Pre-operative Consultations:
Every patient undergoing any surgery needs to properly understand what they are undertaking. It is essential to take the time to consider all issues carefully. Printed Information sheets need to be read carefully and you should write down any questions that arise so that they can be discussed during a further consultation.

Patients contemplating cosmetic procedures may find seccond opinions helpful. However it is important that additional assessments are just that and not just cost comparisons. I am always happy to suggest the names of collegues who I believe will offer excellent assessments and opinions.

Cosmetic Surgery —a retail product?
I believe it is becoming increasingly more difficult for patients to avoid developing the notion that cosmetic surgery is a retail product that can be selected "off the shelf" and comes with consumer garrantees like a manufactured product. No realm of medical practice can offer this certainty. Unfortunately "infotainment" type television programs and magazine articles deal with cosmetic surgery in very short presentations and the quality of the information provided is often doubtful. Disappointingly some individuals promoting cosmetic surgery do not properly represent the limitations and potential complications as fairly as they describe the benefits.

The vast majority of popular cometic surgery operations are indeed associated with high levels of patient satisfaction, however this requires:

• Appropriate patient selection

• Comprehensive surgical training

• Diligent post operative care

• Carefully explained preoperative information balancing the likely
benefits against potential risks

Ethical Practice and Cosmetic Surgery
All patients are fully entitled to expect that any medical treatment proposed for them is primarily for their benefit. Surgeons are under a fundamental ethical obligation to recommend and undertake procedures only when it is expected that the patient will derive a worthwhile benefit.

The mutual responsibilities between the Patient and the Surgeon
Cooperation is needed between patient and surgeon to optimise the surgical outcome.Whilst the surgeon has a fundamental obligation to properly plan, conduct and follow-up all procedures, patients undergoing surgery need to carefully comply with reasonable instructions, attend for follow-up and contact their surgeon if they have any reason to believe there is a problem.

Smoking
No person should contemplate elective surgery and smoke. Cigarette smoking can have several detrimental effects during the surgical process.

Inhaled nicotine is a potent vasoconstrictor and reduces the blood flow, particularly to areas of skin that may have a marginal circulation. This can result in significantly impaired / delayed healing, particularly in patients undergoing facelifts and breast reductions.

Smokers tend to cough significantly more after general anaesthetics and this can be uncomfortable and is associated with a higher incidence of wound problems.

Patients who smoke and undergo major surgery such as abdominoplasty (tummy tuck) have a higher rate of deep vein thrombosis (blood clots) in the legs. These can cause very serious problems including fatal embolism.

Surgery and Your Medications

Aspirin (& other drugs); Medications that alter the clotting of blood
Many medications influence the way blood clots. This can be the intended action of the drug or simply a side effect. Most of these drugs have effects that last up to three weeks and even a single tablet within that time before surgery can have significant effect. It is essential that your surgeon know if you take any of the following medications.

Unless instructed otherwise, the following drugs must NOT be used for at least 14 days before, and 10 days following surgery.