Liposuction Over time, through lifestyle and as we age, fatty tissues build up on our flanks, our lower abdomens and thighs in women and the abdomen, chest and flanks in men. The removal of this fatty material is usually carried out through liposuction. The procedure works through the usage of a tube and a cannula which is attached to a powerful vacuum.

Liposuction used to be only possible with large cannulae but the process has become more sophisticated and thinner and smaller cannulae can now be used for easier, more effective and more controllable removal of the fat deposits. These procedures should not and are not considered a replacement for weight management and it is not a substitute for a healthy diet and exercise. The focus is specific fatty deposits and pockets of fat, which may not be, shifted even with an intensive exercise as well as dieting regime.

Benefits of Liposuction

Surgical liposuction offers two main benefits to those with excess body fat:

1. A reduction in size of specific parts of the body 2. Improved contours to the flesh.

Another benefit reported by some patients is the long term results offered by liposuction. This means the area should not “fill up” again, which is reassuring that the problem is unlikely to reoccur. Of course, some factors such as ageing, alcoholism and medical conditions could override this outcome.

These are the physical benefits but naturally when we look better we generally feel better too. And so, perhaps the real benefit is an emotional one. It is because a patient has been unhappy with their appearance for a prolonged period of time, and feels pessimistic about any improvement through natural efforts, that they seek medical help.

With successful treatment a patient can get back some inner confidence. They might even find a new lease of life and ultimately achieve a level of self esteem they truly deserve.

Combining Liposuction With A “Tummy Tuck”

Liposuction alone is not always the best option. If you have a particularly difficult problem, especially in the abdominal area, abdominoplasty (or tummy tuck) is offered. For patients who are clinically obese and are at risk of declining health the method of cutting away fatty tissue combined with the liposuction technology can be highly effective.

A full abdominoplasty procedure involves making incisions horizontally at the top of the pubic area and the circumference of the navel. Scarring is therefore around the navel and above pubis (similar to the caesarean-section surgery needed for childbirth). Due to the nature of this procedure, a full general anaesthetic is required. A stay in hospital is necessary and the duration of this will depend upon your immediate post-operative recovery.

As this surgery affects the very centre of your body, you must be prepared to take good of care of yourself to ensure a full recovery without complications. Normal movement will be restricted for a while as well as lifting, carrying and exercise.

For those requiring less fat/skin removal a “modified” abdominoplasty can be performed. This does not involve the removal of the navel, meaning less intrusion and scarring. This surgery is often recommended for those who have lost a considerable amount of weight and have a residue of surface tissue and skin.

Types of Lipoplasty technique Standard traditional Lipo PAL e.g microair (vibration) VASER (ultrasonic) LASER RASER (radiofrequency) Water jet Smart lipo Cryo lipo Sculpsure

What areas can be treated?

The typical areas of the male body that benefit from liposuction are:

• Flanks • Abdomen • Chest • Buttocks • Inner and outer thigh • Hips • Knees • Upper arms • Back and shoulder blade area • Neck • Double chin/jowl

Everyone is unique and therefore all consultations should be considered as treating your needs in a bespoke way. Almost all fatty areas can be addressed with some degree of success.

Who benefits from Liposuction?

The treatment was devised as a solution to reducing fat from areas of the body that simply refuses to shift through the conventional weight loss attempts. Liposuction was not designed specifically for women although it is this group that has been the “early adopter” of the procedure. More men are turning to this method after having tried and failed to lose the weight through dieting and exercise approach.

For men there is also the potential problem where fat can settle after the cessation of body building or super athletic activities. Muscle can rapidly waste away and the

area instead starts to store fat in a way that is most stubborn for breaking down after prolonged and intensive periods of training.

It might be that you have inherited the excess fat condition from your parents which means you can be sure that how they reacted to, or treated, the problem (with or without success) will mostly likely be the same outcome for you. There is plenty of opportunity at the first consultation to explain your situation and desired results.

We are happy to offer the procedure once we have been assured that:

1. You are a physically healthy individual 2. You are mentally well, and certain that you have considered all possibilities 3. You have tried your best to rid the fat through diet and/or exercise.

What are the results?

You can expect to see impressive results with surgical liposuction. Liposuction procedure is a safe and reliable method for long-term fat reduction and smoother body contours.

After around 1 to 2 week post surgery you will have an assessment with the surgeon. By this time, initial swelling should have subsided enough to judge how successful the procedure has been. Most patients see a noticeable size reduction at this stage.

If you had set out to achieve a more even skin surface you should, after a few weeks, see an improvement and you can discuss the progress with your consultant.

With the treatment of multiple sites, or complex procedures you may need to wait a while before seeing the desired outcome. Most people report an improvement of around 70+% success rate and feel they have gained the result they set out to achieve.

• A smaller area with firmer skin being the No.1 aim.

You can expect to see the optimum results between 6-12 months after the surgery. A full 12 months is likely for larger or more complex areas. Your surgeon will not conduct a final review of the treatment until he/she considers the recovery period complete.

Long term effects:

Men considering liposuction treatment must understand that bodily changes such as ageing, weight gain/loss or medical conditions can affect body mass and skin contours visually and to the touch.

The Procedure

The first step is agreeing with the consultant that surgical liposuction is the right procedure for you.

An appointment will be made (and here is where you must consider planning around your work/leisure schedule), and all pre and post operation details will be fully explained.

For liposuction (not including abdominoplasty), the standard practice is quite a simple and reliable method using vacuum suction:

• The area will be shaved and cleansed. • Local (or sometimes general) anaesthetic is administered. • A small puncture is made to the treated areas. • A long hollow tubing (cannula) is inserted to the layers of the fat. • A saline solution mixed with anaesthetic is pumped through to break down the fat. • The fat is then extracted by vacuum suction provided by either a pump or large

syringe. • Because you may lose body fluids you will be connected to a drip for a short period

of time following surgery. The small incision sites generally do not require stitches. • Anaesthesia is required for liposuction. Usually the surgeon will combine local

anaesthesia to the area long with sedation. Occasionally a general anaesthetic is required.

• Surgery time will depend upon the number areas being treated, the complexity of these areas and the volume of fat being extracted. Typically, though you should expect to be in theatre for 1-2 hours.

• You will feel a bit drowsy for some time after the procedure as the general anaesthetic wears off.

• As with all other forms of liposuction, you will be required to wear a compression garment after a laser liposuction.

• Recovery time will depend upon the complexity of the operation and the volume of flesh affected. It is expected that you will need around one week to recover before returning to your normal lifestyle. Full details for a successful recovery will be given at the time of your first consultation and post-surgery.

• A follow up consultation will be required around 1 week after your surgery to ensure successful healing, and a later appointment to assess the full results of the procedure.

Other techniques include:

• Advanced Laser Lipo or a combination of techniques. This method uses laser-assisted lipoplasty and is simply a combination of laser and liposuction.

• When provided separately Advanced Laser Lipo is performed under local anaesthesia in the minor procedure room on an out-patient basis.

• Initially a small cannula is inserted into the fatty tissue through a puncture site and local anaesthesia/IV fluids are introduced to numb the treatment areas. Then the optical laser fibre is used to emit heat which literally melts the fat using back/forth motions in a fan shape. The action of the laser means that less invasive suction is required to remove the fatty tissue.

• Average procedure time is 2 hours. • Lipo-Selection uses a specific targeting technology, a patented grooved solid metal

probe is first inserted through small skin incisions. Ultrasonic energy is emitted from the sides and end of the probe, as it passes back and forth and this breaks down fatty deposits before a cannular is inserted in the area of emulsified fat cells.

You should see some improvement within a few weeks, once the post-operative swelling has reduced. You can expect to see the optimum results between 6-12 months after the surgery. A full 12 months is likely for larger or more complex areas.

What are the risks?

Every medical procedure carries some degree of risk either during or post surgery. Occasionally a patient has a bad reaction to the equipment, medication or dressings, but the highest risk is that of infection. This can be greatly minimised with the correct post operative care which will be detailed as part of your consultation.

Industry reports indicate some negative results associated with liposuction but in nearly all cases, the problems are solved with appropriate and timely intervention. Reported problems include:

Pain and discomfort; leakage; bruising; swelling; bleeding; skin discolouration; uneven skin surface/tone; changes in sensitivity; irritation; scarring; skin elasticity; deep vein thrombosis; toxic shock syndrome.

Alternatives to Liposuction

Men considering medical treatment for fat reduction should also think about some alternative procedures.

Laser Liposuction

Also known as lipolysis, laser liposuction is an advanced system for reducing small fatty areas of flesh that refuse to shift from dieting and/or exercise. Laser lipolysis can be combined with the conventional methods and is proving to be highly effective for men of all ages.

The procedure is conducted under local anaesthetic with a mild sedation. Small incisions are made the skin to enable the laser light device target the fat cells. These are then absorbed to form an emulsion of fatty tissue. This substance is then gently removed via the ultra fine probes. Because this treatment is virtually non-invasive there is no need for an over night stay and you should experience a very speedy recovery. Getting back to your normal lifestyle as soon as possible is a top priority for most men having aesthetic treatments and with this procedure you should expect to see great results with minimal downtime

SculpSure

An intriguing name but we are seeing some very positive feedback from our clients on this relatively new aesthetic treatment. A good number of men are showing interest in this unique procedure because it is non invasive and requires virtually no downtime. The fat cells are heated to the optimum temperature and, over a period of a few weeks, the fatty tissue is eliminated naturally through the body’s lymphatic system. We partners with SculpSure. This process is ideal for small parts of the body such as the chin and knees and is particularly suited to the male chest area – the problem commonly referred to as “manboobs”.

FAQs

We have set out some typical questions that men have regarding liposuction. If you have a question that is not fully answered here, please give us a call to discuss your situation

Is the treatment a one-off, or will I need to have multiple procedures?

Most men find that one procedure is enough to give them the results they desire. It is worth noting that it is important to set realistic expectations from the start. Liposuction is not a miracle worker and it might take some time before the optimum results are visible – perhaps one year on from the procedure.

How much discomfort am I likely to experience?

Surgical liposuction impacts the deeper layers of flesh. The incisions and pressure to separate the fatty tissue would be painful without anaesthetic. You will receive adequate pain relief from the intravenous anaesthetic system. For larger areas or more complex cases a general anaesthetic is required. This means some more recovery time, but once the procedure is over, the discomfort – rather than severe pain, can be treated with non-prescription pain relief medicine.

How long does it take to see the full results I expect?

Each man’s body is different and recovers in its own unique way. Seeing the results that you were hoping for will depend upon the complexity of the operation. You should see an improvement in size reduction very quickly, within weeks. If you are looking for a finer body reshaping solution it might be that you will need to wait a full year. Therefore it is ideal to consider this and plan your surgery accordingly.

What about scarring?

Even with non- or low-invasive treatments, there is a degree or risk associated with scarring. Sutures (stitches) are usually the cause for noticeable scarring. Depending upon the amount of flesh treated and the number or size of incisions, stitching is generally minimal or not required at all. Your current state of health, healing behaviour and lifestyle may all play a part in the eventual outcome. You will be given the best advice to avoid any unnecessary scarring during your consultation and also post operation.

I’ve heard about SculpSure – is it better than the traditional liposuction method?

SculpSure is a relatively new technique, and it is a very different process to liposuction – requiring the body to eliminate the fats naturally via the lymphatic drainage system. This can take longer than the surgical approach which removes the fat in one go while under anaesthetic and sedation. With fat freezing, results are less predictable and therefore if less fat than expected has drained away, another attempt may be required.

In comparison, the benefits of fat freezing are mainly due to the procedure being a non-invasive treatment and therefore an almost “zero downtime” treatment. Risks associated to intravenous anaesthetics are also minimised.

Non- or low invasive treatments are wonderful but something you need to be mindful of when considering the various practices near to you is that the practitioners may not be medically qualified. Considering this you need to question their professional standards even more rigorously.

Will the fat return to the same area? It is unlikely that the targeted area would store fat again in the medium-long term. It is possible in the much longer term due to the natural ageing process or because of excessive weight gain, and/or a medical condition and its drug therapies.

We have no recorded incidents of a redistribution of fat to areas that the patient would not normally store fat. Saying that, we cannot rule it out in future. You will discuss these risks as part of your consultation but in the meantime it is worth you conducting further research and that of your family health history.

Does surgical liposuction bring better long lasting results compared to body contouring?

The new technology for body contouring uses a combination of ultrasound and radio frequency, because of this, it offers the benefit of removing fat along with cellulite and even wrinkles or sagging skin. For men, cellulite is less common but for those with sagging skin as a result of drastic dieting, this option could be a good solution. Only a full discussion with a qualified aesthetics clinician can tell you if body contouring would be better for you than surgical liposuction.

So, what’s the worst that can happen?

Poor healing and/or infection are the most common causes of problematic surgical procedures. This can be minimised by smart post operative care from the provider and the patient. Health history and information on allergies and sensitivities are captured at the consultation but there is still an outside change that someone will react to the equipment, the physical method of fat removal, medications or dressings. Industry reports the following outcomes in a very small percentage of patients: Pain and discomfort; leakage; bruising; swelling; bleeding; skin discolouration; uneven skin surface/tone; changes in sensitivity; irritation; scarring; skin elasticity; deep vein thrombosis; toxic shock syndrome. When can get back to work and my exercise routine? The first 48 hours will require quality rest but not bed rest. It is recommended you book one week off work but if your job is sedate or you work at home the week after the procedure will mean no exercise, carrying or lifting. Exactly how much time off work will depend upon your job and how well your body usually heals. At your first post-operation consultation, you can discuss returning to exercise and increasing activity etc. I am a 40 year old man and have been suffering from “manboobs” since my early twenties, would liposuction suit me? Liposuction can be offered for this condition but it might be that one of the other procedures such as body contouring, or fat freezing would be a better option. Call a Juvea consultant to discuss your situation and you can talk though the various procedures offered at our clinics. It might be that you will need to be examined before a final decision on the best treatment can be made.

Is liposuction just for the torso? Liposuction is appropriate for areas that hold a significant amount of fat. It is not usually conducted on the face, but if a male patient has a problem with severe jowls or a “double chin” then liposuction can be offered. It is always recommended that you discuss this with an expert clinician as it might be that a different method of fat removal could provide a better solution.

Preparation for Liposuction The liposuction procedure does require some preparation and you will need to take time off work to recover in most instances. Most people have their liposuction performed as a day case or with a single overnight stay. Most people should take around a week’s rest from work and only begin light exercise after about 2 weeks. This may differ from person to person and is something you can discuss on an individual basis before confirming and booking your surgery.

Every patient undergoes a full consultation so they understand and are comfortable with their surgery plans, preparation and aftercare. Any questions will be answered and we work to ensure all your worries are dealt with.

Please contact us today to discuss your surgical options and arrange a consultation.

Patient Care Pathway

My aim is always to ensure patient’s safety and patient’s satisfaction. Virtually

any operation carries with it a risk of complication, because it is a cosmetic

procedure does not mean there is less risk. During the consultation with your

surgeon, the potential risks will be discussed in detail and you will have your

opportunity to ask any questions you have about the procedure. Here is the

brief overview of the whole process of your journey :

1. Medical History

It is extremely important that you give a full and honest account of your

medical history. This should include illnesses, operations, drugs,

allergies and any significant family history of disease. Your surgeon

needs to be able to make a well-informed decision on your suitability to

the procedure based on the information you give him/her. If you

withhold any relevant information you might be placing your own wellbeing

at risk and this could affect any complaint thereafter.

2. Pre-Operative Screening

Your health and safety is our Number One priority. We therefore

operate a “patient selection criteria”. In order to complete this we must

make an accurate assessment of your condition of health along with

your requirements.

Following your pre-consultation and review of your past medical

history, the physician or pre-operative nurse will choose any tests

considered appropriate. Please note, for minor procedures there might

not be a need for tests. Most of the tests will include routine blood

tests but the medical team may request further tests such as an ECG,

x-rays or ultrasound scans. These further tests will involve additional

fees. All routine tests and screening programmes are included in your

inclusive fee package and your patient coordinator can advise you of

any such fees. This is essential to help reduce risks during the

operation itself and also to ensure a full recovery. You might like to

look at this part of the procedure as a bonus – you are getting some

extra health care screening which can be very reassuring!

Occasionally the gathering of this information can cause a delay in

booking the date for your operation. It might even mean a

postponement or cancellation of surgery if for medical reasons the

surgeon believes it is not appropriate. In this event, we will try to give

as much notice as possible but you must be mindful that if the booking

has been made, the results of these tests may cause a change in your

plans.

All patients must have pre-operative photographs taken. Surgery will

not be permitted without these photographs taken. Please rest

assured that the photographs will remain part of your confidential

medical record. A separate consent form will be available, if you are

willing to share your story or results of your procedure on social media

or web site.

3. The Role of Your GP

Your General Practitioner (GP) is responsible for your on-going

healthcare and the records thereof. I believe it is important that you

keep him/her informed of your decision to proceed with any cosmetic

surgery. You are within your rights to keep the matter private.

In certain circumstances, such as unusual findings in your tests, or the

need for further information, it may be vital for us to contact your GP

and/or any other relevant specialist that you may have seen previously.

This is entirely for your own medical safety. Should this be necessary,

your surgeon will complete the request for information from your GP.

Your meeting with Mr. Mashhadi

We want you to feel empowered to ask your surgeon anything at all.

Whatever concerns or general queries you have, they should be talked

through at this consultation. Specific actions and items for discussion are:

a) Your medical history in detail (including immediate family members).

Requests for preoperative tests will be raised at this time.

b) An understanding of your expectations and a discussion on realistic

achievements.

c) An examination of the area you are considering treatment for – noting any

irregularities.

d) Photographs of the area. Your nurse may take the photographs during

your pre-operative screening.

e) An explanation of the potential complications and dangers of any form of

surgery and anaesthesia.

f) Care advice both pre, during and post operation.

g) Surgeon may ask for psychological/psychiatrist assessment before

proceeding to the surgery.

Following the discussion and examination, the surgeon may decide it is not in

your best medical interest to proceed with surgery. If for any reason the

surgeon’s discussion with you falls short of your expectations, you may

consult another surgeon for a further opinion.

What Questions you may ask your Surgeon

Below is a list of questions that you must feel have been explained fully before

going ahead with surgery.

a) Is my choice of surgery right for me?

b) Exactly what is the procedure, end to end?

c) Will I have a designated go-to person for any problems/questions at any

stage of the procedure?

d) What are possible risks and conditions associated with this type of

surgery?

e) Will there be any pain or discomfort during or after the operation?

f) What is the aftercare like? Will I get access to support weeks/months after

surgery?

g) How do I ensure good recovery?

h) What is considered a normal recovery time?

i) Will there be any scarring and where will it be?

j) Will other people be able to tell I have had surgery?

k) Does my GP need to know – and if so before or after?

Additional Information

Age Limit

The minimum age for any consultation and surgical procedure is 18.

Body Mass Index

The minimum BMI for any surgical procedure is 16 and maximum is 30.

Period of Reflection

Cosmetic surgery is an elective procedure and not without risk or potential

regret. The Royal College of Surgeons recommends that following

consultation with your surgeon for a cosmetic intervention, you allow a period

of at least 14 days before making such a decision.

About the Consent Form

You need to have a clear understanding of all the potential risks and benefits

of the planned surgical procedure before signing the consent form. These

risks and benefits are also discussed with you during the initial consultation

and also mentioned in the letter sent to you with the copy of the consent. You

should also know the alternative treatment options discussed during the initial

consultations. Please remember that it is a shared decision making and

shared responsibility of patient and surgeon to have any elective cosmetic

procedure and it’s consequences. Please don’t proceed to surgery if you have

any doubts about the planned procedure and it’s risks potential risks. Your

surgeon may refuse to perform the surgery if he thinks that you are not sure

about the surgery or not in a healthy state of mind. You may not be allowed to

change your mind about the agreed plan e.g implant size on the surgery day.

Any last minute cancellations as a result of your own circumstances would

result into non-refundable procedure fee.

Second Consultation or Second Opinion

We encourage our patients to arrange a second consultation or even to seek

a second opinion from another surgeon before making a final decision about

their cosmetic surgery.

Fees

Please note that the consultation with you surgeon is £150, which will only be

reimbursed if you would decide to book your surgical procedure, hence

making the consultation free of cost. Your surgeon at consultation will

determine the exact nature of your surgery and we will then be in a position to

provide the fee for your proposed surgery. As a guideline the range of fees at

present are from £3000 to £ 8000

General Risks and Complications:

The risks and conditions that might occur during or following your surgery are

set out below. Please note this list is not exhaustive and that these are

problems that have been reliably reported :

Pain and Discomfort :It is typical for a most patients to feel some degree of

pain or discomfort. Everyone is different and their idea of what calls for pain

relief will be personal. Usually standard pain relief medication is sufficient for

the period of time immediately after surgery

Bruising and Swelling: In the majority of surgical procedures, bruising and

swelling is normal immediately after surgery and for some weeks later. The

swelling might initially obscure the evidence of surgical “success”. Therefore

they should not be too quick to judge the results until most of the swelling has

subsided.

Bleeding (haematoma): Occasionally, after surgery, bleeding may occur

from the tissue within a wound cavity. If this happens, the treated area might

be swollen and painful. In some cases, a drainage procedure may be

required which might mean a return to hospital.

Infection: It is important to recognize that a surgical incision or the

introduction into the body of any foreign material contributes to a risk of the

introduction of bacteria from the patient’s own skin. Indications of infection

might be tiredness, weakness, fever and muscle aches and pains. Antibiotics

given during most operations reduce this risk to a minimum. Rarely a patient

may require readmission to hospital. If you experience any symptoms of

infection, contact your clinic nurse or the advised emergency contact number.

A) Wound Healing

Healing of wounds varies from patient to patient and even from one

part of the body to another and is a gradual process. Smoking (this

includes all nicotine based products such as e-cigarettes, gums or

patches;), for the period leading up to your surgery and afterwards can

seriously hinder the healing process.

B) Necrotic Wounds (dead tissue)

Usually black or brown in appearance, this problem may occur (albeit

rarely) as a result of healing complications. The wound will not heal

until the necrotic tissue is removed and this may mean a prolonged

period of wound management and additional visits to the clinic.

Fat Necrosis :Applicable to abdominal surgery and those where excess fatty

tissue is removed, a clear liquid (tinged yellow or brown) may dray from the

wound the day after surgery. This happens because blood supply to fat cells

is poor and surgical intervention exacerbates this – causing fat particles to

rise to the surface. Although this is rare, the final result can mean hardened

or calcified skin tissue.

Neuropathic (nerve) Pain:Rarely neuropathic (nerve) pain can occur for an

undetermined period of time. You will have advice on further treatment from

your surgeon.

Changes in Sensitivity: It is entirely normal for patients to experience some

changes in sensitivity to the area that has been treated and even beyond that

area. It might be numbness, increases sensitivity or something very different

altogether. This usually passes in time, but some patients report permanent

numbness.

Seroma : In a very small number of patients, fluid builds up around the wound

site (this is known as a seroma). Additional surgery might be required to

remove this fluid. Subsequent seromas can occur.

Location and variable nature of scar: All prospective patients must be

aware that the rate at which their scars may heal and fade are entirely

variable and individual. Uncommonly, a scar does not heal in the normal way,

this is known as hypertrophic scarring. Scars may be red (or highly coloured),

thick, painful and may take several years to improve, if at all. Although this is

an unusual problem, it cannot be avoided or diagnosed in advance. There is

a treatment to improve hypertrophic scarring but this would not be

recommended until well beyond the full recovery period of your surgery.

Residual Bulges: These bulges can occur after operations where excess fatty tissue and/or skin is removed. If this happens, further treatment can be performed by the surgeon and this will be included in the readmissions policy.

Allergic reaction/retained sutures: Rarely, local allergies to tape, suture

material or other preparations used in surgery can occur. Please ensure you

inform your surgeon of any known allergies. Occasionally dissolvable sutures

do not dissolve as intended and may require removal in the future. On rare

occasions the wound healing process can mask the presence of sutures at

the time of your nurse appointments and you may need to return for further

suture removal in the future.

Asymmetry: It is important to understand that it is normal for patients to have

some asymmetry in their body. In fact it is rare that anyone has perfect

symmetry. A different degree of asymmetry can sometimes following surgery

depending upon the procedure the natural healing process.

Deep Vein Thrombosis and Pulmonary Embolism: This is a rare but

serious complication of surgery and anaesthesia, where a blood clot forms in

the veins, usually the legs, and then moves to the lungs interfering with their

normal function. You may be asked to wear special stockings during your

admission and will be actively encouraged to mobilise early following surgery.

You can further reduce the risks after discharge by avoiding dehydration and

remaining mobile. If you experience sudden chest pain or breathlessness, you

should seek medical help without delay. Please note you should not fly for at

least two weeks following major surgery and you should not take a long haul

flight for six weeks.

Revision: As with any type of surgery, there is always a possibility that your

surgeon is of the opinion that you could benefit from some form of revision

operation after your original surgery. Please refer to the Readmission Policy

(within this booklet) for the relevant terms and conditions.

Subjectivity: Patients must recognize that this procedure is performed for

cosmetic reasons and because of this, the results can only be assessed

subjectively. Therefore, it is important to understand that while you will be

advised as to the probable results this should in no way be interpreted as a

guarantee. This list of risks and conditions associated with any procedure is

not exhaustive. It is important that patients recognize that it is not always

possible for the surgeon to predetermine the individual and psychological

reaction of patients to post-operative complications.

Further Investigations

Occasionally a surgeon might feel the need to order a scan for the patient to

check post-operative progress if he/she has any concerns about the recovery.

This will be an added cost for the patient.

Emergency Support

I’ll provides a 24 hour emergency telephone support service for any

complications that may arise outside normal office hours.

Risks of General anesthesia:

Side effects are the unwanted effects of drugs or treatments but are

generally predictable and or even expected. For example, nausea is a side

effect of a general anaesthetic but there are ways to prevention this side

effect.

Complications are unwanted and unexpected events due to a treatment.

However, they are recognised as events that can happen. An example is a

severe allergic reaction to a drug or damage to your teeth when inserting a

breathing tube. Anaesthetists are trained to prevent complications and to treat

them if they happen.

Index of side effects and complications

This index lists possible side effects and complications according to how likely

they are to happen.

Very

common

Common Uncommon Rare Very rare

1 in 10 1 in 100 1 in 1000 1 in 10,000 1 in 100,000

Very Common and common

1. Nausea and vomiting – RA GA

Some operations and anaesthetics and pain-relieving drugs are more

likely to cause sickness than others. Anti-sickness drugs are routinely

given with most anaesthetics and extra doses can be given to treat

nausea or vomiting.

2. Sore throat - GA

For most general anaesthetics, the anaesthetist will place a tube in

your airway to help you breathe. This may cause your throat to feel

sore after the procedure. It is treated with pain relief medications.

3. Dizziness and feeling faint – RA GA

Anaesthetics can cause low blood pressure. Your anaesthetist will

treat low blood pressure with drugs and fluid into your drip, both during

your operation and in the recovery room. You will only go from the

recovery room back to the ward when your blood pressure is stable.

4. Shivering – RA GA

You may shiver if you get cold during your operation. Care is taken to

keep you warm and to warm you afterwards if you are cold. A hot-air

blanket may be used. Shivering can also happen even when you are

not cold, as a side effect of anaesthetic drugs.

5. Headache – RA GA

There are many causes of headache after anaesthetic. These include

the operation, dehydration and feeling anxious. Most headaches get

better within a few hours and can be treated with pain-relief medicines.

Severe headaches can happen after a spinal or epidural anaesthetic.

If this happens to you, your nurses should ask the anaesthetist to come

and see you. You may need other treatment to cure your headache.

6. Chest infection – RA GA

A chest infection is more likely to happen after major surgery on the

chest or abdomen, after emergency surgery and after surgery in people

who smoke. It is treated with antibiotics and physiotherapy. In some

circumstances, having an RA, rather than a GA, can reduce the risk of

a chest infection. Occasionally severe chest infections develop which

may need treatment in the intensive care unit. These infections can be

life-threatening.

7. Itch – RA GA

This is a side effect of opiate pain-relief medicines. It can also be

caused by an allergy to anything you have been in contact with, include

drugs, sterilising fluids, stitch material, latex and dressings. It can be

treated with drugs.

8. Aches, pains and backache – RA GA

During your operation you may lie in the same position on a firm

operating table for a long time. You will be positioned with care, but

some people still feel uncomfortable afterwards.

Muscle pains can also happen if you receive a drug called

suxamethonium. Your anaethetist will tell you if you need this drug.

Some drugs are used for general anaesthesia or for sedation given

with regional anaesthesia cause pain when injected.

9. Pain when drugs are injected – RA GA

Some drugs used for general anaesthesia or for sedation given with

regional anaesthesia cause pain when injected.

10. Bruising and soreness – RA GA

This can happen around injection and drip sites. It may be caused by a

vein leaking blood around the cannula (device used to insert the drip

into the skin) or by an infection developing. It normally settles without

treatment other than removing the cannula.

11. Confusion or memory loss – GA

This is common among older people who have had a GA. IT may be

due to an illness developing such as chest or urine infection. There are

other causes which the team looking after you will take care to treat. It

usually recovers but this can take some days, weeks or months.

12. Bladder problems – RA GA

Difficulty passing urine, or leaking urine, can happen after most kinds

of moderate or major surgery. If this happens, the team looking after

you will consider whether you need a urinary catheter (soft tube)

placed in the bladder which drains the urine into a bag. If the difficulty

is expected to get better very soon, it is best to avoid a catheter due to

increase risk of urinary tract infection (UTI). Your nurses will make sure

that you are clean and dry as soon as possible. Most bladder

problems get better so that your normal urinary habit returns before

you leave hospital.

Uncommon risks

1. Breathing difficulty – GA

Some people wake up after a general anesthetic with slow or slightly

difficult breathing. If this happens to you, you will be cared for in the

recovery room with your own recovery nurse until your breathing is

better.

2. Damage to teeth, lips and tongue – GA

Damage to teeth happens in 1 in 4,500 anaesthetics. Your

anaesthetist will place a breathing tube into your throat at the beginning

of the anaesthetic, and this is when the damage can happen. It is

more likely if you have fragile teeth, a small mouth or a stiff neck.

Minor bruising or small splits in the lips or tongue are common, but heal

quickly.

3. Awareness – GA

Awareness is becoming conscious during some part of a general

anaesthetic. It happens because you are not receiving enough

anaesthetic to keep you unconscious. The anaesthetist uses monitors

during the anaesthetic which show how much anesthetic is being given

and how your body is responding to it. These should allow your

anaethetist to judge how much anaesthetic you need.

If you think you may have been conscious during your operation, you

should tell any member of the team looking after you. Your

anaesthetist will want to know so they can help you at this time and

with any future anesthetic you may have.

4. Damage to the eyes – GA

It is possible that surgical drapes or other equipment can rub the

cornea (clear surface of the eye) and cause a graze. This is

uncomfortable for a few days but with some eye-drop treatment it

normally heals fully. Anaesthetists take care to prevent this. Small

pieces of sticky tape are often used to keep the eyelids together or

ointment is used to protect the surface of the eye. Serious and

permanent loss of vision can happen but it is very rare.

5. Nerve damage – RA GA

Nerve damage (paralysis or numbness) has a number of causes during

local, regional or general anaesthetics. It varies with the type of

anaesthetic you are having. Temporary nerve damage can be common

with some types of anaesthetic, but full recovery often follows.

Permanent nerve damage to nerves outside the spinal column is

uncommon.

6. Existing medical conditions getting worse – RA

Your anaesthetist will make sure that any medical condition you have is

well treated before your surgery. If you have previously had a heart

attack or a stroke the risk that you will have another one is slightly

increased during and after your operation. Other conditions such as

diabetes, high blood pressure and asthma will be closely monitored

and treated as necessary.

Rare or very rare complications

1. Serious allergy to drugs – RA GA

Allergic reactions can happen with almost any drug. Your anaesthetist

uses continuous monitoring which helps to ensure any reaction is

noticed and treated before it become serious. Very rarely, people die

of an allergic reaction during an anaesthetic. It is important to tell your

anaesthetist about any allergies you know you have.

2. Damage to nerves in the spine – RA GA

Permanent damage to the nerves in your spine is very rare after either

general anaesthetic, spinal or epidural anaesthetic.

3. Equipment failure – RA GA

Many types of equipment are used during an anaesthetic. Monitors are

used which give immediate warning of problems and anaesthetists

have immediate access to back-up equipment. The chance of a

serious event due to equipment failure is rare or very rare.

4. Death – RA GA

Deaths caused by anaesthesia are very rare. There are probably

about five deaths for every million anaesthetics given in the UK.

Although there are risks associated with anaesthesia, these are uncommon

and Juvea’s surgeons, anaesthetists and nurses work as a team to minimize

the chance of any unexpected harmful events.

Further information regarding anaesthetists is available from the Royal

College of Anaesthetists. www.rcoa.ac.uk/patients-and-relatives/risks

Arrangements for the Surgery

At this stage, you are probably quite confident that surgery is right for you.

We understand that a straight forward booking process is important, even if

you still have some concerns or questions that you wish to discuss with a

medical professional. Below is a recommended schedule that should ensure

you have a smooth pre and post surgery experience:

1. We can help you arrange a suitable date for your surgery. Think

carefully about the timing for your operation. It might be that you have a

big event in the year that you want to feel and look your best for, but

with any surgery, you must always remember that any risks are likely to

cause a setback. In other words - don’t book the surgery just one

month before your wedding! Consider the following first:

a) Time required off work. For major surgery, we usually recommend

2-4 week off work, depending upon the surgerical procedure and

the nature of employment. Please note that some occupations will

require a longer period of recovery, for example those which are

physically demanding (eg. Manual working, armed forces) and if

you are unable to cease work for the required period of recovery

you should defer surgery. This also applies to patients who have

similar hobbies (eg. horse riding, gym activities). If you do

experience a complication the period to refrain from such activities

will be extended until you have recovered. Please note lack of

compliance could lead to the readmission policy being voided.

b) Childcare: If you have young children you may need help from

family or friends. For example, lifting children following surgery

might be painful at first and should be avoided.

2. Your fees will need to be paid promptly by the required date. Please

make sure your funds are properly organized. Last minute delays can

cause unnecessary frustration, and possibly a cancellation of your

operation.

3. Ensure your GP has been informed of your planned

4. Arrange to attend for your pre-operative screening with any and us

other tests deemed necessary by the surgeon or anaesthetist.

5. Arrange your transport to the hospital and back home again. On no

account can you drive or travel home alone. Failure to arrange

transport home, by a nominated responsible person, may result in the

operation being postponed.

6. Prepare an overnight bag to take with you. Read your pre-operative

instruction sheet before the day. This will help prepare you for the

operation and suggest what to bring with you and what to leave at

home.

7. Please inform your clinic nurse or patient coordinator if you feel ill, have

a cold/flu or any other signs of an infection prior to surgery.

8. It is not possible to proceed with treatment if you become pregnant.

Please ensure you take necessary precautions. And if you are in any

doubt use a pregnancy testing kit.

9. Call your patient coordinator if you need any help or reassurance.

Postoperative Recovery

1. We want you to have the best possible recovery and that means

getting you to feeling really well and happy soon after the surgery. We

have a great aftercare package and all the right procedures in place

but we will also require your participation to aid a full and speedy

recovery. Please note, however, that we are unable to offer a District

Nurse service and all appointments will be arranged at your local clinic.

Occasionally we may require a patient to return to the hospital, such a

decision is only made in your best medical interest. So that you are

informed on what will happen when you first leave the operating

theatre, read the following steps and make sure you understand the

post-op events:

2. You will feel sleepy and groggy but the depleting anaesthetic should

ensure that you will not feel very much pain.

3. Depending upon the surgery, you are likely to have some dressing to

prevent infection from airborne bacteria.

4. Before being discharged from hospital you will be given an information

guide on what you should or should not do over the coming weeks.

5. You might be given medication to take.

6. An emergency help number will be part of your leaving package so that

you can be assured of help at any time if you are worried or feel ill.

This is recommended over and above calling your GP or going to your

local hospital.

7. Although rest and avoiding heavy work is important, it is vital that you

do not spend too much time in bed or lying down, this behavior can

bring on other medical problems.

8. For those having stitches, it is usually around 10-14 days after surgery

that your stitches are removed.

9. At this time you should make a “first review” appointment with one of

the clinic’s nurses or surgeon.

10. After this, you will have periodic assessments over the following

months. You are expected to make these appointments to suit you.

The number of appointments will depend upon your recovery rate, your

surgeon will advise on this.

11. Please note that occasionally a patient needs to return to hospital, but

this is only done if absolutely necessary.

How soon can I drive?

You must not drive until your stiches are not removed Due to the effects of the

anaesthetic you would technically be driving under the influence of drugs and

therefore your insurance would be null and void, you may even be subject to a

driving penalty. As this is very serious, then should you choose to ignore this

information and drive yourself to the hospital, intending to drive yourself home

post surgery, we must cancel your operation. A cancellation in such

circumstances will mean that no refund of fees is due.

In order to ensure the effects of the anaesthetic have worn off, we advise

waiting for 2-3 days before driving. You must also bear in mind any strong

medications for pain relief can impair your judgment. Other than these

factors, you should wait until you feel completely confident to handle a vehicle

and react accordingly in case of accident or emergency.

Tests, investigations, consultations

Any general tests and investigations like ultrasound scan indicated by your

surgeon, following your surgery will cost you. Any care commenced during

this period will be continued on this basis as deemed necessary by the clinical

team will be provided free of charge, however, if you need to go back to

theatre, you’ll need to bear the cost of hospital charges.. Also any personal

expenses such as travel or loss of earnings are the patient’s own

responsibility and we will take no legal responsibilities to compensate these.

Please note that the assessment of the outcome of a cosmetic surgery

procedure involves a great deal of subjectivity and if your surgeon decides

that the results of your surgery are within the normal limits then further

surgery at no cost will not be possible. We cannot commit to providing

continuing surgery where the results of the surgery originally provided has

been affected by changes in life style, pregnancy, illness or the natural ageing

process.

If you decide to undergo further consultations or surgery with another

surgeon, you will also be responsible for any additional fees this will incur

This policy may be affected if a patient fails to attend review

appointments or follow advice and guidance as indicated by the your

surgeon

Review Appointments

Post operative review appointments with the clinic nurse or your surgeon will

be provided in line with the post operative care regime for your procedure, or

as your recovery dictates. No further appointments are required unless clinical

indicated. There will be a fee for surgical consultations and surgical procedure

outside of our readmission period ie. three years after surgery.

THE PRIVATE HEALTHCARE INFORMATION NETWORK (PHIN)

PHIN has a legal mandate to gather and publish performance information

regarding all hospitals and consultants providing private treatment.

From the 1st April 2016, it is mandatory for all private healthcare providers to

submit patient treatment data to PHIN.