Find out about cosmetic or aesthetic surgery, including when it's available on the NHS and what you need to think about when considering treatment.
Cosmetic or aesthetic surgery is a type of surgery used to change a person's appearance to achieve what they perceive to be a more desirable look.
In certain situations, cosmetic surgery may be needed for functional reasons – for example, breast reduction is sometimes used to relieve back or neck pain.
Cosmetic surgery is different from reconstructive plastic surgery, which is a type of surgery used to repair damaged tissue caused by surgery, illness, injury, or an abnormality present from birth. There are separate pages on plastic surgery.
Considering cosmetic surgery
Having cosmetic surgery is a major decision. It can be expensive, time consuming, and the results can't be guaranteed.
Sometimes people feel that having cosmetic surgery will help solve a problem in their life and will make their life better.
It's important to ask yourself why you want to have cosmetic surgery. It's a good idea to discuss your plans with your GP before going ahead with treatment. If you decide to have surgery, be absolutely sure about your reasons for wanting to have it and don't rush into it.
Read more about whether cosmetic surgery is right for you.
Can I get cosmetic surgery on the NHS?
Cosmetic surgery is rarely available through the NHS. There must be a major physical or psychological reason for needing the surgery.
In rare cases, a clinical commissioning group (CCG) may decide that cosmetic surgery is required to improve 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.
Choosing a surgeon
If you decide to have cosmetic surgery, it's important that the surgeon and other healthcare professionals 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 you're fully aware of what the procedure involves, how it will be carried out, what the results might be, and what happens if anything goes wrong.
There are many different types of cosmetic surgery procedure. Some of the most common include:
- breast augmentation – surgery to increase breast size using breast implants
- breast reduction – surgery to reduce the weight and volume of the breasts
- eyelid surgery (blepharoplasty) – surgery to remove excess skin from the upper and lower eyelids to get rid of hooded eyelids or eye bags
- liposuction – surgery to remove unwanted body fat
- ear reshaping (otoplasty or pinnaplasty) – surgery to treat protruding ears
Read more about common cosmetic surgery procedures.
A popular alternative to cosmetic surgery is non-surgical cosmetic procedures. These can change a person's appearance using injections and lasers, for example.
Common non-surgical procedures include:
- botulinum toxin injections – such as the brand Botox; these help relax facial muscles and make lines and wrinkles less obvious
- dermal fillers – injected into wrinkles or creases to fill them out
- chemical peels – these use chemicals to remove the outer layer of skin cells
- microdermabrasion – this uses fine crystals and a vacuum to remove dead skin cells
- laser and intense light treatments – such as hair removal
However, there is little regulation of these procedures and many don't require the person who performs them to have any medical qualifications.
Read more about common non-surgical cosmetic procedures.
Making a complaint
As with all types of surgery, cosmetic surgery can sometimes go wrong and the results may not be what you expected.
If you've had cosmetic surgery and you're not happy with the results or you think the procedure wasn't carried out properly, take up the matter with your surgeon through the hospital or clinic where you were treated.
If you wish to take the matter further, you can contact the Care Quality Commission (CQC). The CQC is a regulatory body that all hospitals and clinics that provide cosmetic surgery must be registered with.
It's important to find out as much as possible about any cosmetic procedure you're considering. Read about some of the most common procedures here.
It's important to find out as much as possible about any cosmetic procedure you're considering.
Information about the following common surgical procedures can be found below:
- breast augmentation (enlargement)
- breast reduction (female)
- breast reduction (male)
- ear reshaping (otoplasty or pinnaplasty)
- eyelid surgery (blepharoplasty)
- facelift (rhytidectomy)
- nose job (rhinoplasty)
- tummy tuck (abdominoplasty)
You can also read about the general risks of cosmetic surgery.
Breast augmentation or enlargement is a procedure used to increase breast size with implants. It's the most common cosmetic procedure carried out in the UK.
Breast implant surgery is usually performed under general anaesthetic. This means you'll be asleep and unable to feel any pain or discomfort during the procedure.
The procedure starts with your surgeon making a cut (incision). They will discuss the exact location of the incision with you before the procedure. It will depend on the shape and size of your breasts and where you would like the scars to be.
After the incision has been made, the implants can be fitted. The implant can either be positioned between your breast tissue and your chest muscle, or behind your chest muscle. Your surgeon will be able to offer advice about the position that's best for you.
Once the implants are in place, the incisions are sealed using stitches, which will usually be covered with a dressing.
Breast implant surgery is sometimes carried out as day surgery, which means you'll be able to go home the same day. However, sometimes you may need to stay in hospital overnight.
If the stitches used aren't dissolvable, they will be removed after 7 to 14 days. Some surgeons recommend wearing a tight-fitting sports bra 24 hours a day for up to three months after breast surgery.
Most breast implants last about 10 to 15 years, after which time they may need to be replaced.
What are the risks?
As well as the general risks of surgery, specific risks of having breast implants include:
- visible creases may develop in the skin around your implants
- your implants may lose their shape
- your implants may split (rupture) – warning signs include lumpiness, swelling, redness and tenderness in the breast
You should contact your surgeon or GP if you are concerned about your implants. Further surgery may be needed to replace them if there's a problem.
Breast reduction (female)
Female breast reduction is an operation to reduce the weight and volume of a woman's breasts. It's usually done under general anaesthetic.
Most breast reduction surgery begins with the nipple, which is moved to its new position, usually while still attached to the blood supply. If you have extremely large breasts, the nipples may be removed before being repositioned.
Excess skin and breast tissue are then removed. The remaining breast tissue is reshaped to create smaller and more elevated breasts.
After the procedure, you'll usually need to stay in hospital for at least one or two nights. The stitches will normally be removed between 10 to 14 days after the operation.
What are the risks?
As well as the general risks of surgery, specific risks of female breast reduction include:
- your breasts may be uneven and your nipples may be asymmetrical after surgery
- you may lose sensation in your nipples, including their ability to become erect
- you may not be able to breastfeed in the future
Read more about the risks of female breast reduction.
Breast reduction (male)
Male breast reduction is used to reduce the size of enlarged male breasts (gynaecomastia) if lifestyle changes such as eating a healthy diet and exercising regularly haven't helped. The procedure is usually carried out using a general anaesthetic.
During the operation, the surgeon makes an incision around the nipple and excess fatty tissue is sucked out. If there is a lot of tissue to remove, cuts may extend down the chest and the nipples may need to be repositioned. After the procedure, you'll usually need to stay in hospital overnight.
If non-dissolvable stitches are used, these will need to be removed after 7 to 14 days. An elastic garment also needs to be worn for one to four weeks after the operation to encourage your skin to heal properly in the affected area.
What are the risks?
As well as the general risks of surgery, specific risks of male breast reduction include:
- your nipples may be slightly asymmetrical
- your chest may be uneven
- you may lose sensation in your nipples
Ear reshaping surgery, also known as otoplasty or pinnaplasty, is used to improve the appearance of the ears and make them as symmetrical as possible.
Surgery involving older children and adults can be carried out under local anaesthetic. This means the affected area is numbed. Younger children may need a general anaesthetic.
During surgery, a small cut is made behind the ear to expose the ear cartilage. The cartilage is repositioned and shaped by removing small pieces, then scoring and stitching the remaining structure into the desired shape and position.
If local anaesthetic is used, you'll usually be able to go home the same day. An overnight stay in hospital may be required if general anaesthetic is used.
The stitches are removed 5 to 10 days after surgery, and you may need to wear a head bandage for a short period to support and protect the ears in their new position.
What are the risks?
As well as the general risks of surgery, specific risks of ear reshaping surgery include:
- your ears may protrude again in the future
- your ears may be slightly asymmetrical after surgery
- your ears may feel numb and tight for weeks or months
- a blood clot may develop in the skin of your ear, which may need to be removed by your surgeon
Read more about the risks of ear reshaping surgery.
Eyelid surgery, also known as blepharoplasty, is used to remove excess skin from the upper and lower eyelids to get rid of hooded eyelids or eye bags.
Both upper and lower eyelid surgery can be carried out under local or general anaesthetic. General anaesthetic is often preferred if both the upper eyelids and lower eyelids are being corrected.
During surgery on the upper eyelids, the surgeon makes an incision along the eyelid crease in the natural skin fold of the eyelid, and removes unwanted skin, fat and muscle. The surgeon then closes up the incision, which will hide the scar in the natural fold of the eyelid.
During surgery on the lower eyelids, the surgeon moves or removes fat from the bags under the eyes either through an incision made just below the lower lashes, or an incision made on the inside of the eyelid. A small amount of skin may also be removed, but the muscle that closes the eyelid is preserved.
The surgeon will normally apply suture strips to support the eyelids after surgery. These are usually removed after three to five days.
What are the risks?
As well as the general risks of surgery, specific risks of eyelid surgery include:
- your vision may be temporarily blurred after surgery
- your eyes may look slightly asymmetrical
- for the first few days, your lower eyelids may sag and you may find it difficult to close your eyes
- there may be bleeding behind your eye, which can lead to blindness in very rare cases
The British Association of Aesthetic Plastic Surgeons (BAAPS) has more information on eyelid surgery.
A rhytidectomy, or facelift, is a procedure used to reduce flabby or sagging skin around the face and neck. The procedure is usually carried out under general anaesthetic.
There are many different kinds of facelift, but generally incisions are made above the hair line at the temples, extending down in front, and under the ear and into the hairline. The skin is then pulled backwards and upwards before being stitched into its new position.
At the end of the operation, the surgeon closes up the incisions with stitches and applies a dressing to protect the area where the incisions were made. An overnight stay in hospital is usually required.
Most surgeons will bandage the face to minimise bruising and swelling. These bandages will stay on for one or two days and the stitches are removed after about a week.
What are the risks?
As well as the general risks of surgery, specific risks of facelifts include:
- there may be a small but permanent reduction in hair growth around your temples
- your face may feel swollen, stiff and numb for a few weeks or months after surgery
- your eyes and facial features may appear asymmetrical
The British Association of Aesthetic Plastic Surgeons (BAAPS) has more information on facelifts. The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) also has information on face and brow lifts.
Liposuction is used to remove unwanted body fat. Most liposuction operations are performed under general anaesthetic. An epidural anaesthetic may be used for treatments on the lower parts of the body. This numbs the lower part of the body while you're awake.
The surgeon usually begins the operation by injecting a liquid solution into the area being treated. This fluid helps to reduce the risk of problems such as bruising and bleeding. The surgeon then makes a small cut in the skin. If the area being treated is large, several cuts may have to be made.
A suction tube attached to a specialist vacuum machine is then inserted into the cut. This loosens the fat in the area being treated and then sucks it out. When the fat has been removed, the cuts in your skin will be stitched closed.
Depending on the extent of your operation and the anaesthetic used, you may need to stay in hospital overnight.
After the procedure, you'll be fitted with an elasticated corset or bandages for the treated area. This can help reduce swelling and bruising, and may need to be worn for several weeks after the operation. The stitches will usually be removed after about seven days.
What are the risks?
As well as the general risks of surgery, specific risks of liposuction include:
- the area where the fat was removed may appear lumpy and uneven
- the treated area may feel numb for several months
- some techniques can burn the skin and cause skin colour changes
Read more about the risks of liposuction.
A rhinoplasty, or nose job, is a procedure used to reshape the nose. There are a number of different types of nose reshaping operation. The exact procedure will depend on the aim of the treatment. The operation may take place under a general or local anaesthetic.
The two main techniques used are called "open" or "closed". Open means that some or all of the cuts are made outside the nose, whereas closed means all the cuts are made inside the nose.
A nose reshaping operation normally involves separating the soft tissue that lies on top of the nose from the bone and cartilage underneath. Depending on the operation, the surgeon might break the nose bone and reposition it, or reshape the cartilage.
You may need to stay in hospital for one of two nights, and it's likely you'll need to wear a protective splint over your nose for at least a week. Stitches inside your nose will probably be dissolvable and will not need to be removed. Your surgeon will advise you about when any stitches outside your nose need to be removed.
What are the risks?
As well as the general risks of surgery, specific risks of nose jobs include:
- your nose may be an odd shape after surgery, although this will usually settle down during the following 12 months
- your nose may bleed heavily for about a week, which may require hospital admission
- you may find it difficult to breathe through your nose for the first week after surgery
- any implants used may protrude through the skin or become infected, in which case further surgery may be required to remove and replace them
The British Association of Aesthetic Plastic Surgeons (BAAPS) has more information on nose reduction and nose augmentation. The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) also has information on nose reshaping.
An abdominoplasty, or tummy tuck, is a procedure used to alter the shape of the abdomen (tummy area) by removing fat and excess loose skin. There are two types of tummy tuck, called "partial" and "full". These operations are usually carried out under a general anaesthetic.
In a partial tummy tuck, the surgeon makes a large incision across the lower abdomen. They then separate the skin from the abdominal wall, remove excess fat and cut away the excess skin. The remaining skin is then pulled together and stitched.
For a full tummy tuck, the surgeon makes an incision across the lower abdomen, just above the pubic area. They then make a second incision to free the belly button from the tissue that surrounds it, and separate the skin from the abdominal wall.
The surgeon pulls down the abdominal muscles and stitches them into their new position, removes fat deposits and cuts away the excess skin. A new hole is cut for the belly button, and it is stitched back into place. Finally, the surgeon pulls the remaining skin down and stitches it together.
After the procedure, you'll usually need to stay in hospital for at least one night. The stitches will be removed after 7 to 14 days, and you'll need to wear a supporting corset for a few weeks to encourage your skin to heal properly in the affected area.
What are the risks?
As well as the general risks of surgery, specific risks of tummy tucks include:
- you may find it difficult to stand up straight as it will feel like your tummy is being pulled, although this will improve over time
- your tummy may feel numb for a few weeks or months
- your scars may not look smooth when they heal and further surgery may be needed to improve their appearance
The British Association of Aesthetic Plastic Surgeons (BAAPS) has more information on abdominal reduction. The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) also has information on tummy tucks.
General risks of surgery
As with any type of surgery, cosmetic surgery has associated risks and complications. The degree of risk depends on whether the surgery is in a small or large area, the level of experience of the surgeon, and the overall health of the person having the procedure.
General complications from cosmetic surgery can include:
- pain and discomfort – which may require painkillers for a few days
- bleeding – which may require a blood transfusion if severe
- swelling and bruising – which can last for weeks or months
- infection – which may require antibiotics or further surgery
- scars – you'll have scars where incisions were made during surgery, although these will usually fade over time
There is also a risk that your expectations of surgery do not match what is realistically achievable, so it's important to discuss these issues in detail with your surgeon before giving your consent to surgery.
You should have follow-up appointments after surgery so your recovery can be monitored.
If you have any concerns regarding your recovery from a surgical procedure, such as pain, swelling, discharge or any other unexpected side effects, speak to your surgeon, GP or healthcare team immediately.