The true cost of cosmetic surgery tourism

cosmetic surgery tourismCosmetic surgery tourism is on the rise as more and more people seek the best deal possible.  But what’s the true cost, both to the patient and to the NHS? As I mentioned in last month’s blog post on the increase in revision surgery, one of the main driving forces behind this surge is men and women undergoing botched plastic surgery procedures abroad and then returning to the UK, often requiring urgent medical treatment on the NHS.

Cosmetic surgery tourism and patient safety

Financial uncertainty in the UK, partly as a result of Brexit, makes the ‘cheap deals’ offered by cosmetic surgery clinics in other countries very attractive. Yet conveniently, there is no mention of the many possible complications as a result of having cosmetic surgery abroad.

Sales-driven surgery: often patients will see a representative of the clinic in the UK and believe that gives them a degree of security. However, this representative is usually a broker or salesperson, driven by financial considerations alone.

A common reason that people are left unsatisfied or in a worse state after cosmetic surgery is that they were medically or psychologically unsuited for a particular procedure – the broker has neither the professional ability or desire to evaluate patients properly. A UK plastic surgeon should have the training and experience required to evaluate a patient properly and turn that patient away if they feel that surgery is not the best option for them at that time.

Informed consent and time to consider: in the UK, we are duty-bound to give patients enough information regarding the procedure that they can make an informed decision about whether to go ahead. No salesperson or non-medical professional can provide that. And, once the patient has committed to surgery and flown to another country, the pressure on them to go ahead often means that they proceed with misgivings.

Paying for peace of mind: the price of cosmetic surgery in the UK may seem more expensive at first glance than the deals offered by clinics abroad, but do you know what you’re paying for? A reputable plastic surgeon in the UK will typically be a member of the independent plastic surgery organisations that charge membership fees – these organisations carry out annual safety audits and are committed to ensuring patient safety.

Your UK surgeon will also be performing your surgical procedure in a private hospital and this makes up a significant part of the cost. These private hospitals and clinics are under a legal obligation to meet certain standards of quality and safety and they are inspected by the Care Quality Commission in England and similar bodies in Scotland, Wales and Northern Ireland.

Furthermore, your UK plastic surgeon will be paying for medical insurance that covers potential complications arising from surgery. Cosmetic surgery tourism patients often find that there is no recourse if something goes wrong and no provision for follow-up care or further surgery.

Aftercare and follow-up: I’m a firm believer that the recovery process after a cosmetic surgery operation can be as important as the surgery itself in terms of patient satisfaction and optimal results. Any surgery carries risk, which is why it is essential to have your surgeon and their team on hand to deal with any possible complications. Infection is a common complication, often compounded by flying too soon after surgery, and needs to be carefully monitored, which is just not possible from abroad. If you do need to return for further surgery, then those costs are usually not included.

The burden on the NHS

Presented at the BAAPS meeting, was a study of patients presenting at one NHS hospital in London, with injuries resulting from cosmetic surgery abroad. Half of the complications treated at the Royal Free Hospital, London resulted from infection, with breast augmentation patients losing their nipples or tummy tuck patients requiring massive skin grafts as a result of dead and dying tissue. The cost to the hospital, from just 21 patients, was in excess of £282,000, with an average cost of £13,500 per patient.

An increasingly cash-strapped and over-burdened NHS may decide to make patients pay for any procedures arising out of botched surgery overseas in the future, meaning that ‘cheap deal’ could come with a significant and unwelcome additional cost.

Eyelid surgery patients are rated as younger, more attractive and more energetic

It’s all about the eyes – eye contact is one of the most powerful forms of communication and your eyes can express a wide range of feelings and emotions. Unfortunately, the delicate skin and powerful muscles around the eyes also makes them one of the first areas of the face to show the visible signs of ageing. Patients at my Leamington cosmetic surgery clinic often complain that their eyes are making theeyelid lift benefitsm appear older, more tired and less attractive than they actually feel.

After breast enhancement, the blepharoplasty procedure or eyelid lift is the UK’s most popular cosmetic surgery procedure for its ability to transform and rejuvenate the face and this has now been confirmed by a new study that appeared in the JAMA Facial Plastic Surgery Journal.

In the study, called A Dual Approach to Understanding Facial Perception Before and After Blepharoplasty, 401 participants were asked to rate the before and after photographs of ten women who had undergone a blepharoplasty procedure, comparing the perceptions of observers with patient reports. Observers were asked to focus on age, attractiveness, energy levels and overall health. Over 150 blepharoplasty patients were also asked to respond and rate their own experiences.

Overall, the results indicated that eyelid lift patients appeared 1.04 years younger. The post-op women were also deemed to be more attractive, healthier and energetic.

Cast your eye over these considerations

Although the eyelid lift is quite rightly a very popular procedure there are always important considerations you must take into account before decided to embark on surgery.

  1. What are the risks of an eyelid lift? All surgery comes with a degree of risk and these will be explained in full during your blepharoplasty consultation. Risks of eyelid surgery include problems associated with the anaesthetic, infection, dry or sensitive eyes or other eyelid problems, scarring, injury to the muscles around the eyes, temporary problems with vision and – very rarely – a loss of eyesight.
  2. Can I have eyelid surgery if I have dry eyes? The eyelids are essential for keeping the eyes moist and one of the risks of surgery is the onset of ‘dry eye’ or worsening of a pre-existing condition. This will be assessed before surgery and, if it is deemed safe to proceed, then a conservative approach in terms of how much tissue is removed must be adopted.
  3. Will I have to hide behind dark glasses for weeks after a blepharoplasty? Patients are often surprised to find that recovery from upper eyelid surgery is typically quicker than other forms of facial surgery. The skin on the eyelid is thin so usually heals very well. Lower eyelid surgery is often more complex with a correspondingly longer recovery time, requiring a greater degree of patience. Some initial bruising and swelling and bruising should be expected anyway, but the full resolution of swelling takes longer, particularly in lower lids. Avoidance of make-up at first and of exposing the eye area to direct sunlight to start with (use those shades!) is important for most rapid wound healing.
  4. Can eyelid surgery deal with the tear trough? The tear trough is the name for the hollow between the nose and the lower eyelid that is formed by the weakening of the lower lids and descent of fat in the cheek area. There are non-surgical treatments such as dermal filler injections which may be more suitable than surgery to improve the appearance of the tear trough.
  5. Is an eyelid lift the correct surgical approach? Often patients fixate on the eyes as their problem area, but I always assess the whole of the face. The brow typically descends as we age and that can be contributing to that tired or angry look around the eyes; in this instance, a lateral brow lift can make the eyes more open and rejuvenated.

Interestingly, the eyelid lift patients in the study themselves reported an increase in their perceived energy levels after they had undergone an eyelid lift, so the benefits of a blepharoplasty are not just in the eyes of the beholder. Upper eyelid lift in people with marked sagging of lid skin, in whom the eyes feel increasingly heavy and difficult to open as the day goes on, always experience a great sense of physical relief that is truly energising, as well as being able to see upwards and outwards much better as their physical ‘blinker has been removed. Very rewarding all round.

Worrying rise in botched plastic surgery needing revision

revision cosmetic surgeryThis month saw the annual scientific meeting of the British Association of Plastic Surgeons (BAAPS) take place. Among the many interesting topics for discussion was an important message that the general public should be made aware of. BAAPS had polled its 230 or so members, of which I am one, and found that four out of five surgeons have recorded a rise in patients needing revision surgery for procedures that had been performed by less able surgeons.

Reasons why revision surgery may be required

All cosmetic surgery may require further revision work – small adjustments may be needed to achieve the optimal result or the body may heal in an unpredictable way – and this will be explained during your consultation so you’re aware of all potential outcomes before making the decision to go ahead. But, in this instance, BAAPS is focusing on botched surgery which falls drastically short of the patient’s expectations and is often unsightly or worse.

There were three main reasons identified as to why revision surgery of this type was on the rise:

  1. In 40% of cases, surgeons believed that the patients should never have undergone the initial procedure, either because they were medically or psychologically unsuitable. Plastic surgery is elective so it is never necessary and an important part of our role as surgeon is to identify patients that have unrealistic expectations, possible body dysmorphia or medical conditions that make them unsuitable for surgery.
  2. Nearly a third stated that the original procedure fell far below the expected standard and must have been performed by someone that didn’t have adequate training or experience. New legislation introduced by the Royal College of Surgeons is aimed at tackling this “cowboy proliferation”, as BAAPS describes this worrying trend.
  3. Another third found that they had been required to treat patients who’d taken advantage of cheap plastic surgery deals abroad with disastrous consequences. Cosmetic medical tourism is on the rise in response to these times of financial uncertainty where price often becomes the major deciding factor. However, the fine print in these ‘deals’ don’t cover the increased risk of complications, lack of patient protection and issues with aftercare or follow-up treatment that are inherent in having plastic surgery abroad.

Unfortunately, despite my level of experience, training and surgical skill and that of my fellow colleagues, it’s usually not possible to produce the results the patients were hoping for when performing revision surgery of this nature.

BAAPS is committed to the education and advancement of cosmetic surgery and conducts annual safety reviews of its members to ensure that high standards are always maintained so membership of an independent surgical association such as BAAPS should be an important factor in choosing your plastic surgeon… certainly it should always be placed above price.

Cosmetic surgery may even help patients quit smoking

cosmetic surgery benefitsThere are many benefits – as well as cons – to consider when deciding whether to embark on cosmetic surgery and now it seems that quitting the habit could also be one.

Prior to undergoing a major cosmetic surgery procedure, such as a tummy tuck, facelift, breast reduction or breast uplift, I insist on patients stopping smoking for at least eight weeks before the procedure and during the healing period afterwards. Now, a new study published in the September issue of Plastic and Reconstructive Surgery, has followed up on cosmetic surgery patients and found that many actually quit smoking in the years after their op.

The lead author of the study, Dr Aaron C. Van Slyke of the University of British Columbia in Vancouver commented, “Our results show an association between cosmetic surgery and smoking cessation at long-term follow-up.” The study interviewed patients who had been smokers prior to their plastic surgery procedure performed five years’ previously. About 40% of patients no longer smoked cigarettes on a daily basis and nearly one-fourth had not smoked at all since their operation.

Dr Van Slyke also pointed to the important role that the cosmetic surgery can play: “Surgeons who request pre-operative smoking cessation may influence patients’ long-term smoking status.” Seventy percent of patients interviewed in the study agreed that discussing the increased surgical risks associated with smoking influenced their desire to quit or reduce smoking.

Other benefits of cosmetic surgery

Increase in confidence: when a physical feature that may have bothered you for many years is altered or enhanced, it can greatly boost self-esteem. For most patients at my Leamington Spa cosmetic surgery clinic, it has been an issue for many years and surgery is a carefully considered option. However, if it is a sudden or recent dislike, then my advice might be to delay surgery at this time.

Improved physical health: although cosmetic surgery is purely elective and not required for medical reasons, there can also be a great improvement in health. Women with overly large breasts, for example, can experience excruciating back and neck pain and this can be greatly reduced or abolished by breast reduction surgery.

Positive lifestyle changes: this research into smoking cessation and cosmetic surgery is one of many recent studies into the potential benefits of cosmetic surgery. In 2013, one study looked at patients undergoing a tummy tuck and found that there was significant and lasting weight loss particularly for those patients that were overweight prior to surgery.

There are many potential pros to cosmetic surgery, but there are also risks to consider as well. During consultations at my Warwickshire cosmetic surgery practice, I always ensure that patients are fully aware of all the possible implications before they make this important decision.

MRHA releases a statement on Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL)

breast augmentation risksLast month, the Medicines and Healthcare products Regulatory Agency (MHRA) released a statement on breast implant associated-Anaplastic Large Cell Lymphoma (ALCL).

 What is ALCL?

Anaplastic Large Cell Lymphoma is a very rare sub-type of non-Hodgkin’s lymphoma and last year the World Health Organisation defined a specific type which is breast implant associated.

The most common symptom in women with breast implants seems to be a collection of fluid, known as a seroma, which accumulates six months or more after surgery has taken place. Typically, though, cases develop many years after surgery.

Currently, there is an ongoing investigation by the MHRA into this new form of cancer and their advice is being continually updated as more information is gathered.

Patient safety is always of paramount importance

The MHRA has formed an independent expert advisory group – the Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG) – who are reviewing the risks associated with breast implants in relation to BIA-ALCL. Their advice will help to guide the actions of the MHRA.

Another important step is the Breast and Cosmetic Implant Registry (BCIR) which was launched in October 2016 in the wake of the PIP breast implant problem. By capturing data on breast implants, this will aid in the early detection of potential issues and provide a mechanism for contacting and managing patients in event of a problem.

Should I be worried about ALCL?

ALCL is very rare but the advice from the MRHA is to seek advice from your plastic surgeon if you develop a seroma or lump in the breast or a swelling around the implant. Currently, the MRHA continues to collect and analyse information on this issue to provide more extensive advice for UK breast implant patients.

The problem seems to be almost exclusively associated with textured surfaced implants and more with one particular type of textured implant than the others. Nagor, the implant brand I use, seems to have an extremely low incidence rate.

As a plastic surgeon, we have received alerts from the MHRA regarding the potential risks of ALCL. Their advice is in line with what I already tell my Warwickshire breast implant patients: regularly check for symptoms relating to your implants, whether that’s lumps, swelling or any changes to the breast, and seek advice immediately if you have any concerns.

During your breast augmentation consultation, we will discuss all potential risks and complications associated with the procedure, so you are fully-informed before making your decision to proceed.

BAAPS weighs in on lip filler debate

lip augmentation problemsSocial media has been named as the chief culprit behind the rise in young people seeking aesthetic procedures such as Botox and dermal fillers and now the British Association of Aesthetic Plastic Surgeons (BAAPS), the UK’s leading independent plastic surgery association of which I’m a member, has been moved to comment on the situation.

Last month, a study published by the Nuffield Council on Bioethics called for the UK government to provide greater protection for young people. In particular, they pointed out the vast amount of makeover apps and online cosmetic surgery games that were accessible and even aimed at very young children.

Furthermore, the rise of social media platforms that focus on ‘selfies’ which can be digitally manipulated before being posted for likes or negative reviews combined with a celebrity culture that portrays an unrealistic lifestyle and airbrushed images, contributes to a spike in anxiety and impact on self-esteem.

Professor Jeanette Edwards of the University of Manchester, who chaired the Nuffield Council’s research into ethical issues and cosmetic procedures, said: “There is a daily bombardment from advertising and through social media channels like Facebook, Instagram and Snapchat that relentlessly promote unrealistic and often discriminatory messages on how people, especially girls and women, ‘should’ look.”

The Council were focusing on those under the age of 18 that might be being pressured into these kinds of procedures and BAAPS agrees that there are serious concerns over how these treatments, particularly dermal fillers, are being marketed to Millenials.

A recent poll by WhatClinic.com found that almost half of traffic to web pages about lip augmentation were from visitors in the 18-24 age bracket and those clinics surveyed said that although they wouldn’t treat under 18s, they would provide fillers to those under 21.

Dermal fillers remain unregulated in the UK and, as a result, plastic surgeons are increasingly being called upon to treat complications arising from treatment. Despite many calls for the Government to introduce more stringent regulations of fillers and a whole host of other ‘minimally invasive’ procedures, patients still remain at risk.

Until new laws are introduced, the best advice is always to see a medically qualified practitioner such as a plastic surgeon that has the necessary experience to both produce the aesthetic results you’re hoping for as well as deal with a problem if it was to arise.

Quality of life improved by body contouring surgery after weight loss

body contouring after weight lossLast year there were calls for the NHS to significantly increase bariatric surgery rates to 50,000 a year to bring it in line with European averages. The paper published in the British Medical Journal, propounded the major health benefits and potential reduction in healthcare costs for the NHS. Yet, according to a new study, quality of life after weight loss surgery may be dependent on the patient undergoing further surgery to tackle excess skin.

For men and women who are determined to transform their lives, then weight loss surgery can be the answer to many years of struggling to lose weight. For those that have a BMI of 40 or more, or a BMI of 35 to 40 with a related health condition, then a gastric band, gastric bypass or sleeve gastrectomy might be appropriate and patients can expect to lose up to 50% of their excess weight in the first six months after surgery.

However, that sort of massive weight loss over a short period of time is not without its downsides and often the biggest – and most unwelcome – surprise is that you’re still unhappy with how you look. After years of being overweight, skin becomes stretched and less elastic and many men and women are left with folds of sagging skin.

Clothes can still fit badly because of the excess skin and you can still be reluctant to bare your bodies on the beach or in the gym. Even physical problems can persist with chafing and rashes and no amount of exercise can improve the problem significantly.

Benefits of body contouring after weight loss surgery

In recent years, there has been more focus on this problem. One report published in 2013 in the Plastic and Reconstructive Surgery journal, found that patients who’d undergone body contouring surgery were less likely to gain weight back than those that hadn’t. One hundred patients that had lost about 100 pounds as a result of bariatric surgery were monitored after their procedure and those that had also underwent a cosmetic surgery procedure to remove excess skin, gained back approximately 13 pounds whereas those that hadn’t had further surgery gained about 50 pounds back.

Now, a new study published in the Aesthetic Surgery Journal has found that those who undergo procedures such as a tummy tuck or arm reduction after losing massive amounts of weight, may have a better quality of life.

The study questioned 112 female patients who’d undergone successful weight loss surgery about their attitude to their bodies and perceived quality of life. These women then went onto have body contouring surgery and the researchers spoke to the women at intervals over the next two years. On average, quality of life scores rose from 44 before body contouring surgery to 86 in the short term and a similar improvement at longer-term assessments.

Body contouring surgery options

Mr Richard Matthews offers a number of different plastic surgery procedures that are aimed at removing excess skin, whether on the breasts, thighs, flanks and abdomen, improving the body’s shape and tone.

Breast lift: also known as a mastopexy, this procedure is suitable for patients who have sagging skin and loss of volume in the upper part of the breast, a common problem after massive weight loss. The aim is to produce a more youthful, fuller, lifted appearance to the breasts.

Tummy tuck or abdominoplasty: this is one of the most well-known and popular body contouring procedures as it is possible to remove excess skin, tighten up the stomach muscles, sometimes combining with liposuction, to greatly tighten and tone the abdomen.

Body lift: often the amount of excess skin resulting from bariatric surgery means the patient requires a body lift. An incision is made around the circumference of the body to reshape the abdomen, waist, hips, flanks, thighs and buttocks by removing excess skin and lifting and tightening the remaining skin.

If your weight is stable and you are committed to a healthy lifestyle, with realistic goals from your surgery, then body contouring after weight loss surgery can be a very positive experience that can greatly boost body confidence.

The link between your BMI and cosmetic surgery

cosmetic surgery and BMIFor many men and women that are dissatisfied with their appearance, a cosmetic surgery procedure can seem like a fantastic opportunity to achieve the body of their dreams. However, if this dissatisfaction results from being overweight then it’s time to step back and look at the bigger picture

BMI guidelines for cosmetic surgery

There are no established guidelines that state a certain BMI, or Body Mass Index, prevents or guarantees that you can undergo a cosmetic surgery procedure. However, higher BMIs do mean greater surgical and anaesthetic risks and a BMI assessment will always be part of the consultation process at our Leamington cosmetic surgery clinic.

Your Body Mass Index is a calculation based on your weight and height and the more you weigh, the higher your BMI. For patients between 25 to 29 on the BMI scale, there is low surgical/anaesthetic risk; from 30 to 35, the risk increases but surgery may still be considered, as long as the patient is otherwise in good health, and also depending on the particular problem. More caution must be taken for possible Abdominoplasty/Tummy Tuck, for example. Over 35 and there are significantly increased surgical risks, which must be taken into account and demand much more caution.

For patients with a BMI over 35, they are typically advised to lose weight prior to surgery (preferable too for those between 30 and 35). Often these men and women have developed associated health conditions such as diabetes or high blood pressure which further complicates matters.

Potential surgical risks include problems with anaesthesia, airway complications, chest infection, deep vein thrombosis (clot in the calf veins), pulmonary embolism (a clot breaking off and going to the lungs), poor wound healing after surgery and an increased likelihood of infection

Another factor that must be taken into account is the impact your weight will have on the final outcome of your cosmetic surgery procedure. Body contouring surgery, whether it’s a tummy tuck, thigh reduction or arm lift, all produce a better result when you’re close to or at your ideal body weight. Liposuction removes fat cells permanently and these can’t ‘grow back’ but putting weight on again after your procedure can cause the remaining fat cells to expand. Even the outcome of procedures such as a breast augmentation or a facelift can be affected if you experience marked weight fluctuations post surgery.

Cosmetic surgery is elective, which means that it is never necessary, and for that reason it is imperative that patients limit surgical risks as much as possible. Achieving and maintaining their ideal body weight results in a better sense of wellbeing and also means more chance of them being highly satisfied with the outcome of their surgery.

Breast implant myths explored

breast implant mythsA recent study much covered in the media, which claimed that breast implants could possibly increase the risk of a false heart attack diagnosis, understandably left many women nervous, whether they’ve previously undergone a breast augmentation or were considering enhancing their breasts.

The research findings were presented at the latest conference of the European Society of Cardiology in Vienna. One of the researchers at the Princess Grace Hospital in Monaco claimed that all women without implants in the study had normal ECG results but, in the women with breast implants, a staggering 57% had abnormal results.

Delve a little deeper though, and it’s not quite as straightforward or as potentially worrying as you may have first thought. Another expert analysed the same data and found 38% of women with breast implants had abnormal ECG results, along with some of the women without. Also, the researchers only assessed 28 women with breast implants and 20 without, which is a relatively small number to extrapolate concrete findings from.

However, it did make me consider the many breast implant myths and misconceptions that still abound, despite breast augmentation being the UK’s most popular cosmetic surgery procedure.

Breast implant myth #1: Your breast implants will need to be replaced every ten years

There is much confusion over how often your breast implants will need to be replaced and that’s partly because there is no definitive answer. Complications arising from having a foreign body implanted in your body can mean that you need to have revision surgery at any point from your initial procedure.

However, if there are no issues with your implants – they have not ruptured or hardened, there is no swelling or tenderness and you’re still happy with your size or shape then you certainly don’t need to have them changed promptly at the ten-year point. Rupture rates differ but approximately only about 15% will be affected before the tenth year; however, from then on, the likelihood of them rupturing increases every year.

I do make all of my Warwickshire breast augmentation patients understand that the decision to have breast implants may mean having them replaced at a future date.

Breast implant myth #2: You won’t be able to breastfeed with breast implants

Breast augmentation surgery is very popular with younger women who are dissatisfied with the lack of development of their breast size. Typically, these women are also planning to start a family at some point, so a natural concern is whether it will still be possible to breastfeed.

Nothing is certain about breastfeeding post-augmentation – you may have been unable to do so even without surgery – but most women find they can still breastfeed afterwards. Placing the implant under the muscle and using an inframammary incision, situated underneath the fold of the breast, tends to pose less risk to the milk ducts and mammary glands

Breast implant myth #3: You can’t have a mammogram with breast implants

As with the ECG study above, there are concerns that breast implants impede certain diagnostic tests. However, although breast implants can make mammography slightly more challenging for the radiographer, it is not true that they make it impossible. Inform your radiographer that you have implants and they will use a slightly different technique to ensure that the breast tissue can be scanned properly.

If you have any further questions about breast implant surgery, call 01926 436341 to make a consultation at my Leamington cosmetic surgery clinic.

Rise of the dad makeover

male cosmetic surgeryLatest figures released in US show that cosmetic surgery is still on the rise, partly driven by a demand from men for facial and body surgery. American men account for 13% of the 1.65 million procedures performed in the US last year which may seem a small amount but is actually a massive jump of 28% from the start of the decade.

Top 5 male procedures

  1. Liposuction: One of the most requested cosmetic surgery procedures on both sides of the Atlantic, liposuction can eradicate stubborn pockets of fat on the face and body. Men are increasingly registering body image expectations for which liposuction can be helpful.
  2. Male breast reduction: It’s thought that half of all UK men suffer from ‘moobs’ as they are often unfortunately described. Whether it’s due to an enlargement of glandular breast tissue or as a result of fatty tissue in the chest area, more and more men are now seeking treatment for gynaecomastia (its proper medical name), largely because there has been more coverage of the topic and men now realise that they don’t have to suffer in silence. Liposuction can successfully reduce fatty tissue, but if it is as a result of over-development of breast tissue then a surgical procedure similar to a female breast reduction may be required.
  3. Eyelid surgery: Known medically as a blepharoplasty, this is a relatively straightforward procedure that can produce a radical transformation, but plastic surgeon choice is key. There are subtle gender differences in the upper third of the face that must be respected to avoid unwanted ‘feminisation’ of a male patient’s appearance. Men tend to have slightly lower brows and a more marked eyebrow crease, whereas a woman will have a high brow with more upper, smoother lid show. Knowing how to achieve that distinction comes with experience.
  4. Nose surgery: Rhinoplasty is also a sought-after cosmetic surgery procedure among male patients at my Leamington plastic surgery practice. Your nose is typically the defining characteristic of your face and the stereotype that men can’t undergo cosmetic surgery to correct or enhance a facial feature that may have always undermined their confidence and self-esteem is fast disappearing. I also see many male patients that have experienced trauma as a result of a sporting injury that is affecting both the external appearance as well as internal function of the nose, correction of which brings many benefits.
  5. Botox: Women have been having Botox for many years to fight against dynamic wrinkles and now men are increasingly turning to muscle relaxing injections as a way of appearing more dynamic and rejuvenated. Even though Botox is characterised as minimally invasive with much lower risks than surgery, differences in facial anatomy, skin thickness and tissue laxity between male and female patients need to be taken into account to produce optimal results.

In the UK, the independent plastic surgery association BAAPS, of which I’m a member, also publishes annual cosmetic surgery figures. Not including Botox, as its considered a non-surgical aesthetic procedure, our top five are identical to America’s, except with the addition of pinnaplasty (UK term)/otoplasty (US term), also known as prominent ear correction. For more information on any of the cosmetic surgery procedures above, call 01926 436341 to arrange a consultation.