General Information

The initial consultation provides an opportunity to discuss the issues/symptoms that have prompted you to seek a Plastic Surgery opinion. It also provides an opportunity to review your past medical history and general health, which may influence the decision-making process. Clinical examination may need to be supported by special investigations if the problem is complex.

All patients receive a full explanation of likely outcomes, potential complications and of what can be expected in the recovery process. For patients considering cosmetic surgery, it is routine to offer a second pre-operative consultation, at no cost, to make sure that every opportunity has been provided to answer questions and provide clarification.

Do not hesitate to ask questions at any time.

Whatever surgery you may be contemplating, whether reconstructive or aesthetic, it is extremely important that you have an opportunity to discuss all relevant treatment options and their implications fully.

For complex surgery and for all aesthetic procedures, I expect patients to attend for a second consultation before treatment, to make sure that all areas of discussion have been covered and all questions answered. I believe pre-operative consultations provide an invaluable opportunity, not only to convey key information but also to develop a rapport and mutual trust.

Close attention to detail at both the pre-operative planning stage, and during the surgical procedure, are key to achieving excellent results on a consistent basis.

I am very keen for patients to have an active role in their wound care post-operatively.

I usually prefer the surgical dressings to stay in place for the first week, but after our one week wound check I advise showering with normal soap and water and the application of either light dressings or no dressings at all.

Surgical site massage helps swelling, and also helps scars to settle down and mature. Moisturisers such as E45, Nivea, Bio-Oil or any other non-perfumed moisturiser are recommended.

Arnica is available either as a cream or a tablet. Arnica can help resolve bruising and swelling and I recommend this particularly for those undergoing aesthetic surgery procedures. Usually, tablets are taken from 1-2 days before surgery until bruising and swelling have settled.

I am happy for my patients to be treated with manual lymphatic drainage massages if they wish.

For scars that misbehave and thicken up during the healing process, treatments can be tried to settle things down. In addition to massage and stretch, I commonly recommend the use of a silicone gel product such as Kelocote or Silgel which works well and when used over long periods. Occasionally we can use steroid injections or other treatments.

It is important that you know what to do in the event of a complication.

In normal working hours, it is usually best to contact the office for advice. Out of hours, it is always possible to contact the hospital in which the treatment was performed. Sometimes, all that is required is advice over the telephone or by email, whereas on other occasions an early outpatient appointment (or even re-admission to hospital) may be the right course.

Infection is the most common problem we see, and usually presents over the first two weeks. Symptoms and signs include redness, swelling, pain, fever, feeling unwell or a discharge of pus from the wound. Superficial infections can be managed by antibiotics and dressings alone, but more severe infections may rarely require re-hospitalisation or even additional surgery. Neglected or severe infection may spoil the results of surgery. Delayed wound healing can complicate larger wounds and is usually treated by dressings and wound care.

Haematoma (blood collection in the wound) is an early complication, typically occurring within the first 24 hours. The treatment is to evacuate the blood collection and arrest any bleeding under local or general anaesthetic. This does not normally have any long-term consequences.

General complications such as deep vein thrombosis and pulmonary embolism (blood clots in the veins of the legs which may dislodge to the heart/lungs, and may be life threatening) can occur. This risk is higher in women taking oral contraceptive pills or HRT but this risk can be reduced by discontinuing the pill for six weeks prior to surgery or converting to a dermal patch. Some patients choose to continue taking the oral contraceptive or HRT, and blood thinning injections can sometimes be given to mitigate the risk.

Although most patients are satisfied with their results from surgery, some may have outcomes that do not meet expectations. The reasons for this may include issues with healing such as infection, or the patient sometimes having unrealistic expectations of what the surgery can deliver. Whatever the reason, in my own practice, I have a low threshold for offering revision or adjustment surgery. I want my patients to feel comfortable and confident to discuss their feelings about outcomes so that, where necessary, further surgery may be considered with a view to providing a result that meets everyone’s expectations.