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Be Informed, But Don’t Get Overwhelmed

I often see patients who have been given conflicting advice by previous doctors.

  • One might have said they need a round implant, while another recommended a teardrop
  • One might have suggested a breast lift with implants while another said implants alone would be fine
  • One might say that you should have your tummy tuck first and then your breast reduction, while another says you can do it all in one go
  • One says the implants should go below the muscle and another says they can go above
  • One says that you need liposuction of your upper abdomen at the time of your tummy tuck while another won’t do this

Who are you to believe?

They can’t all be right, can they?
You can understand why it can be confusing and in my Facebook Live Q&A every Tuesday, I often have patients who are beside themselves and don’t know what to do.

As a surgeon, I can see why they are getting conflicting advice

…and as a human, I can see why this can appear to be contradictory.

I think it is good to get different opinions from surgeons, but sometimes, the more opinions that you get, the less clear it can become!
The fact is that, in many cases, they are all right.
You see, there are pros and cons of most of these decisions.
Putting implants under the muscle will make it less likely that you will get rippling
…but it is more likely for the implants to sit high or wide and the possibility of animation deformity.
Combining a tummy tuck with a breast reduction will get it all done in one go with one recovery
…but it is a big operation and it will knock you back.
There is no right answer.
It is about being aware of the pros and cons so that you can make an informed decision about what is right for you.
Teardrop implants might be right for one person, but round implants might be ideal for another.
I think that some surgeons will portray the situation as black and white.

These are the best implants

or

It is better to have the implants under the muscle

But the truth is that if there was one best way of doing something or one type of implant that was the best, we would all do it that way or use that implant.
…but we don’t
We all have our own opinions and experiences that lead to our judgements about what might be best for you.

I always say that the most important decision for you to make is to choose your surgeon.

Do your research about the surgeon and the clinic or facility that you are going to be treated in.
This is much more important than going in to minute detail about nanotextured implants or different types of liposuction.
There are often many different ways to get a good result.
One surgeon might use VASER liposuction while another uses power-assisted liposuction.
The results might be exactly the same.
…or more importantly, the results will be better in the hands of the better surgeon.
It is more about the skill of the surgeon than the technique used.
You can spend months researching the ideal shape, profile and model of breast implant, but if the pocket is

  • too small,
  • or too big,
  • or too high,
  • or too wide,

You will get a poor result.
Some of my patients will go backwards and forwards with an implant choice, giving themselves sleepless nights convinced that their decision will be the difference between a good and a bad result.
…when in reality, their decision will have very little effect on the outcome.
The difference between the implants they are trying to choose from is often millimetres and I could use either and they would not notice.
However, if I am not careful to place the implants properly.

  • …to ensure that their nipple is placed in the centre of their breast
  • …that their cleavage area is maximised and not too wide apart
  • …to be meticulous in creating a pocket for the implant that allows it sit naturally on their frame so that they do not look out of place

They will be unhappy, regardless of the implant they have chosen.

So beware of anyone who tells you that they know the ‘best’ way to do it (especially if they are not actually the person who is going to be doing it).

…and spend you time researching your surgeon rather than the procedure.

Of course you need to educate yourself about what you are having done.
…but you don’t need to know the minutiae about the difference between a dual plane type I and a dual plane III submuscular placement of breast implants.
Good luck and if you want to know more, get in touch or jump on to one of my LIVE Q&A’s on Facebook every Tuesday night at 7pm.
Hope to see you there!

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I’m a doctor, so can you trust me?

Times have changed and patients are becoming a lot more informed these days with the freely accessible wealth of information available on the internet.

There is no need to pay for information anymore and the days of people investing in the Encyclopaedia Britannica are long gone.
The value these days comes in the interpretation of information, because the more you know, the more you will see that life is not black and white.

Many cosmetic surgery patients go to several doctors before they settle on the final one and will often post questions online asking about the best procedure for them, or the best implant choice, or the best way to do something.
I understand how it is confusing when one doctor would suggest one thing and then another suggests something else.
It is usually not because one is wrong, they are just making a judgement on their own experiences and expertise, and this is what you are really getting from a doctor.

Patients are often seeking the answer as to what they should do, but there is no answer, particularly in cosmetic surgery because it is such a subjective area and there are no algorithms or standard pathways for us to follow.

We have to listen to patients, understand what their aims and objections are, taking into account where they are starting in terms of their body shape and tissue quality, as well as making allowances for the future depending on the patient’s age and lifestyle.
We often cannot answer the question:

what are the best implants for me?
or should I have a full facelift, a mini-facelift or just non-surgical treatment?

Different options will give different outcomes and there will be pros and cons of any treatment, so we will not tell you what the best way forward is, but we will listen to you and try to understand your expectations and advise you as to what the best way to get there might be.
There is and never will be any guarantees, at least in terms of a guarantee of what the outcome will specifically be.
We never guarantee the cosmetic results because we are dealing with tissues and scarring and the effects of gravity and ageing over time, so the results are always unpredictable.

However, what we can guarantee is that we will do our best, we will listen to you and we will try to understand what you are seeking to achieve.  We will give you our best advice and do everything we possibly can to get you there.

In the days of more and more information being available, it is even more important that you trust the doctor.
You may be able to find a contrary opinion or article on the internet, but taken in the context of your own body, it would be open to discussion because the internet will never give you the answer and can only give you information in the broadest sense and is subject to misinterpretation.

I think it is great that the internet exists and we work hard to put out information for patients to understand as much as possible about their proposed procedure.
This is why I will always say to patients that the choice of their surgeon is probably more important than any other choice, certainly in terms of the precise procedure you have or particular type of implant that you have.
You need to be comfortable and confident with your surgeon and to be able to ask questions.
You should be completely at peace that the operation is the right choice for you at the right time, and also comfortable that the surgeon and the clinic will be there for you after the procedure to help to get you through the post-operative period.
It is often difficult initially, with swelling and asymmetry, red tight scars, and pain and discomfort.
It is important that you feel nurtured through this period because it can be frightening and unsettling and you need to trust in your surgical team who have seen it and been through it countless times with previous patients and should be in a position to let you know when and when not to worry.

So, trust me, I am a doctor! 

 

I will give you the best information I can and I will do the best I can to make sure you are looked after.

I cannot guarantee that things will go well, but will guarantee that if they do not go well (a surgeon without any complications is a surgeon who does not operate), we will do everything we can to make things right.

If you have any questions, you can always join me on Facebook where I do a live Q and A every Tuesday at 7 p.m. and I will be available live to interact and discuss any issues.
Feel free to leave a comment below, or drop us an e-mail.
If you want to come for a consultation with one of our plastic surgeons, please call or email us or fill in the on-line contact form.

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Why you need to keep your documentation if you have surgery

 It is not uncommon for us to see people here at the clinic who have had surgery many years before.

Typical examples would be patients who have breast implants and may now have some problems with them or would like a different size or shape, or maybe a patient who had a breast lift many years ago and the tissues have sagged again and perhaps needs another lift.

As a surgeon, it is important to have as much information as possible.

This is particularly true when treating patients who have had surgery before and this is why it is important to keep as much information as you can, even though you may not think it is relevant at the time.

We now have a national database of breast implants and we encourage all our patients to sign up to it (it is voluntary) and this has not been the case for many years, so it can be difficult to find details of your original operation.

Sometimes patients forget who their original surgeon was or their original surgeon might have retired or moved on.  Clinics tend to come and go and so it may not possible to approach the original hospital or organisation who did your surgery.

So if you do have any information about your surgery I would encourage you to keep it.

We give all our patients copies of the clinic letters that we write to your doctor and we also give details of the breasts implants that they have.

It may not seem that these letters or details are relevant at the time, but they can be very useful in the future.

If you are changing your breast implants it is always nice to know the size and shape of your current breast implants, particularly if you want to go bigger or smaller, because then we can give you a reasonable expectation of what sort of size you can change to.

Similarly, if you have had a breast lift or a breast reduction in the past, this operation involves isolating the nipple and there are many different ways you can isolate it, and if you are going to have another breast lift or reduction, you must isolate in the same way in order for it to maintain its blood and nerve supply.

This will usually require a copy of the operation notes and so it would be great if you knew where your original operation was held so that we could approach them, as most hospital are very accommodating in giving details of surgery.

If you have had surgery with us and you have not got details of your operation, let us know because we would be happy to forward them to you and of course, you can rest assured that we will always be here so if you do need anything in the future, you or your new provider can always approach us and we would be happy to provide them with details of what you have had done (with your consent of course).

If you have any questions and want to get in touch, then contact us on the website or on Facebook where I do a live Q and A on Facebook every Tuesday at 7 p.m.
Feel free to leave a comment below, or drop us an e-mail.

If you want to come for a free no obligation consultation with one of our plastic surgeons, please call or email us or fill in the on-line contact form.

Realistic expectations are the key to happy patients

I am amazed when I hear stories of patients seeing a surgeon in a clinic, only to find on the day of the procedure that a different surgeon is going to operate on them who they have never met before.

This is bad practice and uncomfortable for the surgeon and I am sure that it does nothing to give confidence to you, the patient.

One of the things we pride ourselves on here at The Staiano Clinic, is that all of your consultations will be with the surgeon who will be performing the surgery.

Because all the consultations are with your surgeon, you will find that we will give you an honest opinion about what can reasonably be achieved, because we will be the one who will see you after the surgery and be with you at each of your follow up appointments.

It is all too easy for a sales adviser or the clinic nurse to gloss over the potential complications and promise a great result if they do not have to face you afterwards and justify the quality of the result that you have achieved.
You can imagine that there could be a tendency to give unrealistic expectations so that you can’t really make an informed decision about whether surgery is right for you.

We want to give you the best advice because the clinic is built on the foundation that we will do everything we can to give you the best result possible, and this might sometimes mean not operating on you.
It is better that you are prepared for the likely result that you will achieve, what the scar will look like, and what effect the surgery can reasonably be expected to have on you.

However, if you do decide to go ahead with surgery it is far more likely that you are going to be happy with your result.

I think this is one of the reasons why we have so many happy patients.

We are so lucky to have a supportive community at different stages of their surgery who will freely talk and give advice to others.

I guess on the face of it you could say that the Staiano Clinic is a plastic surgery clinic, but that is not what we are really about.

We are about

  • listening to people
  • understanding your concerns
  • taking on board your hopes and fears
  • and talking about what can be done to address them

Then, we can go through the options to allow you to come up with a plan for what is right for you.

We are all about the long game and want to make patients for life.

Different clinics will have different values and while we do have company goals and commitments, you can sum up our values in two words,

“we care”,

Plastic surgery is a very personal thing and a personal choice but it has become synonymous with cowboy operators and botched bodies.

I think this is because it is increasingly commercialised and there are a growing number of non-fully trained plastic surgeons providing the surgery often with a corporate backing which is focused on the most efficient and cost-effective way of delivering the service.

This often involves the surgeon only performing the surgery and other members of staff dealing with the patient interaction before and after.

I believe the aftercare is crucial and this is something we focus on here.

I guess different models will work for different people.

There are many ways that we could create efficiencies and increase our profits, but this clinic is not run by a corporation who only care about the profits.

It is run by me, a plastic surgeon, who wants to give the best outcome possible for every patient.

We do not measure ourselves on profit, we measure ourselves on patient satisfaction

I want The STAIANO Clinic to be known for giving you the best service and really looking after you.

This is why we have so many lovely reviews and happy patients and this will always be what we strive to achieve.

JJ Staiano
Plastic Surgeon & Director
The STAIANO Clinic


Join me for a LIVE Q&A on Facebook every Tuesday night at 7pm

or contact us for more information

Why We Charge For Your Initial Consultation

Do You Expect To Pay For A Consultation With A Surgeon?

There is always a debate as to whether to charge for consultations or offer them for free.

In fact I did a blog post a few years ago discussing the topic.

Traditionally a consultation with a doctor would carry with it a fee as you might expect with any professional service.

However, things are different in plastic surgery for two reasons.

  1. First of all, plastic surgery is a very ‘surgical’ speciality. There is very little in the way of diagnosis and the skill and expertise is very much weighted towards the surgical ability of the surgeon rather than any clever diagnosis. It might be required in other surgical specialities such as general surgery if you presented with abdominal pain.  Most people present to a plastic surgeon with a cosmetic feature that they dislike and they have an idea about how they would like it to be corrected, and so we understand the reluctance to pay a large consultation fee.
  2. Furthermore, a lot of plastic surgery is provided by commercial clinics and they routinely offer free consultations although admittedly these are often not with the surgeon themselves. This has created an expectation amongst patients to receive a free consultation. Because all of the surgeons here at the Staiano Clinic are members of the Plastic Surgery Professional Associations, BAPRAS or BAAPS, we are bound by professional guidelines and free consultations are not encouraged as we are doctors providing a professional service and we certainly do not want to be seen to be encouraging or coercing patients to have surgery.

We do charge a consultation fee.

However, I am very aware that there might be some resistance to pay a consultation fee, because you might not be able to have the surgery that you wanted, or what if you just do not like the surgeon, or are unhappy with the opinion given.

I have always stressed that the ethos behind the clinic is to create happy patients.

We are not about achieving targets and goals in relation to conversions or number of operations.

The key metric that I judge our performance on is whether our patients are happy or not.

We charge a consultation fee because I believe that there is value in coming to speak to one of us.

We are specialists in our field and we will always try and give you the best opinion on what might be right for you.

There are too many people in the cosmetic surgery world who are generalists and will operate on any part of the body, whereas here at The STAIANO Clinic everyone is a specialist with specialist knowledge and experience.

I believe that we give value to our patients and we do not take it lightly that there is a charge associated with the consultation.

Satisfaction Guarantee

That is why we have our satisfaction guarantee because if you feel that your consultation has been unhelpful or if you are not suitable for surgery, we offer a no quibble, no questions asked, full refund of your consultation fee paid.

We only ever charge for your initial consultation and all future consultations will be free, whether they are before or after surgery.

In fact we encourage our patients to come back for at least one more consultation to go over things before going ahead with surgery.

We also offer emotional support from a counsellor who specialises in the field of body image and weight management for all of our patients.

I think that you will find that if you come to The Staiano Clinic for a consultation, we will give you our best advice and you will feel the value that we offer every patient.

We are constantly striving to provide more value and to lift ourselves above the many poor standards and practices that the media loves to report on in the cosmetic surgery world.

We want to be the leading provider of cosmetic surgery that stands for quality and service and we will not be able to do this unless we can deliver over and above expectations to all of our patients.

Call us now on 0121-454 3680 or drop us an email to give us a chance to show you what world class service looks like.

Book A Consultation Online Here

BAAPS 2017

I was lucky enough to have been invited to be a speaker at the the annual conference of plastic surgeons (BAAPS 2017) a couple of weeks ago.
My message to the BAAPS Conference was about how important it is to look after your patients.
Most of the conference was dedicated to strategies and techniques to improve surgical outcomes and this is undoubtedly important.
But I think that a lot of surgeons lose sight of the other aspects that go towards a successful outcome and a happy patient.
Things like:

  • Is your clinic easy to find?
  • Is it easy to park?
  • Are the receptionist and clinic staff welcoming?
  • Do you provide an atmosphere where patients feel they have the time and space they need to make an informed decision?
  • Do you support patients after they have seen you in clinic and after they have had their procedure?

I was asked to talk at the meeting because this is where I have invested a lot of time and energy and this is the main reason that I opened my own clinic.
So that I can control all of these aspects of your experience.
I have built my practice around my goals and values.
There is more to surgery than the traditional aspects that we tend to measure “ things like infection rates, or time to wound healing or revision rates.
I realise that the difference between a happy patient and an unhappy patient is not necessarily completely dependent on the surgical result.
My goal is to develop a world class service at The Staiano Clinic and I know that to do this, we need to not only deliver the best surgical outcomes possible, but we also need to give excellent service and look after patients before, during and after their treatment.
I am continually working towards my goal and I was delighted to be able to share my experience with my plastic surgery colleagues at BAAPS 2017.
The ultimate judge of our service is you and you can help to shape the service that we offer.
If you have any comments or feedback, then please let us know because we are continually trying to improve the service and this culture of improvement will never stop.
We aim to practice what we preach, so feel free to leave comments below or email us and help us to maintain our standards.

Why Choose a Plastic Surgeon for your Mole Excision?

One of the areas we have had a lot of growth in here at The Staiano Clinic is in mole excision. I think one of the reasons is that we are able to offer a ‘See and Treat’ service which not many clinics are able to. We have our own state of the art operating suite here on site and so should you decide to have your mole excised on the same day as your consultation, then we can go straight to the operating suite and remove it for you.
The other reason that I think we are so popular when it comes to mole excision is that all of the Surgeons here at The Staiano Clinic are fully trained Plastic Surgeons. When it comes to mole excision there is a very wide range of Doctors who offer this procedure right from General Surgeons or ENT Surgeons through to GPs or Dermatologists who may not have any surgical training at all. So why choose a Plastic Surgeon for your mole excision?
When it comes to getting a good scar, there are several factors to consider. Plastic Surgeons are trained to respect the tissues and are known for their delicate instruments and meticulous techniques. If ever there is a complex wound to close in sensitive areas such as the face, around the eyes or lips, in situations where tissues are fragile or friable such as in the elderly or young children, and in cases where there has been extensive tissue loss or damage such as in explosive injuries or major trauma, the Plastic Surgeon is called in to put things together again.
We spend time thinking about what sort of sutures we are going to use to close the wound and what techniques would give the best cosmetic result with the maximum strength. Priorities are different for other surgeons and you may have seen a classical laparotomy scar which is classically a straight line on the abdomen with dots on either side. This is because General Surgeons, when they are performing a laparotomy, have a priority to treat some intra-abdominal pathology in the quickest, most efficient and safest way. They are not focusing on the cosmetic outcome of the skin scar, and if I was having a laparotomy I would not want them to be too concerned about the cosmetic outcome because it is usually performed for a serious condition. Most Surgeons when they are performing operations open and close the skin as a means to an end which is to perform their core surgical procedure, but in plastic surgery often the core surgical procedure is the opening and closing of the skin. We only operate on soft tissues and are trained to contour the body or remove tumours and therefore the training revolves around excision and closure. Because we are all trained as reconstructive surgeons we are very aware of the need to completely remove the tumour in the most effective way to allow us to close and reconstruct the defect with a minimum amount of morbidity. We will often be called in to reconstruct a defect after another surgeon has removed a cancer; and in these circumstances, the surgeon who is performing the excision is solely focused on getting a clear margin for tumour clearance and they do not have to think about the reconstruction because they know the Plastic Surgeon will come in and be able to handle any defect that they find.
We are in a unique position as Plastic Surgeons of being able to remove tumours and reconstruct them afterwards and so we can find that balance between making sure we get the lesion out completely, but at the same time minimising the damage to neighbouring structures and giving the best cosmetic outcome.
Plastic Surgeons are able to deal with skin lesions of any size and any type. We treat benign skin lesions, warts, skin tags, xanthelasma’s (cholesterol deposits around the eyes), we treat skin cancers (BCC, SCC and melanoma) of all shapes and sizes and in all locations. For this reason, when it comes to simple moles and cysts there is nothing that can phase us and if something was to crop up it is very unlikely that we will not have seen it before and know how to handle it. It is perfectly reasonable for GPs and Dermatologists and other Doctors to be removing moles and cysts and they can get good outcomes too, especially if they have spent some time with Plastic Surgeons learning some of our techniques. So, if you do have a lesion that you would like to have removed, whether it is because you are worried about it, or whether because it is unsightly, or it might be that it catches on your clothes, or bleeds, or is a nuisance; you can come for a free consultation with one of our Plastic Surgeons and if you did want to have it removed on the day then we could take you straight to the minor operating suite so that you could be rid of it forever within the hour.
For more information of what to look out for in a mole, you can download our guide here, and if you want to arrange a free, no obligation consultation then please call or email us.
If you are not sure whether your mole or lesion is suitable for excision then you can always send us a photograph and you will get an opinion from one of our Surgeons as well as a detailed quote of what it would cost to have it removed. All surgery is performed under a fixed price package which means there is an all-inclusive fee which covers the after-care and all dressings as well as any follow-up appointments.
Furthermore, our Director Jonathan Staiano does a live Q&A every Tuesday evening at 7pm so feel free to join in by going to our Facebook page and asking questions live, or email Laura your questions beforehand.
We would love to hear from you.

The Hidden Costs of Medical Tourism

I have just read another article about the dangers of medical tourism.

Medical Tourism is a thriving industry and many people from the UK travel abroad to have cosmetic procedures. I completely understand why they do this because it can be seen as having a holiday or having a trip overseas, not to mention the significant saving in costs with the surgery.
However, I cannot recommend it and this is why.
When I get referrals from patients who live overseas or even in other parts of this country, I always recommend that they seek a surgeon closer to home, because whilst there are not that many plastic surgeons in the country, we are represented in most towns and cities. If you know what qualifications to look out for, you should be able to find someone who is appropriately skilled and qualified to do your surgery. In fact, I dedicate a chapter of my book to the risks and benefits of medical tourism or having surgery far from home.
I have read a recent report about patients in overseas cosmetic surgery clinics suffering significant infections following surgery. One of the many problems with having surgery overseas is that the standard of training of the doctors and the standard of cleanliness cannot be guaranteed. The processes and checks that are performed in the clinic may not be to the same level that they are in this country.
Clearly there are many well trained surgeons and excellent clinics overseas but the issue is in knowing who and where they are. The surgery is often significantly cheaper and you should ask yourself why this is?
It may be that the level of indemnity insurance of the surgeon is much less than required in the UK which means that if you do have a problem, you will have less comeback on the surgeon.
It may be that the clinics and the hospitals do not need to invest in stringent and robust infection control procedures and safety checks that are required in UK facilities.
It may also be that the level of aftercare and support following a procedure could be affected as I always stress that it is best to see your surgeon, not only before but after your surgery to put your mind at rest and to make sure things are progressing satisfactorily.
At the end of the day, it is up you, to the patient to make the decision as to where to have surgery, whether it be at home or abroad and the onus is on us as practitioners to make sure you are fully informed about all the risks and the benefits of each.

I go back to my mantra I will always tell patients, which is:

“Do your research and do not be afraid to ask questions”

If you would like a copy of my book which is available now click the link here.

I talk about why Plastic Surgery is cheaper overseas in one of my LIVE Q&A sessions on Facebook every Tuesday night at 7pm, watch it here:
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Jack Of All Trades Or Master Of One?

People are often surprised at how diverse a plastic surgeon’s skills extend.
We are one of the only medical specialities that can operate on any part of the body.
We are trained in:

  • Cancer reconstruction in the head and neck, breast and skin
  • Treatment of burns
  • Hand injuries
  • We treat congenital birth defects including cleft lip and palate
  • We manage any soft-tissue defects such as lower limb trauma after a road traffic accident or management of pressure sores or ulcers

We can literally operate from the head to the toe.
All plastic surgeons will sub-specialise in a particular field and his or her practice will be limited to that area while working in the NHS.
However, in the private sector, where most plastic surgeons perform cosmetic surgery, there is no limitation to the area that they operate on.
Any fully trained plastic surgeon will be able to do a facelift, a nose job, put in breast implants, do a tummy tuck and do liposuction as well as the range of non-surgical injectable treatments available.
When I was in the NHS, my practice was limited to breast reconstruction following cancer and now that I work in the private sector, I limit my work to breast and body contouring.
This is very rare and most plastic surgeons will at least offer facelifts and botox, even if they specialise in the breast.

In fact, there are only a handful of plastic surgeons that specialise in the breast, and so pretty much every plastic surgeon will offer breast enlargement even if they are trained as a hand or a burn surgeon.

I certainly have a lot of patients who request botox or a blepharoplasty and I am capable of performing the procedure, but the ethos behind my clinic is to provide a world-class service delivered by the most highly trained professionals.

I have been very careful about who I choose to work with me at the clinic to help me expand and grow.

It is great to have Khurram Khan on the team.  He is a Consultant Plastic Surgeon at the Children’s Hospital and he is focusing on all of the local anaesthetic work. His main area of interest is in facial plastic surgery, so he is the perfect complement to the team to allow us to expand the range of treatments that we can offer.

We also have Azzam Farroha, who is a Consultant Plastic Surgeon at the QE Hospital in Birmingham and he specialises in skin surgery and treats benign and malignant skin lesions with a special interest in skin cancer.

I have been very careful how I expand the clinic because it can be tempting to just take on as much work as possible.

However, early on, I set out our Brand Values and I will stay true to these and will always aim to do the right thing.

Ethics and delivering the best results to our patients will always be the core focus of what we do.

As plastic surgeons, we are trained to be ‘Jack of all trades’ and this is one of the great appeals of the speciality, but I feel that we are moving in to an age where the specialist is becoming more important and certainly in the niche of cosmetic breast surgery, there is a need for surgeons who are experts in the field to help to bring the speciality away from some of the negative publicity that it receives.

The variety of surgeons who offer breast enlargement is vast.  In fact, I have written a book about it!

“Never Accept A Lift From Strangers – how to choose the best plastic surgeon for your cosmetic breast surgery”

As is the case with most things in life, it is not enough to be doing excellent work and the success or failure depends on getting the message out there and getting the world to listen.

Please help me to get the message out – share this on Facebook, email your friends and Tweet it on Twitter.

I am always happy to receive comments and feedback, so it would be great to hear from you and if you want to chat with me live, you can find me on Facebook Live at 7pm every Tuesday night, so like our page and I will see you there.

Just because they look like a plastic surgeon and they say they are a plastic surgeon, doesn’t mean they are a plastic surgeon!

One of my passions is to raise awareness about cosmetic surgery to try and change perceptions so that it is not portrayed as being a branch of medicine that is somehow less worthy than other branches of medicine.

There is an image that all plastic surgeons are unethical, money grabbing cowboys but the reality is very far from that (well I would say that wouldn’t I?).

One of the problems is that for many plastic surgical procedures, patients look for a surgeon by going on the internet or look at advertising and marketing in glossy magazines, rather than the traditional route of going to see a GP and being referred.

This has allowed a huge growth in practitioners who are not fully trained to set up and practice plastic surgery (practice being the operative word).

Whenever I talk to people about this, they are always shocked and alarmed to discover that there are so many untrained doctors performing surgery.

They think that surely there is a law against such a thing and that it should not be allowed, but I am afraid there is no law against this and it is allowed and it is going on all over the UK.

I feel so strongly about it that I have written a book called ‘Never Accept a Lift From Strangers: How to choose the best plastic surgeon for your cosmetic breast surgery’ and it is available from Amazon.

One might ask why I have had to write a book about this as you would have thought that it was obvious to see which surgeons have been trained and which haven’t.

Unfortunately, it is not obvious.

I talk about cases in my book of high profile people, both here and abroad, who have had complications following plastic surgery performed by non-trained plastic surgeons, people like Colin Hendry the Premier League football player and the pop stars, Kanye West and Usher, have all had family members who have been affected and I am sure they thought their plastic surgeons were fully trained.

The problem is that when someone asks me to tell them what to look out for, it is not so clear cut.

That is why many doctors and surgeons have very impressive sounding biographies and you may be fooled into thinking that they are properly trained, but only when you delve deeper do you realise that they have no formal training in plastic surgery or that they may have started it but not completed it.

To be honest I blame us, the professionals. I think that we make it too difficult for people to seek and understand what all the credentials mean.

You see, there are a lot of associations and qualifications that do not count for much, although there are others that mean a lot and stand for many years of specialist training in a very competitive environment and yet to the outside eye, they can all look good.

I do not think it is a problem unique to doctors either.

I talk in the book about a problem I had finding an accountant and only later realising that there are many advisors out there who sound credible but are not qualified chartered accountants.

The same is true in the legal profession as I was talking to a friend of mine who for many years I thought was a lawyer, but in fact I discovered he was neither a solicitor nor a barrister and actually had a paralegal qualification, and I have to be honest I still do not quite understand the difference which leads to the next question:

Does it matter?

Well in surgery, yes it does matter because surgical training is very long, very competitive and very hard.

It is an extended apprenticeship which takes many years, it took me thirteen years of training after becoming a fully qualified doctor (which in itself takes 6 years) to finally finish and receive my certificate for specialist training in plastic surgery, FRCS (Plast).

There are exams to take, culminating in a final exit exam which tests whether you are safe and skilled enough to be put in charge of patient care independently once the training is finished.

If you are accepted to become a full member of the BAAPS, The British Association of Aesthetic Plastic Surgeons, then there is an audit every year where we must submit our figures on the number of operations we have done and any complications or revisions we have had to perform.

We have a strict code of conduct to which we must adhere and we have a peer group that we are accountable to.

However, there are many doctors out there who are performing plastic surgery who are not a member of one of the plastic surgery associations (BAPRAS and BAAPS).

Not only does this mean that may not be fully trained in plastic surgery, it also means that they will not be held accountable to the same rules and ethical guidelines which they are bound to practice within.

I don’t think we are going to solve this problem overnight because I think there must be something inherent with people in a profession that they keep it shrouded in mystery to make it look impressive and worthy of their stature.

I would love to be able to say to you look for this one thing to be certain that your doctor is fully trained in plastic surgery and surely that would make sense.

It might help to stop the horror stories you hear about rogue practitioners working out of their front room.

The media love to pick up on these stories and report how terrible it is, but I think the real piece of news is that they are usually not doing anything wrong and it is perfectly within the law for people to perform treatment and practice out of their front room, even people with no qualifications, that is the real story.

I don’t think we will be seeing any legislation any time soon. We cannot rely on the Government to protect us from this, certainly not at the moment, so I see my job as a plastic surgeon to do what I can to inform and educate people as much as possible.

So, what should do if you are thinking of having plastic surgery?

Unfortunately, there is no easy soundbite but I would say do your research, look for reviews and ask for a personal recommendation for anyone who is a full member of BAPRAS or BAAPS, anyone who has FRCS (PLAST) after their name and anyone who is a consultant plastic surgeon in the NHS will be fully trained in plastic surgery.

I am always happy to answer questions and to help and advise. You can see me on Facebook live every Tuesday night at 7pm and you can get hold of a copy of my book here.