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Lockdown 2.0

So, we are in lockdown again.

We are much better prepared this time and over the last few months, we have put measures in place to ensure the safety and protection of everyone at the clinic and we have robust measures which are over and above what you might expect in other public environments.

  • because we offer a boutique, bespoke service, we have never been about high volume and so we can limit access to the clinic to one patient at a time. This ensures that you will not be entering a busy waiting room and passing other patients in the corridors
  • we have screening measures in place that ensure that if you have had any contact or any symptoms, then we will ask you not to attend clinic. In this way, we can ensure as much as possible that we are what is known as a ‘clean site’.
  • we offer virtual consultations that can be held by phone or video call with the facility for a screen share to go through before and after photographs and talk about your goals or your progress. This avoids the need to attend clinic in many cases and saves on the stress of having to drive in to Birmingham!
  • because we are a medical clinic, we are used to using PPE and it is second nature for us to wear surgical face masks, gloves and gowns to ensure that we keep you safe. We will also ask you to wear shoe coverings and face coverings when at the clinic.
  • we are very lucky to have our own minor operating suite on site, and so we can offer procedures under local anaesthetic which can even be done on the same day as consultation by prior arrangement
  • the Private Hospitals that we normally work at are being used by the NHS, so we have not had access to the main operating theatres since March. However, we have not rested on our laurels and we have formed relationships with facilities that are not being used by the NHS and so we are one of the few clinics in the country that are still able to offer surgery under both general anaesthetic and local anaesthetic with sedation (twilight anaesthesia).

We are confident that we can continue to work safely and would be pleased to welcome you to the clinic.

However, we appreciate the need to avoid unnecessary journeys and encourage you to stay at home when possible.

If you can have a virtual consultation rather than an in person one, then we can arrange this and if you do have a consultation or a procedure booked and you prefer to cancel it or postpone it, then we completely understand and will be happy to reschedule or offer you a full refund.

Furthermore, if you were to have any sort of treatment with us and we were to go into a more restrictive lockdown period, we want you to be reassured that we would still be able to look after you.

Even during the previous lockdown when we had to close the clinic for 3 months, we were still doing virtual consultations and if anyone had a clinical problem, we would have been able to see & treat them at the clinic because that would be considered an urgent matter.

The lockdown involves the closure of non-essential shops and services and medical clinics can remain open.

We feel comfortable with our safety measures to be able to work effectively and maintain our levels of service and hope that you will feel comfortable too.

We are trying to do the right thing and I am very conscious about striking the balance between maintaining a service to our patients and containing the spread of the virus.

As ever, if you have any concerns or questions, you can get in touch or find me on Facebook and Instagram every Tuesday night at 7pm where I will be available for a live Q&A.

View our COVID guidance for patients

If you would like more information, please leave a comment and we will get back to you or call us on 0121-454 3680 or contact us here.

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Twilight Anaesthesia – A Change For Good?

The Coronavirus Crisis is likely to have a long lasting effect on many aspects of our lives – both good and bad.

  • Remote working has taught us that we perhaps don’t need to use our car as much and there can be benefits in reducing commuting and carbon emissions.
  • Regular hand washing and hygiene can help to reduce the spread of many infections, not just the coronavirus.
  • Spending more time at home has been welcome especially for those of us with young families.

“It is what it is, as my son would say”

…and so we have to try to see if we can take some positives from it.

It has certainly forced me to look at the way I operate.

The Private Hospitals have been taken over by the NHS in and are not accepting any Plastic Surgery patients until the New Year.

This has meant that I have had to look for other facilities to treat patients (either that, or shutting up shop for 6 months – or more!).

There are still some smaller Private facilities that are not big enough to be of use to the NHS, but are able to offer surgery under General anaesthetic and Twilight anaesthesia (local anaesthetic with sedation).

Until now, I had only done a small proportion of my cases under Twilight anaesthesia and only in those patients who specifically requested it.

…but I have to admit that it has been an eye-opener.

We have done quite a few cases under Twilight anaesthesia now and it works amazingly well.

The sedation is such that you are not really aware and usually quite relaxed with little or no memory of the procedure.

In fact, for most of the surgery, it is similar to a General anaesthetic.

The main difference comes in the postoperative recovery.

…it is a lot smoother following Twilight anaesthesia and you are pretty much ready to get up and walk out within an hour of finishing the surgery.

There are still the bigger cases that need General anaesthetic like tummy tucks or bigger breast reductions but even these can be done with twilight anaesthesia and so I think it is probably a matter of time before it becomes the standard.

We are very lucky to have access to surgical facilities during these challenging times and I can’t tell you how pleased I am to be operating again.

If you are thinking of having surgery, whether it is under General anaesthetic or Twilight, then please get in touch because we are lucky to have access to some really great surgical facilities.

If you would like more information, please leave a comment and we will get back to you or call us on 0121-454 3680 or contact us here.

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Is it safe to have surgery during Coronavirus?

Surgery During Coronavirus Crisis

If you are planning to have surgery, you may have some concerns about all of the measures in place around COVID-19 and might be wondering if it is safe to have surgery during coronavirus.

The risks of contracting the virus relate to the spread in an aerosol form hence the requirement for face masks and visors.

This means that you will find measures in place when you come to the clinic to reduce transmission in the same way that you would when visiting other shops and services.

However if you are considering surgery during this time you may have further concerns.

There are risks to the healthcare professionals delivering the surgery as well as risks to yourself having the surgery.

Risks to healthcare professionals

In my field of breast and body contouring, I do not do surgery that would be classed as high risk in producing aerosol which would be more related to surgery around your mouth such as ENT or dental surgery.

There is however a risk during intubation and extubation at the beginning and end of a general anaesthetic, however there are robust measures to protect everyone around these times.

Private hospitals aim to be COVID-free environments which is why you will be asked to self isolate, fill in a questionnaire and have a COVID test before admission.  It is also why, for the time being, visitors are being discouraged.

Unlike NHS Hospitals, Private Hospitals do not have an A&E Department and so do not accept direct admissions.   This means that they have much more control over their environment as all admissions are planned.
Everything is being done to make the hospital environment a safe environment to be in for both the staff and the patients during these challenging times.

Risks to you

In relation to the risk to yourself if you are considering surgery then this is by no means clear.

There was a study which suggested that if you have surgery and go on to develop COVID-19, then your outcome may be worse than if you hadn’t had surgery.

This study seemed to affect patients who are in higher anaesthetic risk category rather than the sort of patients who have elective cosmetic surgery . It also seemed to be in patients having longer and more complex surgery. which is why this has been discouraged at the moment.

The Royal College of Surgeons has produced this information leaflet.

It has not been suggested that we should stop during surgery during coronavirus and the guidance is that for most elective cosmetic surgery, it is safe to proceed although we will ask you to fill in a COVID-19 specific consent form before your operation.

Following surgery, you will also be given a specific postoperative instruction sheet for COVID-19.

The main issue that we have at the moment is with accessibility to theatres as all of the major private hospitals in the UK have been taken over by the NHS and are offering limited access to plastic surgeons.

However we like to solve problems and overcome challenges and so have adapted and there are more and more clinics in the UK who are offering local anaesthetic and sedation which is suitable for many plastic surgery procedures.

My clinic is not set up for local anaesthetic and sedation at the moment, but we have access to other clinics to use their facilities.

This is something that we have been doing on a small scale before the coronavirus outbreak and will be doing more of moving forward and I think it is actually a positive step.

The recovery after local anaesthetic and sedation is much quicker and it can be extremely well tolerated by patients.

However it is not for everybody and there will still be some larger operations that require a general anaesthetic and we have some access to general anaesthetic theatres.

The information that we are getting from the hospitals is that we will be back to normal capacity after Christmas although this is of course dependent on how things progress with the coronavirus pandemic.

We are trying to keep everyone updated as well as we can but unfortunately, we are getting theatre lists on an ad hoc basis, so it is difficult to plan and give you a lot of notice if you are on the waiting list for surgery.

These are challenging times for all of us all,  but I think it is important to recognise the significant benefits that can come from cosmetic surgery and I believe that it is safe to continue to perform surgery during coronavirus and still maintain our high levels of service given the limitations and restrictions imposed upon us.

If you have any questions or would like to talk about any of the issues around this please feel free to get in touch or join me on my Facebook and Instagram live Q&A every Tuesday at 7pm.

Resources:

The Royal College of Surgeons information leaflet
Specific guidance sheet for COVID-19
COVID-19 specific consent form