LPSA

What should I bring to my consultation?

Depending on the complexity of your case your first consultation can be expected to last between 25 and 40 minutes. We are aware that you are probably busy and likely to be pressed for time, we are conscious that if delayed only half of your brain will be on the consultation while the other half will be preoccupied with the prowling traffic wardens. We will do our best to see you on time, but please forgive us if there is a delay, minor emergencies and difficult consultations can occasionally push us behind schedule. If you have any concerns in this respect please speak to the secretaries or practice manager, who will do their best to help.

• Details of your past medical history

  You will be asked to fill in a medical questionnaire and your surgeon will discuss your health, past medical history and will need a list of any medicines taken and drug allergies. Please be honest about the amount of cigarettes you smoke as heavy smoking will affect results in some operations.

• An opinion

  If you are coming for an aesthetic consultation your surgeon will ask specific questions about your concerns. Try and think about your concerns beforehand as we do not want you to feel you have been 'put on the spot'.

• A little prior knowledge

  We will try to avoid jargon but it is inevitable that if you have been able to read a little around the subject you will find it easier to follow/ lead the discussion. A little reading will give you good clues for questions to ask. We don't expect you to pick up a surgical textbook, the information provided by our website should be adequate. Alternatively there are a number of alternative sites that can be accessed via http://www.londonplasticsurgeryassociates.co.uk/links.htm

• A list of qustions

  Don't be afraid to ask questions. It often helps to prepare a list beforehand; otherwise there is a risk of leaving the room and remembering the most important question as you step into the lift. Your surgeon will be very used to these consultations and hopefully will pre-empt most of your questions as he explains the procedure, however if there is anything you are unsure about please ask.

• A second pair of ears

  You will possibly find yourself swamped with information and sometimes patients find it helpful to attend a consultation with a partner, family member or friend. Frequently each will find that they have remembered different parts of the discussion.

What can I expect?

• Be asked to return

  With many preoperative consultations you will be asked to come back for a second meeting so that the surgeon can ensure you both have similar aims and expectations and are aware of the implications of surgery. There is no charge for any further preoperative consultations; it is another chance to ask any questions you may have forgotten at the first meeting. Second consultations usually last for about fifteen minutes but should you anticipate that it will take longer than normal, perhaps because you wish to discuss a separate procedure, please let the office know and they will allocate more time.

• Discuss limitations, implications and possible complications of surgery

  You surgeon will do his best to ensure you are aware of the intended benefits of surgery, and will try to be clear if there are aesthetic issues that the procedure will not address. It is important that you are aware of the implications of surgery in terms of swelling, scarring and bruising, time needed in hospital, time that will be required for recovery and the time before you can return to work and exercise. It is also important that you are aware of the potential complications that have previously been highlighted in plastic surgery literature.

• Don't be surprised to be advised that delaying your surgery may be sensible

  If your surgeon suggests delaying your surgery it will usually be for one of three reasons
  1. Because he feels that your health could be improved beforehand, possibly by stopping/ reducing smoking or even by seeking a medical opinion from your GP or a physician colleague.
  2. Because you are taking tablets that may complicate surgery, the most common of these will be aspirin or non-steroidal anti- inflammatory tablets.
  3. Because he has concerns that you are not giving yourself sufficient recovery time before you MUST be ready for work or an important social engagement/ long haul flight etc.

• Anaesthetic opinion

  Occasionally your surgeon will suggest that it might be sensible to have an opinion from an anaesthetic colleague before making formal plans for your operation; there is no further charge for this consultation.

How do you choose your surgeon?

Qualifications and Credentials

Ensure your surgeon is accredited in plastic surgery with the GMC.
BAAPS and BAPS are the bodies recognised by the Royal College of Surgeons as the legitimate representative of aesthetic and reconstructive surgery respectively. All members will be fully trained and must adhere to a strict code of conduct. These organisations aim to provide continuous education to its members, they are also aware of their responsibility in providing information and guidance to the public. A list of approved surgeons can be obtained by telephone or at www.baaps.co.uk

GP Referrals

Consider asking your family doctor, many GPs will be able to advise on surgeons who specialise in certain areas.

NHS resident

Ask whether your surgeon works for the NHS, although this is not imperative, it is true that surgeons employed by the NHS have all completed training to the highest level and will be subjected to regular and stringent peer scrutiny and appraisal.

Beware the free consultation and surgical 'deals'

Your surgeon is there to provide advice on the best procedure for you and to apprise you of the alternative as well as the implications, limitations and potential complications of any surgery. If you want impartial advise you will almost certainly pay for it, free consultations are viewed by the professional organisation as a form of enticement and the same is true of deals, where you may be offered a cheaper deal if you sign up on the spot. Be suspicious!

Never /always

The human body is complex and slightly unpredictable, cosmetic surgery is largely very safe with a low rate of complications but words such as always and never cannot reasonably be used when discussing results and complications, be suspicious of such firm assurances.

Second opinion

If you have any concerns following you consultation do not be afraid to seek a second opinion, any reputable surgeon will fully understand this. It may seem to be an unnecessary expense, but making a mistake by choosing the wrong surgeon will be far more costly.

Think carefully about surgical tourism

Surgery combined with a holiday abroad and the whole package priced cheaper than the same operation in the UK sounds very attractive. There are undoubtedly some very skilled and highly respected surgeons working in countries that offer surgical tourism, although most of them will have large home-grown practices and feel uncomfortable looking after patients who fly in and out. Regulation governing surgeons and hospital differ widely across the world. We have all witnessed the disasters that can result from a poorly planned surgical trip. A meeting with a cosmetic sales advisor (sales person), or if lucky with a peripatetic surgeon in the UK, arrival in a city a long way from home having paid the bills, the slow dawning of a suspicion that this may not be the wisest of ideas. At this stage it takes a strong character to pull out. The most difficult situation is experienced by the patient who arrives home and experiences a complication however small once they are x thousand mile from their surgical team. All of us who work in the NHS and UK private practice have found ourselves dealing with a significant increase in problems resulting from surgical tourism. Think very carefully.

Avoid cosmetic advisors

You should always see a surgeon to discuss you surgery before deciding whether to proceed. In some practices you may be given extra advice from a practice nurse or manager but there is no substitute for an honest consultation with your surgeon. Beware of the hard sell.