GENERAL

Who is a good candidate for cosmetic surgery?
Those seeking to improve their appearance and have realistic expectations as to what cosmetic surgery can accomplish. Those with a physical disfigurement who wish to undertake cosmetic surgery to make themselves look more normal are also ideal candidates. Cosmetic surgery is not advisable for those going through a crisis in their work or homelife, who believe that changing their appearance could be the solution to all of their problems. Another group of people who should be dissuaded from cosmetic surgery are those who suffer from a rare psychiatric condition known as dysmorphophobia. These people - who look entirely normal - are convinced that they look ugly or misshapen and seek repeated operations.

Is cosmetic surgery advisable for children?
Most cosmetic operations are delayed until children have reached adulthood. However, few parents would dispute the wisdom of their child having surgery if he or she is marked out by a defect, such as a hare lip, or has been left scarred by a burn or other injury. More frequently, children with prominent ears have them surgically pinned back, or have facial birth marks or port wine stains removed by laser. More controversially, a handful of children with Down's syndrome are having facial surgery - the idea being that if they look more 'normal' they will be accepted more easily.

How successful is cosmetic surgery?
This depends on widely variable factors: general health, age, heredity, bone structure, skin texture, as well as the gravity of the specific problem to be corrected. While a surgeon can predict good results in selected cases, the healing process is influenced by factors not entirely under his control. It would therefore be wrong for him to guarantee completely successful results. Remember that there is always a downside to surgery.

Does cosmetic surgery hurt?
Since cosmetic surgery is usually performed under general anaesthetic or under local anesthetic, there is seldom any severe pain. After surgery, any discomfort can be controlled by oral medication. The important thing to remember is that post-surgery discomfort is temporary.

Will there be much bruising?
The degree of swelling and bruising produced by cosmetic surgery depends on the procedure used and on the individual patient. Most cosmetic surgery produces some swelling and bruising, especially when performed around the loose tissue of the eyes. Most swelling subsides within several days however, and make-up can conceal any temporary bruising. The homeopathic drug Arnica will often help.

Will I be left with scars?
Scars are an inevitable part of the healing process of any surgical incision, although unlike bruising, they do not disappear but will improve with time. However, the surgeon will endeavour to make the thinnest possible incisions in areas where scars can be easily camouflaged.

How can the surgeon improve my looks without using a scalpel?

He/she can enlarge our lips with injections of collagen and outline them with tiny dots of colour, or temporarily paralyse our frown lines with Botox. He/she can suck out our fat by liposuction and eradicate our wrinkles and blemishes with the use of lasers.

Are there any risks involved in cosmetic surgery?
As in any surgical procedure, there is a possibility of complications. The invasive nature of surgery can cause pain, bruising and scars, and its success is dependent on the surgeon's skill, the patient's constitution and the type of operation. Complications can include muscle or nerve damage (facelift surgery, breast implants and abdominal reduction) and haematomas (breast/abdominal reduction) or infection. Recovery from cosmetic surgery can take several months before scars have softened and matured.

How do I know if a surgeon is a specialist?
The General Medical council (GMC), which is the governing body of all doctors, holds lists of specialist trained surgeons, including a list of plastic surgeons. So if you want to know if your surgeon is a specialist ring the GMC on 020 7580 7642 and ask if his name is on the specialist register. Increasingly surgeons who have trained in Europe are allowed to practise in this country may be on this list. Sometimes their training will not be as full and complete as specialist Uk training.

Is there any insurance I can take out to cover me if an operation should go wrong and I have to go back into hospital?
Most surgeons will belong to one of three organisations - the Medical Defence Union, the Medical Protection Society or the Medical and Dental Defence Union of Scotland - which provide them with indemnity against the results of legal actions by patients unhappy about their treatment. It is advisable to check that they belong to one of these organisations before proceeding with surgery. Recently companies have started insurance policies for breast augmentation. They are very expensive.

What can I do if things go wrong?
If you feel that your operation has gone wrong, go back and tell your surgeon that you are unhappy with the result. A reasonable surgeon will often perform a second operation to correct the fault with no additional surgeon's fee. If you no longer feel confident in his or her work, you will want a second opinion. If your surgeon refers you to a colleague, you need to establish first of all who will pay for the consultation and for any subsequent surgery. No secondary surgery can be carried out until scars have softened - usually at least a year after your first operation. You may decide to take legal action. You can only sue a surgeon for negligence or assault and battery. A surgeon is negligent if he or she falls below an accepted standard of performance, either with pre operational advice, by operative performance and/or aftercare. Assault and battery is if a surgeon carries out a procedure which you haven't agreed to. It is therefore vital that the surgeon secures the patient's informed consent. This means he must explain to you the operative procedure, the recovery, the result and the possible complications before the operation. You will be asked to sign a document before the operation agreeing that all this has been explained to you. If you do decide to take legal action, an organisation called Action for Victims of Medical Accidents will point you in the direction of a solicitor who specialises in negligence cases. Normally you will have to issue proceedings for a claim within three years of the date of surgery.

How much does cosmetic surgery cost?
Your first consultation with a PSP surgeon will cost £100. The consultation fee should be regarded as the most important part of the overall cost as it is only after all the surgeons advice that you should decide whether to have surgery or not. Cosmetic surgery can cost anything between £1-10,000 depending on the type of operation. Lasering costs £150 for an initial test, and then £300 for each area treated whereas as total facelift with surgery and laser treatment can cost onwards of £7,000.

Is it possible to get cosmetic surgery on the NHS?
If a psychiatrist is convinced that someone is in real psychological distress about a particular feature, such as their nose or breasts, it may be possible to get cosmetic surgery on the NHS. Priority is given to reconstructive surgery for people disfigured by disease or injury, and also those with functional problems such as not being able to breathe through their nose.