I am amazed when I hear stories of patients seeing a surgeon in a clinic, only to find on the day of the procedure that a different surgeon is going to operate on them who they have never met before.

This is bad practice and uncomfortable for the surgeon and I am sure that it does nothing to give confidence to you, the patient.

One of the things we pride ourselves on here at The Staiano Clinic, is that all of your consultations will be with the surgeon who will be performing the surgery.

Because all the consultations are with your surgeon, you will find that we will give you an honest opinion about what can reasonably be achieved, because we will be the one who will see you after the surgery and be with you at each of your follow up appointments.

It is all too easy for a sales adviser or the clinic nurse to gloss over the potential complications and promise a great result if they do not have to face you afterwards and justify the quality of the result that you have achieved.
You can imagine that there could be a tendency to give unrealistic expectations so that you can’t really make an informed decision about whether surgery is right for you.

We want to give you the best advice because the clinic is built on the foundation that we will do everything we can to give you the best result possible, and this might sometimes mean not operating on you.
It is better that you are prepared for the likely result that you will achieve, what the scar will look like, and what effect the surgery can reasonably be expected to have on you.

However, if you do decide to go ahead with surgery it is far more likely that you are going to be happy with your result.

I think this is one of the reasons why we have so many happy patients.

We are so lucky to have a supportive community at different stages of their surgery who will freely talk and give advice to others.

I guess on the face of it you could say that the Staiano Clinic is a plastic surgery clinic, but that is not what we are really about.

We are about

• listening to people
• understanding your concerns
• taking on board your hopes and fears
• and talking about what can be done to address them

Then, we can go through the options to allow you to come up with a plan for what is right for you.

We are all about the long game and want to make patients for life.

Different clinics will have different values and while we do have company goals and commitments, you can sum up our values in two words,

“we care”,

Plastic surgery is a very personal thing and a personal choice but it has become synonymous with cowboy operators and botched bodies.

I think this is because it is increasingly commercialised and there are a growing number of non-fully trained plastic surgeons providing the surgery often with a corporate backing which is focused on the most efficient and cost-effective way of delivering the service.

This often involves the surgeon only performing the surgery and other members of staff dealing with the patient interaction before and after.

I believe the aftercare is crucial and this is something we focus on here.

I guess different models will work for different people.

There are many ways that we could create efficiencies and increase our profits, but this clinic is not run by a corporation who only care about the profits.

It is run by me, a plastic surgeon, who wants to give the best outcome possible for every patient.

We do not measure ourselves on profit, we measure ourselves on patient satisfaction

I want The STAIANO Clinic to be known for giving you the best service and really looking after you.

This is why we have so many lovely reviews and happy patients and this will always be what we strive to achieve.

JJ Staiano
Plastic Surgeon & Director
The STAIANO Clinic

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Join me for a LIVE Q&A on Facebook every Tuesday night at 7pm

or contact us for more information

We are very proud to share another award with you, Staiano Plastic Surgery has received the

Award for Excellence in Breast Plastic Surgery 2018 – West Midlands

in the UK Healthcare & Pharmaceutical Awards, hosted by GHP.

I have just finished submitting my audit figures to the BAAPS (the British Association of Aesthetic Plastic Surgeons) which is something I have to do every year as a member of BAAPS.

This means that there is a central body that collects all of our data to look at the number of operations we are doing, our infection rate, and our re-operation rate.

People are always shocked when I tell them that the majority of cosmetic surgery done in this country is not done by plastic surgeons, and they wonder ‘how could this be?’

The answer is that there is no law that says that it has to be a plastic surgeon who performs a plastic surgery procedure and because there is a huge demand for cosmetic surgery such as breast implants and liposuctions, there are an enormous amount of surgeons and doctors who are offering these procedures who have not gone through the extensive and rigorous training of plastic surgery.

That is why I have written a book about it.

The truth is that if you are doing enough of a procedure then you are likely to start to get good at it, so many of these surgeons could say that they have done hundreds of cases and are now good at it.

The problem is that they are not regulated or monitored in the same way as a plastic surgeon would be.

We are bound by strict guidelines as members of BAAPS and we have a code of conduct we are accountable to.

If our complication rate or re-operation rate is very high, it will be picked up.

We have criteria around what we can say to patients in terms of advertising and marketing and we are not allowed to give time limited offers or any inducements to surgery, and so when patients ask us if there is any movement on the price it is not that we are trying to be difficult or aloof, we actually cannot give any discounts because this is after all a medical procedure, and the prices are set.

The situation would be different if you saw a non-BAAPS member because they would just be limited by the guidelines of the GMC, which are much more broad about how doctors treat patients in general and it is not uncommon to see special offers or inducements to have surgery within a certain timeframe.

As a plastic surgeon we also have to have medical insurance and no-one expects to need this just like you do not expect to need it with your car, but it is important that you are fully insured and that patients are protected.

We need to have insurance of between 5 and 10 million pounds of liability cover and other types of surgeons may not have this level of cover.

The area of cosmetic surgery covers quite a wide spectrum and includes doctors who are not trained in plastic surgery but are trained in other specialties, such as general surgery, or ENT.

It also includes doctors who are not trained in any surgical speciality at all.

I am sorry to say it also includes people who are not trained as doctors at all!

If you have any concerns you can always go to the practitioner’s professional association, and as I have said, BAAPS has strict guidelines and of course, we are also bound by the GMC.

As you get into the world of treatment done by non-medical personnel, and this is particularly common in the non-surgical area in terms of anti-wrinkle injections and fillers, if you are treated by someone who is not a member of any professional association you have no-one to go to if you feel that your practitioner is not working within adequate professional standards.

You will only have the law to fall back on and I am sorry to say this is very lax in the area of cosmetic surgery and you will not find much protection unless you can prove an actual assault.

As ever, do your research to maximise your chances of a good outcome.

If you have any questions then contact us on the website or on Facebook where our director does a live Q and A on Facebook every Tuesday at 7 p.m.  Please visit our Facebook page if you would like to put a question directly to Jonathan.

Feel free to leave a comment below, or drop us an e-mail.

If you want to come for a free no obligation consultation with one of our plastic surgeons, please call or email us or fill in the on-line contact form.

In the process of putting together the second edition of my book, Never Accept a Lift from Strangers, it is all about providing information and education so that people can ensure that they are treated by a fully trained practitioner.
I think we have a duty to impart this information, because the law does not protect you when it comes to having surgery from an untrained practitioner, and so the onus is on you to do your research to make sure that your practitioner is fully trained.
I have found that there is not clear information out there for people to tell whether they are being treated by a fully trained practitioner, and so when they read stories about patients who have come to harm and subsequently found out that their so-called plastic surgeon, was not a plastic surgeon at all, I am not surprised that patients themselves are often alarmed and dismayed because they were under the impression that it was a plastic surgeon.

One interesting point is around the term ‘junior doctor’.

The public is familiar with the term junior doctor and I think most people would associate it with a younger doctor or surgeon, but this is not necessarily the case.

The term junior doctor refers to a doctor who is not fully trained.

In the medical world you become a senior doctor when you have finished your training.

This can either be as a GP or as a hospital consultant, and until you have reached that level you are termed a ‘junior doctor’.

Depending on what field you tend to specialise in, it can take a long time to train and so there are ‘junior doctors’ out there well into their thirties, and even forties, and there are a huge number of doctors who never even finish their training and reach the level of an NHS consultant and so if they went to work in the NHS they would always be termed ‘a junior doctor’.

There are a couple of ways to tell whether your practitioner is a senior doctor.

First of all if they hold, or have held, an NHS consultant post, then you can be assured that they have finished their training.

You can also tell by the letters after their name.

Many people are impressed by letters, FRCS stands for a Fellow of the Royal College of Surgeons, but only when you have finished specialist training do you become a senior doctor, and then you will have the letters with a specialty in brackets after the FRCS, for instance, FRCS (PLAST) for a plastic surgeon, FRCS (GEN) for a general surgeon, FRCS (ORTH) for orthopaedic surgery, and so on.

If your surgeon does not have the speciality in brackets or just has ENG (which stands for England) after the FRCS, then they only have a basic FRCS qualification and would be considered a junior doctor if they were to work in the NHS. 

The problem is that when it comes to hierarchy there is a very strict level within the NHS and you have to work through certain posts and pass exams in order to finally achieve the level of consultant.
However, this hierarchy does not exist in the private sector and doctors can leave the NHS training scheme at any point and set up in private practice before they have finished their training.

There is a high profile case with Dr Leah Totton who won The Apprentice a few years ago when she was a junior doctor in training, and subsequently she set up a chain of cosmetic clinics and has not gone back to finish her training and so remains a junior doctor and yet is perceived to be a specialist.

Unfortunately, cosmetic surgery is full of junior doctors who have not finished their training and go into the private sector and hide behind glossy advertising and marketing which covers up their lack of qualifications.

Cosmetic surgery should not be treated any differently to any other surgical procedure, and you must do your research and make sure that your doctor is a fully training surgeon with the appropriate experience and qualifications.

Do not be blinded by a biography that talks about the ‘extensive experience’, or a classy website, or convincing sales person.

Take a look at the qualification and ask whether they hold or have held an NHS consultant post and if so, in what specialty.

If you are talking to a fully trained surgeon they should be happy to talk about their experience, and if you experience resistance or reluctance to answer your questions, then I would worry.

If you are concerned you can check whether your doctor is on a specialist register by looking at the GMC website where you can search for their name or GMC number.

Caveat Emptor “ let the buyer beware. 

Good luck with your search and let me know if you need any information.  You can get a copy of my book here.

Don’t forget that I do a live Q and A on Facebook every Tuesday at 7 p.m.  Please go over to our Facebook page if you would like to put a question directly to me.
Feel free to leave a comment below, or drop us an e-mail.

If you want to come for a free no obligation consultation with one of our plastic surgeons, please call or email us or fill in the on-line contact form.

 The major surgery which we do at the Staiano Clinic, such as breast augmentation, breast reduction, breast lifts, gynaecomastia and tummy tucks have a dramatic effect on your body both physically and mentally and you should allow enough time to recover from them.

Surgery often involves tightening or stretching the skin, so it can feel tense and swollen for some time and you should avoid exerting yourself.
Not only does this run the risk of putting tension on the wound and the possibility of the wound not healing up as well as we would like, but it will also increase the swelling and the swelling can take some time to subside.

If you overdo it in the early stages then it can be a false economy in the long run and you would have been better off giving yourself more time to let things settle to start off with, and although cosmetic surgery has an image of a lunchtime procedure with no downtime, if you are seeking a dramatic change in the shape of your body then you should expect and plan for a period of rest and recuperation.

The First Week

The first week after surgery is always uncomfortable.

Everything feels tight and tender and you will not feel like doing much.

You will be able to potter around the house and look after yourself, but you should plan for little more.

After the first week you will come back to have the dressings removed and you usually do not need any dressings after this time.

However, everything will still be quite fragile and you should continue to take things easy in the second week, although you may be able to work from home for short periods.

Depending on the procedure you have had done and how you are feeling, you should be able to drive after two to three weeks although occasionally you are able to drive after one week.

You should always check with your car insurance company to make sure you are insured and talk to us as we will be able to guide you.

Every individual is different and you should listen to your body, so that if things are uncomfortable or start to swell, then you should ease off and rest.

It is important not to be too immobile and we always encourage you to keep your legs and arms moving, either by walking around or gently exercising while sitting, as well as taking deep breaths to expand up your lungs.

We encourage you to cough if you feel like you have anything on your chest.

After Two Weeks

After two weeks you may be able to resume gentle activities and you may be able to go back to work as long as it is not too strenuous.
If you have had surgery to your upper body, now is the time you can start exercising your lower body on the exercise bike or the stepper at the gym, but you should avoid too much activity with your arms.

Two To Four Weeks

Between two and four weeks you will start to feel better, although the scars will still be quite fragile and the tissues will still be quite swollen.
We normally advise people to wait at least four weeks before starting to massage their scars with cream, as they might be quite red and firm at this stage.

Four To Six Weeks

After around four to six weeks you can start engaging in more strenuous activities including heavy lifting or upper body exercises at the gym.  I would stress that this is the time to start these activities which does not mean that you should go straight in, doing the same level that you were pre-operatively.  It is merely that you can start to gently see how you feel and gradually build up.  If it is uncomfortable or the tissues swell then you should stop and give yourself more time to rest.

Three Months

It takes about three months before the shape and the scars really start to settle and there can be numbness or altered sensation, which can take many months to subside.

Twelve Months

At around twelve to eighteen months, you will be getting an idea of what the final results should be like, but it is not uncommon to still have some degree of settling after this.

We keep a close eye on you in the clinic and encourage you to get in touch if you have any concerns about how you are healing.  We realise that everyone is an individual and this is just guidance.
If you have any questions or concerns then we’d love to hear from you.  You can e-mail us or call us.
Or you can ask our director, Jonathan Staiano, a question LIVE on Facebook at 7 o’clock every Tuesday evening, so feel free to drop in.