then you should stop and give yourself more time to rest.

Three Months

It takes about three months before the shape and the scars really start to settle and there can be numbness or altered sensation, which can take many months to subside.

Twelve Months

At around twelve to eighteen months, you will be getting an idea of what the final results should be like, but it is not uncommon to still have some degree of settling after this.

We keep a close eye on you in the clinic and encourage you to get in touch if you have any concerns about how you are healing.  We realise that everyone is an individual and this is just guidance.
If you have any questions or concerns then we’d love to hear from you.  You can e-mail us or call us.
Or you can ask our director, Jonathan Staiano, a question LIVE on Facebook at 7 o’clock every Tuesday evening, so feel free to drop in.

Treatment for Breast Asymmetry

Treatment for breast asymmetry

All patients have a degree of breast asymmetry to a greater or lesser extent and when performing a breast reduction or a breast augmentation it is often possible to correct minor degrees of asymmetry, but we always warn people that there will be some residual asymmetries as it is quite natural to have differences between the two halves of our body.

It is cases of severe breast asymmetry that can pose a challenge and often require a little more thought and planning.

The first question to ask if you have a breast asymmetry, is whether you are happy with one of your breasts.

If you are happy with one of your breasts then it might be possible to just operate on one side to try and make that breast look like your ‘good’ breast.
If you are unhappy with both your breasts, then you may need surgery on both sides.

The next question is whether it is the size or the shape, or both the size and the shape that you are unhappy with.

If it is just the size that you are unhappy with and both breasts are of an acceptable shape, then it will be possible to make the big one smaller by doing a breast reduction or the small one bigger by using breast implants and sometimes and combination of these is required.

Breast implants are very effective at increasing the size of the breasts and although they come in a variety of different shapes and profiles, they do not have a dramatic effect on the shape of the breast.
If it is the shape that you are unhappy with, then your best option would be a breast lift (or a breast reduction if you wanted your breasts to be smaller).

As you can see, surgery for breast asymmetry can often be complex involving a variety of techniques including breast implants which often have to be of different shapes and profiles to give different effects to each breast, breast lifts, and breast reductions.

Whenever different surgery is done to each breast there is a risk that as you age, the breasts will settle differently.

If one breast is smaller and has an implant in, but the other side does not have an implant, then it is likely to be more pert and have a fuller look than the opposite side which is made up of breast tissue, because breast tissue will naturally droop or sag as the years pass.

This is where conversations come in where some patients might want a reduction of a bigger breast to match the volume of the smaller one and then to have the same size implants put into both so that they age in a similar way.

However, this then does bring in the complications associated with implants into a breast that may not have needed them.  It is swings and roundabouts.

Plastic surgery is really an art more than a science

and so there is often no easy answers in these situations and it requires a full and frank discussion with your surgeon.

You need to spend time exploring all of your options and will often have to accept that there will be a degree of asymmetry whatever surgery you have.

The aim of surgery is usually to restore symmetry as best as possible to make you balanced while wearing clothes and sometimes out of clothes you will still see some asymmetries and these are often magnified because you have lived with a more significant symmetry in the past.

I think it is important to realise at the beginning that all patients have a breast asymmetry to some degree, so it is usually a case of bringing it back into normal limits rather than achieving perfect symmetry.
We look at the consultation as a partnership between us and you and while we will help and guide you through the process, we will always aim to come to a mutual decision as to what might be the best option for you.

Don’t worry if this does not come in the first consultation.

It often takes two, three, or more consultations before you come up with a clear plan and that is why we only charge for the initial consultation because we want you to feel that you can come back as often as you need to go over things and make sure that you are happy with the plan.

As ever, it is always important to wait until your breasts have stopped developing so ideally you should wait until you are at least 18 before having surgery for breast asymmetry and you should also be happy and stable with your weight before having your breast asymmetry corrected.
You will need to be aware that as time goes on, particularly if you put on weight or have children, your breasts can change and so we always offer all our patients unlimited follow ups in the future because we know that life can be unpredictable.

For more information please download one of my guides and if you would like to arrange a consultation with us, the only plastic surgery clinic in the UK that specialises in breast surgery, call us now to arrange a consultation so that we can go over all of the possible options.

What Is The Minimum Age For Cosmetic Surgery?

How Young Is Too Young To Have Cosmetic Surgery?

We often get enquiries at the clinic asking what age patients can have cosmetic surgery.
There is a simple answer to that and a more complicated answer.
The simple answer is that we only treat patients who are over 18 due to the strict guidelines and controls over operating on children

…but the real answer is that there is no limit on the age for cosmetic surgery.

One of our surgeons at the clinic, Khurram Khan, is a specialist in paediatric plastic surgery and holds an NHS consultant post at the Birmingham Children’s Hospital.
Children undergo cosmetic surgery all the time.
Cleft lip deformity is primarily a cosmetic problem.  This is performed on babies.
Prominent ear correction is commonly performed around the age of 6.
It is not unusual to treat children with vascular lesions, moles, or birthmarks which are primarily a cosmetic problem.
It comes back to the image of cosmetic surgery – the public has a picture of a glamour model with enormous breasts and huge lips.
We are about improving quality of life and this is what we, as plastic surgeons, are trained to do.
Cosmetic surgery comes in many forms and it may be clearly ethical and justified to perform surgery on a child if it is in their best interest.
However, I think the question is often used when talking about breast surgery and in those circumstances there is a good reasons for waiting before having surgery.
It is important before operating on any growing organ, to wait until it has stopped growing before performing surgery, so it is completely reasonable to wait until around the age of 18 before considering having any breast surgery.
Having said that, there may be an argument to perform surgeries sooner in situations of significant asymmetries or extremely large breasts, but by and large, it is common practice to wait until puberty has finished and in fact, the longer you wait, the better.
This is particularly true if considering breast implants because these can have ongoing issues and the need for further surgery in the future, so will require detailed discussions with the patients and the family before embarking on any surgery.
So whilst the easy answer is that you should wait until you are 18 before having cosmetic surgery, like most things it really depends.
It is not so easy to give blanket answers to all-comers.

It depends on what your problem is, how that problem is likely to develop, and how that problem affects you.

It really requires a conversation, and perhaps several conversations with you and your family so that we can create a plan and give you the best result possible.
We are delighted to have Khurram Khan at the clinic, as he is one of only a very select group of plastic surgeons who specialise in paediatric plastic surgery and so he has experience of operating on children of all ages.
We are also very lucky to have close links with local private hospitals who have facilities in theatres and on the wards to treat paediatric patients.
So the headline answer is that you should wait until you are 18 before having cosmetic surgery, but if you think that you or your child might benefit from surgery before the age of 18, we would be happy to discuss it with you, and we always love to hear from you.
Call us on 01214543680 or e-mail
Our director Jonathan Staiano does a Live Q&A on Facebook every Tuesday at 7pm, so feel free to drop in there.

If You Are Considering Cosmetic Surgery, Download My Guide With ‘5 Questions To Ask Your Plastic Surgeon’ To Make Sure You Are Treated By A Specialist

What Happens To My Nipples During A Breast Lift Or Breast Reduction?

What Happens To My Nipples During A Breast Lift Or Breast Reduction?

People often ask ‘What happens to my nipples during a breast lift or breast reduction?’.  It is commonly believed that the nipples are removed during a breast lift or breast reduction and then put back on at a higher place on the breast mound once the extra skin and volume from the lower part of the breast is reduced.
However, whilst this is certainly one of the recognised techniques for breast reduction, it is usually reserved for massive breast reductions and is not something that is commonly performed during one of the more standard breast reductions or breast lift procedures.
When the nipple is removed it is known as a free nipple graft and when doing this, there can be problems:

  • with healing of the nipple
  • often the nipple itself lacks projection
  • the pigmentation of the nipple skin may not be normal
  • and there is always altered sensation in the nipple.

For these reasons it is usually better to keep the nipple attached to the breast on what we call a pedicle which is a stalk of tissue which maintains a nerve and blood supply to the nipple and so gives a greater chance of it healing and having improved sensation compared to a free nipple graft.
However, there is still a risk of altered sensation and the possibility of healing problems even when a pedicle is used.
When performing the surgery, we cannot see the blood vessels and the nerves travelling in the pedicle and so we have to leave enough volume attached going to the nipple and hope that the blood supply and nerve supply is sufficient.
Similarly, there will be milk ducts in the pedicle and so you may be able to breastfeed following a breast lift or breast reduction; however, this is not guaranteed because of all the tissue around the pedicle is released and removed in order to allow the nipple to be moved into a higher position on the chest.
It can be a balance especially when doing a very big breast reduction between removing enough tissue from around the pedicle in order to give a significant reduction in the volume of the breast, but not too much so that the blood or the nerve supply is compromised.
This is something that comes with experience and is why it is important to have a full discussion with your surgeon pre-operatively around the sort of results you can expect to achieve.
We will not be able to tell you the exact cup size you are likely to be, because this is not something that is possible to predict, but we will be able to give you a realistic expectation of what might be possible and what your chances of needing a free nipple graft are.
Breast reduction and breast lift can be revolutionary operations and transformational, not only in terms of the cosmetic outcomes they deliver, but also the functional aspect by removing the weight and lifting the breasts on the chest to make them so much more comfortable.
However, moving the nipple is an integral part of the operation, and so you need to be fully aware of the potential for scarring and complications so that you can make an informed decision as to whether surgery might be right for you.

Want to find information on pricing?

Find out prices here for Breast Lift or Breast Reduction.

For more information, please contact the clinic on: 0121 454 3680, or email us.
You can also join our Director Mr Jonathan Staiano on Facebook Live at 7pm every Tuesday evening, where he does a live Q&A.
Please feel free to comment on the blog.

Download our guide with frequently asked questions about Breast Lift and Breast Reduction

Mommy Makeover, 1 Op or 2?

Mommy Makeover In Birmingham




The Mommy Makeover is a term popularised by our American colleagues (hence the ‘o’ in Mummy) and is used to describe plastic surgery operations of the breast and abdomen combined.
The abdominal operation would usually be a tummy tuck or a mini tummy tuck and the breast operation could be a breast lift, breast reduction, breast implants or breast lift with implants. It is so called because it is surgery that might be needed following pregnancy due to stretching and descent of tummy and the breast.

However, the Mommy Makeover is not limited to post-pregnancy women and may be required by anyone who has had significant weight loss, because this too will cause the tissues to stretch and descend causing a redundant apron of skin in the abdomen and droopy breasts that have lost volume.

A Mommy Makeover is a significant operation, that is something that we quite commonly perform here at The STAIANO Clinic. You would need a full and frank discussion with your Surgeon, in fact you would normally need more than one consultation to go over all the pros and cons of having a Mommy Makeover, rather than having a tummy tuck and breast surgery at different times. As is the case with most things in plastic surgery, there are no right or wrongs. It is a question of weighing up the benefits against the risks to see what would be right for you.


Tummy tuck and breast reshaping operations done separately are relatively major undertakings, and so to combine them does make it into quite a big operation. Either operating time would be longer than either one separately, but it would be slightly less than the time taken for each combined. Much of the time during surgery is involved in setting up, prepping and draping and anaesthetic time, and so there will be economies in performing it all in one go. However, the length of time of anaesthetic for a Mommy Makeover is usually between 5 and 8 hours and so this can knock you back and you will need to factor in adequate time for recovery.


Again, the recovery following Mommy Makeover is much less than the tummy tuck and breast shaping if performed separately because your abdomen would be healing at the same time as your breasts, so essentially there is only one recovery period which is not much longer than it would be if you were having a tummy tuck on its own. This means that the time off work following a Mommy Makeover would be much less than if you were to have two operations and it might be easier for your employer if you were to take just one period of sick leave.


Tummy tuck and breast reshaping surgery are not without their complications and you must be aware of this before contemplating surgery. There will be several wounds to heal and so the risk of some wound healing problems is greater than each separately, but no more than them combined. In fact, if there is a minor wound healing problem in the tummy or the breast then they can both be healing at the same time and so while the rate of complications might not be less, if you do get a complication in both areas, it can be easier to deal with as complications usually involve things like minor wound breakdown requiring dressing. Clearly, if you had a major complication in both areas it would be difficult to cope with, but fortunately the scenario is rare. As I mentioned the anaesthetic is quite long for a Mommy Makeover, but from an anaesthetic point of view it is safer to have one slightly longer anaesthetic than two shorter ones. It is a bit like air travel where the danger times are take-off and landing, it does not matter that much how long you are flying for. Similarly, for a general anaesthetic, dangerous times are on induction and when waking up from an anaesthetic.


The psychological aspects of cosmetic surgery should not be under-estimated and any time you are changing the shape of your body there will be an emotional element to deal with. It can be a rollercoaster because in the initial post-operative stages the tissues are swollen, the scars are fresh and it is not uncommon for one side to behave differently to the other giving asymmetry. Most of these things settle but can take many months to do so and so you need to work closely with your Surgeon for the support to get you through this period.

Breast reshaping or a tummy tuck can induce immense psychological and emotional changes usually very positive, but can be difficult to acclimatise to particularly in the early stages. You may struggle to cope physically or emotionally and it is always best to address these issues before surgery and here at The STAIANO Clinic we have dedicated Counsellors who can help to support you, as well as the office and nursing team who will be with you throughout your experience.

If you feel that a Mommy Makeover is too much to take on then do not worry, it is very common to have the procedures in two stages, and to simply deal with the area of most concern in the first instance and recover and then consider having the other area done. This can be months or even years later depending on how you feel.


There is a cost saving to having a Mommy Makeover compared to having the operations separately. It may not be as dramatic as you might think. The time spent in the operating theatre is very expensive and so the fact that the operating time is slightly reduced does have a bearing on the final cost. However, there is often not a dramatic difference in hospital stay as the tummy tuck usually has a 2 night hospital stay and breast reshaping a 1 night hospital stay, whereas a Mommy Makeover would be a 3 night hospital stay on average. And so, whilst there is a reduction in the overall cost this will probably not be the sole reason for choosing a Mommy Makeover. The other thing to consider is that payment is all required up front, whereas if you were to stage the procedures you would have time in between to prepare for the cost, although the hospital’s do provide 12 month interest free credit to help you spread the payments for any cosmetic procedure.

In summary…

I think it comes down to the individual as to whether you think a Mommy Makeover might be right for you. If you want one period of recovery and feel mentally and physically prepared for the changes that will take place, then there are definite benefits in having one period off work and one period of recovery and healing. However, if you are unsure or have one overwhelming area that you would like addressed then it might be worth having this addressed first and seeing how that heals and how you recover from it before considering having the other area dealt with.
If you want more information then please visit our pages on:

Breast Reduction, Breast Lift, Breast Augmentation and Tummy Tucks

Or, if you have any questions, then Jonathan is on Facebook Live every Tuesday night at 7 pm. Or you can email the Clinic or give us a call on 0121-454 3680 with any questions, we would love to hear from you.

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Less is Not More

Less is not More. In Fact, Less is Usually Less.

We live in an age where everyone wants the best, the fastest, the tallest and the most expensive.

We want it now and we do not want to wait and we want it at the cheapest price. Of course this is natural. It is human nature to want to get the best deal. However, it is important to realise that often compromises will have to be made. This is very true in cosmetic surgery.

Everybody wants the least invasive procedure.

Of course they want the one stitch facelift or the scarless breast reduction or the mini tummy tuck. Less scarring, less downtime, less cost. This is fine, but it is important to realise that as with anything, there is a compromise.
A lot of plastic surgery involves removing skin in order to tighten the tissues and to combat the effects of gravity and weight fluctuations, whether it be in the face, the breasts or the tummy. If we are going to remove skin, then inevitably there will be scarring. Much of the art of plastic surgery revolves around placing the scars so that they are difficult to see and handling the tissues carefully so that when the skin has healed the scarring is just a faint line and blends in with the normal skin.

There is a big difference

between the scar you get from a cosmetic blepharoplasty compared to that when having an emergency appendicectomy, partly because as plastic surgeons we are fortunate to operate on the face a lot and the face tends to scar very well but also because the priorities of surgery are different. The whole aim of a blepharoplasty is to improve the appearance, so taking care over the scar is crucial, whereas an emergency appendicectomy can be a lifesaving procedure and quite rightly the quality of the scar will not be of paramount importance to the surgeon.
Despite our efforts to leave the best quality scars hidden in natural skin creases and shadows, it is important to realise that all scars are permanent and if you look hard enough you will be able to see them. For this reason, if it is possible to perform a procedure with less scarring then we will be all for it.
However, the problem with all of the minimal scar procedures is that if you leave less scarring then you can remove less skin and if you remove less skin, then you cannot tighten the tissues as much and if you do not tighten the tissues as much then you cannot give as dramatic a result as you might want to.
I saw a quote the other day:

Our service is cheap, fast and good quality but you can only have two of the three

By all means you can have a short scar facelift or a mini tummy tuck, but you would have to accept that the result would not be as dramatic as if you had a full facelift or a full tummy tuck. Now for many people this might be an appropriate compromise and they would be quite happy to have a slightly less dramatic result, particularly if the skin laxity preoperatively is not significant; in favour of the reduced complications and scarring. However, this is a conversation that you have to have and you cannot expect to get as impressive a result as you might have done if the surgeon is limited to the amount of scarring that he can leave.
Unfortunately advertising and marketing plays a major role in cosmetic surgery and there will always be those who will seek to use headline benefits like minimal scarring and minimal downtime to attract and seduce customers. However, I would caution you to be careful, to look behind the advertising and make sure that you see before and after photographs and even talk to previous patients to ensure that the headlines deliver on the expectations.

Managing expectations is crucial to our ultimate goal which is to deliver a happy patient.

We all know that these techniques exist.

You will often find that many surgeons do not perform these limited procedures as often as you might think given their stated and highlighted benefits. This is because if they do not deliver a happy patient, it does not matter how short the scar is, the operation will not be deemed a success.
You have to question why you are seeking surgery in the first place because the least scarring and the least downtime comes with no surgery at all, which of course is always an option. However, if you have significant skin laxity or a cosmetic problem, you need to find the best and most effective way to treat that and be guided by your surgeon rather than focus on headlines that promise scarless surgery or a lunchtime facelift.

Many plastic surgeons are against the concept of advertising in cosmetic surgery

and I can understand why but I do think that there are benefits in advertising when it is used to educate and inform the public about what is available. The problem comes when advertising is used to target vulnerable people, is insincere or inaccurate with its claims.
There will always be those who want to chase the sale and worry less about delivering the best service possible. I cannot help but think these people will have very shaky and short term businesses. Any individual surgeon in private practice is in it for the long haul and will put great emphasis on building a good reputation. There is no place for unscrupulous advertising.
It comes back to what I will always advise which is do your research and by all means look at and read advertising material but at the end of the day, ask your surgeon questions, look at the results and talk to previous patients to ensure that you are choosing the right procedure for you, not just the one with the shortest scar.

I want to be a DD and nothing else will do!

When talking to patients considering breast surgery, I always ask what bra cup size they would like to achieve “ some patients have a very clear view ‘I’d like to be a DD and nothing else will do!’, while others are not so specific ‘I’d like to look natural, be comfortable and in keeping with my frame’.

I always ask the question because cup size is the way that we talk about breast size but I then always say that I cannot guarantee the final cup size.

The bra size is made up of two measurements, there is the chest size, 32, 34, etc., and the cup size, A, B, C, etc.  The chest size should not change following breast surgery (there may be a temporary increase due to swelling) and it is the cup size that is likely to be affected.  However, the precise change in the cup size is difficult to predict for several reasons:

  • bra size is relative.  The bra size is measured by measuring the circumference of your chest (this is the chest size), then the circumference around your bust.  The difference between the chest circumference and the circumference around your bust gives the cup size.  1 inch difference is an A cup, 2 inches is a B cup, 3 inches a C cup and so on.  Because the cup size is the difference between your chest and your bust circumference, it is not an absolute measurement, an A cup will be different for a person with a wide chest compared to someone with a narrow chest.  Therefore, I cannot show you a photograph of a pair of breasts and tell you the cup size, because the same sized breasts on you may be a different cup size if your chest circumference is different to the person in the photograph.
  • bra size varies between manufacturers.  I often have patients tell me that they wear a C cup in one make of bra or a D cup in another make
  • people often wear the wrong bra.   Most people could probably fit in to one cup size bigger or one cup size smaller than they normally wear if they were to adjust the strap size.  It may well be that someone who is a 34D could wear a 36C or a 32DD.

Having said all that, bra size is all we have got to go on, so I always ask what cup size you would like to be.  Just don’t be surprised when I say that I can’t guarantee that I will achieve it!

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