In the minds of the public, the term ?plastic? is closely linked to aesthetic and cosmetic surgery. For this reason, there are now surgeons who, while not fully trained as plastic surgeons, have included the word 'plastic' in their titles.

Accredited plastic surgeons are those who have completed supervised, recognized training in designated training centres across the UK. They will have passed the exit examination ? FRCS (Plastic Surgery), or FRCS (Plast) ? in addition to their basic surgical qualification, the FRCS or Fellowship of one of the Royal Colleges of Surgeons. They should also be listed on the Specialist Register of the General Medical Council.

If you are searching for a Plastic Surgeon, they should be full members of the British Association of Plastic Surgeons (now the British Association of Plastic, Aesthetic or Reconstructive Surgeons) or full members of the British Association of Aesthetic Plastic Surgeons. For a Plastic Surgeon to obtain full membership of BAPRAS, they have to be , or have been, appointed as Consultant Plastic Surgeon at one of the National Health Service (NHS) Plastic Surgery Units in the UK or Ireland.

Being appointed to a Consultant post in an NHS hospital in one of the most competitive surgical specialties shows that the surgeon has completed all the necessary plastic surgery training , successfully passed the required basic and specialist exams, and has been selected in competitive interview from a cohort of other equally qualified peers. This is therefore an indication that the surgeon has met a high standard of competence.

All surgical operations carry an element of risk, and no plastic surgeon can legitimately claim to have 100% success rates. Selecting a trained and experienced surgeon should help reduce your risks of having problems, especially those due to errors of surgical technique or clinical judgment.

Ask if your surgeon has published professional papers in peer-reviewed journals. It is useful to find out if he or she has teaching commitments and research interests. Do discuss specific risks and personal treatment approaches with your surgeon, and their approach to aftercare. You should ask to see some photos of the surgeon?s previous work (bearing in mind that not all patients are the same in terms of the rationale for, and the degree of, surgical correction required), which will go some way towards showing you the surgeon's skill.

Personal recommendation from a satisfied patient who has undergone surgery with your surgeon is a big plus!

A quick visit to the General Medical Council website will give you a lot of information about whether your surgeon is qualified, and more importantly, whether they are on the Specialist Register.

A word of caution ? after the procedure has gone wrong is not a good time to find that your practitioner is not registered with the General Medical Council ! Although such cases are thankfully less common now, the principle of caveat emptor (buyer beware) applies. Note that all a surgeon needs to carry out a cosmetic procedure is a basic medical degree, and for them not to have misled you about having qualifications that they do not possess ? even more reason for you to question your surgeon about their qualifications and training.

There are other practitioners who advertise in the 'cosmetic surgery' sections of directories and magazines, such as ?cosmetic doctors? who are not surgeons, but are usually general practitioners with an interest in ?non-surgical? procedures such as filler injections or injections of facial relaxants.

You may be aware of several large organisations who advertise extensively, offering free consultations and 'competitively priced' surgery. Not many fully accredited surgeons work for these companies, so do check that your surgeon is qualified if he or she is working for one of these organisations. Many of these surgeons fly in from other countries to carry out the procedure in the UK, tempted by favourable currency exchange rates.

These companies and their sales staff are often more interested in convincing a patient to have a procedure which they may or may not need, offer less follow up and have an inconsistent policy for dealing with complications. A recent undercover investigation into unsatisfactory practices in the cosmetic surgery industry was carried out as part of a Which? consumer campaign (Jan 2008), which makes for interesting reading!

You may be tempted to take up an offer of having your operation overseas. You can certainly meet good surgeons in the USA and continental Europe, but it may be difficult for you to establish the qualifications and skills of your particular surgeon. Surgery overseas is certainly risky, as you have no legal redress if things should go wrong, not to mention the fact that it is difficult for both the surgeon and the patient to meet for regular follow ups, especially if there are issues in the post-operative period.

Do not make your judgments based on cost alone. It is often better to have no surgery, than to take the risk of cut price operations and end up with complications which can inflict lasting damage on your health and your quality of life.

Try to have your operation with a surgeon who can show you evidence of accredited training and specialist registration, preferably someone who is recommended on the basis of good results. Ideally, this is also a surgeon that you like, that you feel you can build up a rapport with and someone you trust to deliver the results that you are looking.

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