Why do cosmetic surgery prices vary so much?

This is an interesting question. Many patients who come to see me at my London cosmetic surgery practice are surprised that I charge for consultations, and that my prices for surgery are high, compared to some of the larger cosmetic surgery chains.

Cosmetic surgery consultation fees

There are a few reasons why individual cosmetic surgeons like myself tend to charge more than the larger groups. Let’s start with consultations: if you have a consultation with one of the clinic chains, which is usually free of charge, it is likely to be with a salesperson, rather than a cosmetic surgeon.

When you have a consultation with a qualified cosmetic surgeon, they are charging you for their time and expertise. A surgeon like myself will perform a thorough medical examination before assessing your suitability for surgery and I charge a consultation fee on the basis that not all patients will go on to have the operation.

Indemnity insurance

UK surgeons have to pay very high indemnity fees before they are allowed to perform cosmetic surgery – around £40,000 a year. This is in order to safeguard patients in the unlikely case of any complications arising following surgery.

Individual surgeons have to account for this when charging their surgical fees. Clinic chains, on the other hand, because they have a large number of surgeons on their books and a large number of patients walking through the doors are able to spread the costs more and so charge lower fees.

Other cosmetic surgery costs

When you have an operation, the surgeon’s time is not the only cost incurred – there’s the anaesthetist, who is there not just to ease your pain but also to monitor your wellbeing during the operation, and the theatre time, as well as any nursing staff.

Again, when you visit a large clinic chain, they tend to bulk book theatre space in advance at a lower cost, whereas individual surgeons will book the theatre space as and when they have a suitable patient.

Why pay more?

The key here is that when you use an individual cosmetic surgeon, your consultation is with that surgeon, so there is no pressure to go ahead and book the surgery as there would be with a salesperson. You also get to know your surgeon and can speak to him/her ahead of time about any concerns you may have.

With the larger cosmetic surgery chains you often don’t meet your surgeon until the day of the operation, which means you don’t know what his/her work looks like, and don’t have the same chance to form a rapport with him/her.

What happens if my cosmetic surgery procedure goes wrong?

Generally, cosmetic surgery is very safe – particularly if you have chosen your surgeon wisely and ensured that s/he is fully qualified and experienced, with membership of the appropriate professional bodies.

However, like any surgery, it does carry some risks – these can be complications of the surgery itself, such as infection and bleeding, anaesthetic complications, or complications post surgery, such as implant rotation.

What can be done?

The first thing to remember is that cosmetic surgeons in the UK pay very high indemnity fees, to insure them in the unlikely event of something going wrong. This means that they should be able to rectify the problem without any additional cost to you.

If the problem is a surgical or anaesthetic complication, this should be dealt with at the time of the procedure, and you may not even be aware of it. If the problem happens post surgery, the process may be more complicated.

Talk to your cosmetic surgeon

If you are unhappy with the results of your cosmetic surgery, or feel that a problem has arisen after the surgery, then the first thing to do is to talk to your surgeon. Most cosmetic surgeons will be happy for you to book an appointment to speak to them post surgery, and to listen to any concerns you may have.

Remember that sometimes a “problem” may be subjective – i.e. what seems like a problem to you may not be something that the surgeon feels they have done wrong – and so if you feel that corrective surgery is needed, you may need to argue your case well or be prepared to pay for additional surgery. If you are asked to pay for the extra procedure then you may want to consider the following:

Find another cosmetic surgeon

If you are unhappy with the results of your cosmetic surgery, but the surgeon feels they have done the best job possible, then it may be that you have not chosen the surgeon most suited to your needs. If you are being asked to pay for revisionary surgery anyway, then you might be best placed to seek a second opinion and consider paying a different surgeon to do the job.

In my London cosmetic surgery practice, the vast majority of patients are very happy with the outcome of their surgery. It is important to have realistic expectations, which is something I encourage at the consultation stage.

What is more important in choosing a cosmetic surgeon: recommendations or before and after photographs?

Both personal recommendations and before and after photographs are very useful tools when it comes to choosing a cosmetic surgeon. Which is more important to you will ultimately be a personal decision, but you should consider a number of different factors, which I’ve outlined below.

Who is the recommendation from?

Do you trust the person who is recommending the surgeon? Is it someone you know well, a stranger whose number you have been given by the cosmetic surgery clinic, or even someone on an online forum?

If the recommendation comes from someone you know well, and you have seen and been impressed with the results of their surgery, then this is probably a good indicator that the surgeon is someone you can trust with your own cosmetic surgery.

Anonymous recommendations

Sometimes a cosmetic surgeon might give you the telephone number of a previous patient who has said they are happy to talk about their experience.

This can be very helpful, particularly if you are feeling nervous about the procedure, but it is important to think about whether the person at the end of the phone sounds genuine. You also might like to ask to see their before and after photographs, so you can see whether you are as impressed with their results as they are.

Recommendations on forums can be tricky, as it is difficult to know who the people are who are posting the comments. Generally, if there is an overwhelmingly positive array of comments online about a particular cosmetic surgeon, then s/he is likely to be good, but in this case before and after photographs will provide an additional aid to put your mind at rest.

In conclusion

Ideally, the surgeon you choose would both come recommended and have before and after photographs that show the kind of results you are looking for.

If a surgeon is unable to show any before and after photographs, however, be wary. Personal recommendations are a fantastic indicator of a surgeon’s bedside manner, but remember that everyone is looking for something slightly different from their cosmetic surgery, and photographs of previous patients are the best way to see whether a cosmetic surgeon can provide the results you want.

Is cosmetic surgery painful?

If you were to undergo any cosmetic surgery procedure without an anaesthetic, then it would of course be very painful! Thankfully, however, anaesthetic techniques are so advanced nowadays that you won’t feel a thing throughout the cosmetic surgery itself.

After the cosmetic surgery procedure

Although you will be numbed throughout the operation, there will be some pain once you have come round from the anaesthetic. How much pain and in what location will depend on the type of cosmetic surgery you have had.

You will be given pain medication to take that will help to make you more comfortable in the first few days after surgery. Generally any residual pain should disappear within the first couple of weeks after you operation.

Facelift pain

People often expect facelift surgery to be particularly painful – in fact, it is one of the least painful forms of cosmetic surgery. There will be a “tight” feeling after surgery, and there may be some bruising and swelling at the point of incision, but generally facelift surgery is surprisingly pain free.

Types of anaesthetic

There are a number of different anaesthetic techniques that can be used for cosmetic surgery. In my London cosmetic surgery practice I prefer for patients to undergo a general anaesthetic, whether it be for facelift or breast augmentation.

A general anaesthetic ensures that the patient is pain free and blissfully unaware of what is happening during the procedure itself. Some cosmetic surgeons perform breast augmentations under twilight sedation – where the patient is semi-conscious throughout – or even local anaesthetic, as this allows the patient to return home on the day of surgery.

In my practice, I believe that it is safer and more comfortable for the patient to be under a general anaesthetic and be closely monitored for 24 hours after cosmetic surgery.