Ask a Surgeon: Cosmetic Surgery Q & A with Mr Simon Mackey

Deciding whether or not to get cosmetic surgery is a very difficult decision. Discussing your treatment options with cosmetic surgeon is essential to helping you decide if this is the right choice for you.

In this blog, consultant surgeon Mr Simon Mackey answers the most common questions asked by men and women regarding cosmetic surgery.

Q1: How much will the surgery cost?

The total cost of an operation will be made up of the fees for the hospital (bed, operating theatre and other tests), the anaesthetist and the surgeon's time. You will normally be given a total cost which includes all these fees. Here you can find our guide prices.

Q2: How do I know if my surgeon is fully qualified?

Your surgeon should be on the General Medical Council’s list of registered plastic surgeons. If your surgeon is registered with BAPRAS, the British Association of Plastic, Reconstructive and Aesthetic Surgery, or BAAPS, the British Association of Aesthetic Plastic Surgeons, they are not only qualified and registered with the General Medical Council as specialist plastic surgeons, but have also been recommended by other specialists who can vouch for their ability and knowledge.

Here is a blog post specifically written to help you with choosing a cosmetic surgeon in the UK

Q3: I’ve booked a facelift. What can I do to prepare for it?

Make sure you’re confident in your surgeon. Avoid aspirin, herbal supplements, anti-inflammatory drugs, steroids and alcohol to reduce the risk of bleeding. Stop smoking, to reduce wound-healing problems. Avoid make-up, and wash your hair on the day of your surgery. Make suitable arrangements for rest and recuperation following surgery.

Further information about facelift

Q4: How long does the swelling and bruising last after liposuction?

Everybody is different, but bruising can be expected to resolve over 2- 3 weeks. Swelling can take 3-6 months to resolve. Avoiding aspirin, and supplements such as Vitamin E and fish oils will reduce bruising. Swelling can be helped to settle with compression garments. Arnica remains a popular remedy for bruising.

Further information about liposuction

Q5: I’m 56 and recently lost 9 stone but it’s left me with saggy skin in places. Is brachioplasty the best option for treating my “bat-wings”?

Brachioplasty (or ”arm-lift”) is likely to be the best option for you after significant weight loss. It is simple and effective to remove the under-arm skin that has been "over- stretched". No amount of liposuction or non-surgical therapy will tighten the in-elastic skin around your arms.

Q6: Is it true that plastic surgery leaves no scars and lasts forever?

Unfortunately all surgical incisions cause scarring. How visible a scar might be is determined by how the surgical incision is closed; how it is cared for after the operation; and where the incision is made. Typically, I’ll make an incision in an area where there are natural creases in the skin, which helps hide the scar.

Everyone heals differently, due to genetics and personal health factors, but some physical evidence of the procedure will always be present. While cosmetic surgery results are long-lasting and can give years of personal satisfaction, many factors determine how long the results will last.

“Plastic surgery can turn back the hands of time - but the clock keeps on ticking”. Great skin care, avoidance of smoking or sun-burn, and your overall health are all important to maintain your appearance.

Q7: Are there any limits to the changes plastic surgery can make to your appearance?

Yes, plastic surgeons are doctors, not magicians! Many factors will determine how much of a change your surgeon can achieve. There are limitations to every procedure, and you must also be well-informed about possible complications before committing to any surgical procedure.

It’s important that you fully understand the implications of any planned treatment before it is undertaken.

Q8: Can liposuction make me “skinny”?

An overweight or obese person should not expect liposuction to substitute for proper nutrition and exercise. While liposuction can make certain areas smaller, liposuction will not make an overweight or obese person look skinny.

Once at your ideal weight it can be excellent at reducing the size of stubborn pockets of fat at specific sites – for example, the thighs, buttocks, abdomen or neck.

Further information about liposuction

Q9: Aren’t plastic surgery patients rich and famous?

If plastic surgeons only operated on the 1%, we wouldn't have a thriving plastic surgery industry. Most cosmetic surgery patients are not the rich and famous, but are average people who simply wish to change areas which are not amenable to diet, weight loss or nonsurgical procedures.

Q10: Is plastic surgery just for women?

Although women have been the traditional recipients of cosmetic surgery, men are choosing it in increasing numbers. Less invasive procedures such as treatments to reduce the appearance of fine lines and wrinkles and dermal fillers can give men a rejuvenated and more youthful appearance without much downtime. These, along with liposuction, and the reduction of male breast tissue (gynaecomastia / gynecomastia surgery) are the most popular cosmetic surgery treatments for men.

Q11: Can multiple plastic surgery procedures be performed at the same time?

It is possible to have multiple procedures performed at the same time. Safety, however, is the primary concern. Combined operations require more time under anaesthesia, and some combinations of procedures are more suitable than others. There can be advantages in terms of reduced “down-time”.

Q12: Do plastic surgery always require a general anaesthesic?

Not all procedures require general anaesthesia (that you are put to sleep). Many can be performed under local anaesthetic or with sedation. Alternatively, if you are the type of person who does not want to be awake, you can choose to have a general anaesthetic.

Q13: Is breast augmentation a “one-off” procedure?

Breast augmentation is one of the commonest and most popular cosmetic surgery operations, but you should be aware that the likelihood of needing subsequent surgery is relatively high. Some women choose to change their initial size, or may need additional surgery due to breast changes resulting from ageing, pregnancy, and weight fluctuations. Additionally, a breast implant may rupture or become hardened, necessitating removal or replacement. Cosmetic surgeon will go through the “ins and outs” of breast augmentation in detail before your procedure, so that you are fully informed.

Read our post about breast surgery basics

Q14: Can dermal fillers and treatments to reduce the appearance of fine lines and wrinkles replace a facelift?

Treatments to reduce the appearance of fine lines and wrinkles are popular and in well-trained hands can provide natural-looking enhancements for individuals who do not want to undergo surgery. They do not, however, take the place of surgery when there is a significant amount of loose facial or neck skin. In these situations, surgical excision of excess skin is the solution.

Surgical and non-surgical procedures complement and enhance each other, but they don't replace each other.

Q15: Won’t fillers give me a “trout-pout” or “pillow-face”?

When carefully placed by an experienced practitioner, fillers can be used to produce a fresh appearance. Because dermal fillers are classed as medical devices, under current EU legislation, however, anybody can give anybody else ”dermal filler”. Additionally, there are over 200 filler materials licensed for use within the European Union, whereas only 6 are licensed for use in the USA. This lack of regulation in terms of “who” can inject “what” into “whom” means that some people have poor results from dermal fillers.

In the UK the British Association of Aesthetic Plastic Surgeons has been trying to increase patient safety by encouraging the government to make fillers “prescription-only”. At Ramsay we tend to use hyaluronic acid fillers as these are biocompatible and are absorbed by the body with time. They can also be removed with hyaluronidase if needed. As a member of BAAPS, I fully support a tightening of the current EU legislation pertaining to use of injectable filler materials.

Q16: Are all plastic surgeons the same?

No. Anybody may call themselves a cosmetic surgeon. For quality control and safety I recommend that you make sure that your plastic surgeon is on the General Medical Council’s specialist register for Plastic Surgery and a full-member of either BAPRAS (the British Association of Plastic, Reconstructive and Aesthetic Surgeons) or BAAPS (British Association of Aesthetic Plastic Surgeons). This should help to ensure that your surgeon has had adequate training in Plastic, Reconstructive and Aesthetic Surgery techniques.

Read our blog post on how to choose a cosmetic surgeon in the UK

Q17: Plastic surgery is not "real" surgery – is it?

Plastic surgery should not be undertaken lightly. While there can be great benefits to undergoing plastic surgery there are also risks. Every operation has a degree of risk associated with it. The specific risks of any procedure should be discussed during your consultation with your plastic surgeon.

Read more cosmetic surgery blog posts to find answers from our consultants to the most common questions including: best place for breasts implants, breastfeeding and implants, cosmetic surgery after weight loss surgery.

About Mr Simon Mackey:

Mr Simon Mackey has been awarded the intercollegiate Fellowship in Plastic Surgery, FRCS (Plast); and is on the GMC’s Specialist Register for Plastic Surgery. He is a member of the British Association of Aesthetic Plastic Surgeons (BAAPS) and the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS).

Mr Simon Mackey is a Plastic Surgeon at North Downs Hospital in Surrey.About Ramsay Health Care UK Cosmetic Services
Cosmetic Surgery from Ramsay is a leading provider of cosmetic surgery and non-surgical treatments in the UK.

Please contact us if you would like to discuss any cosmetic surgery procedure in more detail.

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