Cosmetic surgery is often carried out to change a person’s appearance in order to achieve what they perceive to be a more desirable look.

However, in certain situations cosmetic surgery may be needed for functional reasons. For example, breast reduction is sometimes used to alleviate back or neck pain.

Cosmetic surgery is different to plastic surgery. Plastic surgery repairs damaged skin and tissue following injury or illness. It also provides reconstructive surgery after major injuries or cancer removal operations.

During cosmetic surgery, a number of different bodily features may be changed, including:

• skin colour
• skin texture
• the structure or position of a body part, such as the nose

Can I get cosmetic surgery on the NHS?

Cosmetic surgery is rarely available through the NHS. There must be major physical or psychological reasons for considering cosmetic surgery.

In rare cases, a primary care trust (PCT) may decide that cosmetic surgery is required to protect a person’s health, although NHS resources are limited and waiting times are usually long. For this reason, most people pay to have cosmetic surgery privately.

Read more about the availability of cosmetic surgery.

Making a decision

Deciding to have cosmetic surgery isn't a decision that should be taken lightly. Cosmetic surgery can be expensive and time consuming. The results are often variable and can't be guaranteed.

Therefore it's important that you give careful thought and consideration when deciding to have cosmetic surgery. It's a good idea to discuss your plans with your GP before going ahead with private treatment. If you decide to have surgery, be absolutely sure about your reasons for wanting to have it.

Read more about considering cosmetic surgery.

Choosing a surgeon

If you decide to have cosmetic surgery, it's very important that the surgeon and other healthcare professionals who will be carrying out the procedure are fully qualified and experienced in the type of procedure you're having.

You should discuss the procedure in detail with your surgeon. Ask as many questions as you need to so that you're fully aware of what the procedure involves, how it will be carried out, what the results will be and whether there will be any after effects.

See recommendations for cosmetic surgery for advice about how to ensure a cosmetic surgeon is fully qualified.

When things go wrong

As with all types of surgery, cosmetic surgery can sometimes go wrong and the results may not be what you expected. To reduce the chances of this happening you should:

• make sure that your expectations of what surgery can achieve are realistic
• make sure that the surgeon understands what you want
• follow the advice that your surgeon gives you about aftercare

Read more on how to make a complaint about cosmetic surgery.

Non-surgical cosmetic treatments and plastic surgery

Non-surgical cosmetic treatments are procedures that change a person’s appearance without using surgery. They include:

• muscle paralysis – such as injections of botulinum toxin (Botox) to help relax facial muscles and make lines and wrinkles less obvious
• dermal fillers – injected into wrinkles or creases to fill them out
• chemical peels – which use chemicals to remove the outer layer of skin cells
• microdermabrasion – which uses fine crystals and a vacuum to remove dead skin cells
• non-surgical laser and intense light treatments – such as hair removal

Read more about non-surgical cosmetic procedures.

If you think that you might benefit from having cosmetic surgery, take time to thoroughly research the procedure you are considering and which hospitals or clinics offer it.

Types of cosmetic surgery

As well as the more commonly known cosmetic surgical procedures, such as breast implants, facelifts and tummy tucks, there are many other types of cosmetic surgery, including:

• blepharoplasty – surgery to remove excess skin from the upper and lower eyelids to get rid of hooded eyelids or eye bags
• dermabrasion – a surgical procedure to change the texture and appearance of the skin to minimise scars and sun damage
• liposculpture – surgery to reshape areas of the body that have fatty deposits which are resistant to a healthy diet and exercise
• mammaplasty – surgery to change the shape of the breasts or repair the breasts after surgery or trauma
• pinnaplasty – surgery to reduce the size or prominence of one or both ears
• rhinoplasty – surgery to reshape the nose or to relieve blockages in the nostrils

Why do you want to have cosmetic surgery?

Having cosmetic surgery is a major decision and the effects of it can vary. It is therefore important to ask yourself why you want to have it.

Sometimes, people feel that having cosmetic surgery will help to solve a problem in their life and will make their life better. If you're feeling anxious about your relationships, social life or work, it's important not to think that cosmetic surgery will make these things better.

When considering cosmetic surgery, ask yourself the questions listed below.

• Do you expect that cosmetic surgery will change your life as well as your appearance, and how do you think your life will be better?
• Is it reasonable or likely that a change in your appearance will radically change your life?
• Are you considering cosmetic surgery for yourself or to please someone else?
• Do you think that having cosmetic surgery will improve your relationship or employment prospects?
• Is it reasonable to expect that having surgery will achieve the changes to your appearance that you're hoping for?

Read more about whether cosmetic surgery is right for you.

If you think your desire to change your appearance stems from anxieties about social situations, or from relationship or work-related problems, you should discuss this with your GP or another healthcare professional, such as a counsellor or a psychologist.

They may be able to help you to address your concerns, overcome your anxieties and build your self-confidence using ‘non-surgical’ treatment methods.

Read more about counselling and psychotherapy.

Cosmetic surgery is rarely available through the NHS. There must be overriding physical or psychological reasons for considering it as a treatment option. For example, in rare cases, a primary care trust (PCT) may decide that cosmetic surgery is required to protect a person’s health.

Most people pay to have cosmetic surgery carried out privately because NHS resources are limited and waiting times are usually long.

GP referral

Visit your GP if you're considering having cosmetic surgery. They can discuss your options with you and advise you about the possibility of having the procedure on the NHS.

If your GP thinks that cosmetic surgery may be a suitable treatment option for you, they will refer you to a consultant who will decide whether NHS-funded surgery is appropriate. Before making a decision, the consultant may ask you to have a psychological assessment.

If you decide to have cosmetic surgery at a private hospital or clinic, it's still advisable for you to be referred by a GP. This is so that the surgeon carrying out the procedure has access to your medical records.

Cosmetic surgery through the NHS

The few types of cosmetic surgery provided by the NHS are:

• breast implants – due to severe underdevelopment or asymmetry (lop-sidedness)
• breast reduction – due to back pain or shoulder pain
• nose reshaping (rhinoplasty) – due to breathing problems
• abdominal surgery – for example, tummy tucks as a result of excess fat or skin after pregnancy or essential abdominal surgery
• eyelid reduction – due to affected vision

Your GP will be able to give you general advice about surgery and they will advise you about any specific issues to discuss with the surgeon. For example, cosmetic surgery isn't recommended for women who are pregnant, people with certain medical conditions or those taking certain types of medication.

Before having cosmetic surgery, you should meet with your surgeon at least twice to discuss what you're hoping to achieve and to get a better understanding about what's realistically possible. The surgeon will also carry out a physical examination and study your medical history to check that you are a suitable candidate for surgery.

Cosmetic surgery through private providers

Due to the limited availability of cosmetic surgery on the NHS, most people who decide to have cosmetic surgery have treatment privately.

All private companies that provide cosmetic surgery must register annually with the Care Quality Commission (CQC). Always ask to see the company’s registration before agreeing to have cosmetic surgery at a private hospital or clinic.

The Care Quality Commission inspects all cosmetic surgery providers and reports on their findings.

You can also read more about making sure that private cosmetic surgeons and hospital staff are properly qualified when choosing a surgeon for cosmetic surgery.

The Department of Health recommends that patients should only receive advice about surgery from healthcare professionals with the relevant qualifications and level of expertise necessary to provide high-quality advice.

The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) published a report in 2010, warning that some organisations weren't giving patients enough information to help them make decisions about serious operations.

From October 2010, all private providers have to be registered with the Care Quality Commission (CQC) and comply with 16 safety and quality requirements, including ensuring the suitability of professionals to provide services.

Checking registration

When you first approach a private cosmetic surgery provider, you should ask to speak to a patient adviser. Check that your adviser is a doctor or nurse and that they're registered with the General Medical Council (GMC) or Nursing and Midwifery Council (NMC).

You can also use the GMC website to check whether a doctor or surgeon is registered. The website gives details of the surgeon’s primary specialty, but it doesn't provide information about any other specialist qualifications that they may hold.

Most cosmetic surgeons will also be members of either the:

• British Association of Aesthetic Plastic Surgeons (BAAPS)
• British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

You can also find out whether a nurse is registered by using the Nursing and Midwifery Council’s searchable database. To check whether your dentist is registered, you can use the General Dental Council’s database. In both cases, you'll need to enter the person’s full name.

Checking qualifications

Surgeons who carry out cosmetic surgery must have received specialist training and have experience in the type of cosmetic surgical procedures that they're providing.

Non-surgical procedures, such as microdermabrasion (to reduce wrinkles and skin imperfections) must also be carried out by healthcare professionals who are fully trained and qualified.

Some healthcare professionals indicate their qualifications by placing letters after their name, such as Dr Charlotte Cornwall MBBS, or they display certificates in their clinics. However, it can sometimes be difficult to work out exactly what a qualification means.

Find out more about the most common medical, surgical, nursing and beauty qualifications, including the training that's needed to gain these qualifications and the letters that the qualification entitles the holder to use after their name.

Surgical qualifications

Surgeons are doctors who have received basic medical training before going on to specialise in surgery. Surgeons spend two years training in basic surgery, followed by five or six years specialising in a particular type of surgery, such as orthopaedic or plastic surgery.

If a surgeon successfully completes their training and passes their exams, they will be allowed to use the abbreviations below after their name, depending on where they qualified:

• FRCS – Fellow of the Royal College of Surgeons of England
• FRCS (Ed) – Fellow of the Royal College of Surgeons of Edinburgh
• FRCS (Glas) – Fellow of the Royal College of Surgeons of Glasgow
• FRCSI – Fellow of the Royal College of Surgeons in Ireland

Sometimes, surgeons from a number of other surgical specialties perform cosmetic surgery as well as their main specialty. The qualifications listed below indicate that a surgeon is highly qualified and experienced in their chosen specialty:

• FRCS (GenSurg) – Specialist Fellowship in General Surgery
• FRCS (OFMS) – Specialist Fellowship in Oral and Maxillofacial Surgery
• FRCS (Otol) – Specialist Fellowship in Otolaryngology (ear, nose and throat surgery)
• FRCS (ORL) – Specialist Fellowship in Otorhinolaryngology (head and neck/facial plastic surgery)
• FRCSPlast – Specialist Fellow of the Royal College of Surgeons in England (who has passed specialist examinations in plastic surgery)

However, although surgeons who hold the above qualifications may also undertake cosmetic surgery procedures, the abbreviations do not denote that they have:

• received specialist cosmetic surgery training
• experience in performing plastic or cosmetic surgery
• experience in performing the cosmetic surgical procedure that you're considering

Therefore, you'll need to find out about their level of training and experience.

Asking questions

As well as checking that the surgeon who will be performing your cosmetic surgery is fully qualified and has a good level of experience, you should ask as many questions about the procedure as necessary to ensure that you understand the procedure and how it works.

The surgeon should explain to you at length what will happen before, during and after surgery. They should also give you advice about what to do if you have any problems after you get home.

Responsible surgeons will be open and honest with you about the risks involved in the procedure and the kind of results that you can realistically expect.

Complaints

If you're not happy with the results of cosmetic surgery or you believe the procedure was carried out incorrectly, you should take the matter up with your surgeon through the hospital or clinic that referred you.

Read more about complaining about cosmetic surgery.

Cosmetic surgery, like all types of surgery, can sometimes go wrong and the results may not be what you expected. It's therefore very important to have a detailed discussion with your surgeon about the procedure that you're considering. This will ensure that you understand what's involved and any possible risks.

As every individual’s body is unique, it's not possible to predict with 100% certainty how your body will react to surgery. However, to give yourself the best possible chance of having successful surgery you should:

• have an identifiable problem that can be improved by cosmetic surgery
• make sure that your expectations of what surgery can achieve are realistic
• tell the surgeon about your expectations and make sure you understand the advice they give you about how the procedure may work for you
• make sure that you understand and follow the surgeon’s pre-surgery and aftercare advice

Complaining to the surgeon, hospital or clinic

If you've had cosmetic surgery and you're not happy with the results, or you think that the procedure wasn't carried out properly, take up the matter with your surgeon through the hospital or clinic that referred you.

The surgeon or hospital staff may be able to deal effectively with your concerns, particularly if the healing process is not complete or your body still needs time to settle down. If, after the healing process is complete, you're still unhappy with the results, the hospital or clinic may offer you further surgery to put things right.

Complaining to the Care Quality Commission

If you're not happy with how the hospital or clinic where you had cosmetic surgery has dealt with your complaint, you may wish to take the matter further.

All hospitals and clinics that provide invasive cosmetic surgery must be registered with the Care Quality Commission (CQC). The CQC can take action against a hospital or clinic if it believes that certain standards have not been met.

If you have a complaint that you'd like to be investigated, see the CQC's website for information and advice about how to make a complaint. The CQC cannot deal with complaints that relate to fees or unregistered practitioners.