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 alleviate back or neck pain.
Cosmetic surgery is different to reconstructive plastic surgery, which is a type of surgery used to repair damaged tissue following injury or illness.
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 to 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.
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 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.
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 (male and female) – 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
A popular alternative to cosmetic surgery are non-surgical cosmetic procedures. These can change a person’s appearance using things like injections and lasers.
Common non-surgical procedures include:
botulinum toxin injections – such as 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
laser and intense light treatments – such as hair removal
However, there is little regulation of these procedures and many don't require the person performing them to have any medical qualifications.
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 that the procedure wasn't carried out properly, take up the matter with your surgeon through the hospital or clinic that referred you.
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 providing cosmetic surgery must be registered with.
Practitioners of non-surgical procedures do not currently need to be registered with the CQC or any other regulatory body, so if you have an issue it's best to take it up with the person who carried out the procedure or the clinic where it was performed.
How common are cosmetic procedures?
In recent years, cosmetic surgery has become very popular. It's estimated that over 120,000 surgical procedures were performed in the UK during 2011. About 9 in every 10 cosmetic surgery procedures are carried out in women.
Non-surgical cosmetic treatments, such as Botox, are even more popular than surgical procedures, accounting for over 90% of all cosmetic procedures.
Cosmetic surgery abroad
Treatment abroad can cost less than in the UK but any savings should be weighed up against potential risksV
Availability of cosmetic surgery
There must be overriding physical or psychological reasons for considering it as a treatment option.
For example, a clinical commissioning group (CCG) may decide that cosmetic surgery is required for health reasons (see below) in rare cases.
See your GP if you're considering having cosmetic surgery.
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 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
breast implants to treat severe underdevelopment or asymmetry (lopsidedness)
breast reduction to treat back pain or shoulder pain
nose reshaping (rhinoplasty) to treat breathing problems
tummy tucks to remove excess fat or skin after essential abdominal surgery
eyelid reduction to treat affected vision
However, resources are limited and waiting times for these types of surgery are usually long.
Due to the limited availability of cosmetic surgery , most people who decide to have cosmetic surgery have private treatment.
All private companies that provide cosmetic surgery must register 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 CQC inspects all cosmetic surgery providers and reports on their findings.
The cost of private cosmetic treatment can vary depending on where you have treatment and the type of procedure being carried out.
As a general guide, prices in the UK for some common procedures are:
breast augmentation – £3,500 to £5,000
breast reduction – £3,500 to £5,500
eyelid surgery (blepharoplasty) – £1,500 to £4,000
ear reshaping (otoplasty or pinnaplasty) – £2,500 to £3,000
facelift – £4,000 to £7,500
liposuction – £1,500 to £5,000
'nose job' (rhinoplasty) – £3,000 to £4,000
'tummy tuck' (abdominoplasty) – £4,000 to £6,500
Common cosmetic surgery procedures
There are many different types of cosmetic surgery procedure and it's important to find out as much as possible about any 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)
nose job (rhinoplasty)
tummy tuck (abdominoplasty)
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 will be asleep and unable to feel any pain or discomfort during the procedure.
The procedure starts with your surgeon making an incision (surgical cut). Your surgeon will discuss with you the exact location of the incision 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. In some cases, the surgeon is able to place the implant partly behind the breast and partly behind the muscle. Your surgeon will be able to offer advice about the position that is 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 will be able to go home the same day. However, if the operation is scheduled late in the day, you may need to stay in hospital overnight. Depending on the procedure you are having, the operation should take between 60 and 90 minutes.
If the stitches used aren't dissolvable, they will be removed after seven to 14 days. Some surgeons recommend wearing a tight-fitting sports bra 24 hours a day for up to three months following breast surgery.
Most breast implants last about 10-15 years, after which time further surgery may be needed to replace them.
What are the risks?
As well as the general risks of surgery (see below), 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 rupture (split) – warning signs of a rupture 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 it 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 and repositioned as a skin graft.
Excess skin and breast tissue are then removed. The remaining breast tissue is reshaped to create smaller and more elevated breasts.
The procedure takes between two and four hours. You are usually required to stay in hospital for 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 (see below), 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
Breast reduction (male)
Male breast reduction is used to reduce the size of enlarged male breasts (known as 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.
The operation usually takes about 90 minutes. You will be required to stay in hospital overnight.
If non-dissolvable stitches are used, these will need to be removed after seven 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 around the affected area.
What are the risks?
As well as the general risks of surgery (see below), risks of male breast reduction include:
your nipples may be asymmetrical after surgery
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.
The length of time it takes depends on the complexity of each case. However, the procedure generally takes one to two hours. If local anaesthetic is used, you will 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 five to 10 days after surgery and you will need to wear a head bandage during this time to support the ears in their new position.
What are the risks?
As well as the general risks of surgery (see below), risks of ear reshaping surgery include:
your ears may protrude again in the future (the problem re-occurs in 5% of cases)
your ears may be slightly asymmetrical after surgery
your ears may feel numb and stiff for weeks or months
a blood clot may develop in the skin of your ear, which may need to be removed by your surgeon
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 anaesthetic 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.
Cosmetic eyelid surgery takes between one and two hours. If local anaesthetic is used, you can usually go home the same day as the operation. If general anaesthetic is used, you will need to stay in hospital until the effects wear off.
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 (see below), risks of eyelid surgery include:
your vision may be temporarily blurred after surgery
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 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 under and behind 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
The procedure can take up to six hours to complete and 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 seven to eight days.
What are the risks?
As well as the general risks of surgery (see below), 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.
Liposuction is used to remove unwanted body fat.
Most liposuction operations are performed under general anaesthetic. For treatments on the lower parts of the body, an epidural anaesthetic may be used. This numbs the lower part of the body while you are 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 like 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.
This procedure usually lasts between one and four hours. You will have to stay in hospital overnight if general anaesthetic is used.
After the procedure you will be fitted with an elasticated corset or bandages for the treated area. This helps to reduce swelling and bruising, and it should 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 (see below), 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
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, and/or reshape the cartilage.
Nose reshaping surgery generally takes around two hours.
After the operation, it's likely you will need to wear a protective splint over your nose for a few weeks. 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 (see below), 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.
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, usually if lifestyle changes like healthy eating and dieting are unsuccessful.
There are two types of tummy tuck, called 'partial' and 'full'. These operations will usually be 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 they separate the skin from the abdominal wall.
The surgeon then 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.
The length of the operation will depend on the extent of the surgery, but it could take up to three hours.
After the procedure, you will need to stay in hospital overnight. The stitches will be removed after seven to 14 days and you will need to wear a supporting corset for one to four weeks to encourage your skin to heal properly around the affected area.
What are the risks?
As well as the general risks of surgery (see below), 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.
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:
bleeding, which may require a blood transfusion if severe
pain and discomfort, which may require painkillers for a few days
swelling and bruising, which can last for weeks or months
infection, which may require antibiotics or further surgery
scars – you will 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