More than skin deep

By at home

A round-up of some of the most popular cosmetic surgery procedures, plus readers’ real life experiences.

With cosmetic surgery becoming increasingly acceptable, accessible and affordable, more and more people are using it to help them look and feel great. And, with so many celebs now happy to talk about their lifts and tucks, the notion of cosmetic surgery is fast losing its taboo.

And why not? We think nothing of spending hundreds of pounds each year on hair, make-up and clothes, so why shouldn’t we invest in a little nip and tuck? Recent studies have shown that nearly half of British women and a quarter of men would now consider plastic surgery – and many would encourage their partners to take the plunge.

Three out of four people surveyed felt looking good would help their careers while 56% said they’d love to look ten years younger. For some people, cosmetic surgery can mean far more than an aesthetic tweak. Confidence and self-esteem are so tightly bound up with appearance that a physical improvement can really change your life…

Real life
‘At 19, I still had a chest like a boy’s. There was no breast tissue…’

Metropolitan Police communications officer, Celeast Crown, 27, had breast implants to take her from a 32A to
a 32DD. She was so impressed with how great they looked and how confident she felt, that three years later she had rhinoplasty to fix her nose, which she’d broken as a child.

Even a 32A was too big ‘My boobs never really developed.

I used to wear a 32A bra but needed three Wonderbra pads just to fill it. I’d wanted a boob job since I was 16 but my mum was against it. By the time I was 19, I still had a chest like a boy’s – there was no breast tissue or fat at all, so finally, my mum understood. I went to see my GP but in my area they don’t do augmentations on the NHS. I’d always thought plastic surgery done privately was just for celebs, but I applied for a loan and when it was accepted I wanted the surgery straight away. I was looking through Cosmopolitan magazine when I came across Rubicon Medical. I’d also seen them on GMTV, so I rang them and spoke to a woman called Janet who was so friendly that I felt I could talk to her about anything.

The big day
‘On the day of the op, I went into Highgate Private Hospital at 7am, they operated at 1.30pm and I was out by 11am the next day. When I came round from the anaesthetic I wasn’t in pain; I just felt bruised.

‘Afterwards I felt really top heavy, which was something I’ve had to get used to. I came out on the Wednesday and was back at work on the Monday. In fact, I went out shopping on the Friday. It probably took a month for me to be totally back to normal.

‘The operation changed my life, and the boost to my confidence was enormous. I don’t have to wear all those pads in my bra any more. I’m now a 32DD, which sounds huge but doesn’t actually look that big – my new boobs totally fit my frame.’

‘His insult shook my confidence’
‘I’d broken my nose as a child and, as well as being crooked, my sinuses meant I had breathing difficulties. I’d been on an NHS waiting list for 18 months, with little hope of an op coming up any time soon, when I had a horrible incident at a club. A guy said he thought I was really attractive, but his friend looked at me and said, “No, she’s not. She’s got a big nose.”

‘I was so upset. I’d been aware of my nose but wasn’t self-conscious enough to feel that I had to rush into surgery. But the incident upset me so much that I called up Janet at Rubicon the next morning. Once again, she was just so understanding.

‘The surgery was quite invasive as my nose had to be totally broken and rebuilt from scratch. It wasn’t painful but they put plugs up my nostrils so it was difficult to sleep. I was off work for two weeks, I had a cast on for a week and it was quite painful when they took the plugs out. After rhinoplasty your nose is actually swollen for about a year. At first it was very numb but I slowly got the feeling back, and now only the tip is a bit numb.

‘The boob and nose jobs both changed my life completely. I’d been bullied at school and have always had really low self-esteem, but not anymore. I’d always thought I was ugly but now I’m quite happy. I feel content with what I’ve had done.’

Nose jobs
What is it? One of the most common procedures performed, the nose job or rhinoplasty, to use its technical term, is also one of the most difficult, as the surgeon conducts it mainly by feel. It may be performed in order to increase the patient’s ability to breathe, to improve the appearance of the nose by reducing or reshaping it and/or to straighten an injured nose.

What’s involved? The changes made include:
Tip of the nose: corrected by adding or excising cartilage at the tip and stitching the cartilage together. A low tip of the nose can be raised by adding cartilage to support the tip, removing excess cartilage in the septum, or repositioning the cartilage.
Dorsal bone: the hump of the bridge can be corrected by removing (with a chisel or rasp) excess cartilage and bone, then bringing the nasal bones together.
Wide bony portion of nose: corrected by breaking the bones of the nose and repositioning them inwards.
Wide base of the nose: corrected by removing tissue at the base of the nose and the nostrils moved closer together.
Nostrils too wide: corrected by removing small wedges of skin from their base and then bringing them closer together.
Angle between nose and lip: corrected by trimming the septum.

Risks? Removing too much cartilage or bone from the nose can create an unnatural look and isn’t advisable
as it may interfere with breathing. Swelling and a minor risk of infection are also possible.

Neck lifts
What is it?
Ideal for people with a softening jawline, prominent jowls or wattles (fleshy bits on the neck). A neck lift resculpts these areas and gives definition. Lasting around two hours, the op is performed under general anaesthetic.

What’s involved? The surgeon makes cuts behind or under the ear and excess fat, muscle and skin are removed.

Risks? The neck may look corded, skin can appear mottled or lumpy and may become loose.

Eyelid surgery
What is it?
Hooded eyelids and bags under the eyes can both be successfully removed. Upper eyelid surgery requires only a local anaesthetic, but lower eyelid surgery is performed under general anaesthetic. Both operations take about an hour.

What’s involved? Eyelid surgery involves one of two ops:

Upper: a cut is made along the crease and excess skin, fat and muscle is removed.

Lower: a cut is made below the lashes or inside the lower lid and fat from the eyebag is removed.

Risks? There is a slight risk of blindness caused by bleeding behind the eye, temporary blurred vision, uneven eyes, lower eyelid sagging and dry eyes.

What is it?
As we age, the skin on the face can start to sag. A facelift eliminates excess fat, tightens muscles and removes sagging skin. The operation can take up to six hours and is carried out under general anaesthetic.

What’s involved? There are many different procedures but essentially, cuts are made along the hairline, enabling excess fat to be removed. The skin is then pulled tighter over your face. Scars are usually hidden by your hair, but after a few months, they will start to fade naturally anyway. Endoscopic techniques, which require smaller cuts, can leave less obvious scarring.

Risks? Paralysis of facial muscles, hair loss, scarring, and facial features – particularly the eyes – may look lopsided.

Tummy Tucks
What is it? After pregnancy or significant weight loss, an apron of excess skin is often left around the tummy area.

A tummy tuck tightens the abdominal wall muscle and removes excess fat and skin. The operation can take up to five hours and is performed under general anaesthetic.

What’s involved? There are two main types of tummy tuck:

Partial: a large cut is made across the base of the belly area. The skin and the abdominal wall are separated and excess fat and extra skin are removed. The flap of skin is then pulled down and sewn back.

Full: More fat and skin are removed than in a partial operation. Incisions are carefully made around the belly button
so it remains in position while the fat and skin is trimmed around it. The skin is then replaced and a new hole cut
for the belly button.

Risks? Numbness and some skin puckering around the scar may occur.

Boob Jobs
What is it?
An operation to increase or reduce the size of breasts, or in some cases to uplift them, boob jobs are one of the most popular forms of cosmetic surgery. Depending on what’s being done, operations can take between one and four hours under
general anaesthetic.

What’s involved? The most common breast operations are:

Enlargement: the surgeon makes a small cut in the armpit, below
the breast or around the areola, creating a pocket in which to insert an implant. A bag, filled with either silicone gel or saline, is inserted into the space to boost breast size.

Reduction: the surgeon cuts around the areola, down the breast and along the crease, and excess tissue, fat and skin is removed.
The nipple and areola are then repositioned and the skin is sewn back into place.

Lift: the surgeon makes an incision in one of three common patterns depending on the shape
of your breast, and lifts and reshapes the underlying breast tissue to improve breast contour and firmness, before repositioning the nipple and areola.

Risks? Hardening or splitting of the breast implant, causing discomfort and pain and unnatural looking breasts; deflation, infection, blood loss, loss of sensation and in some cases, the inability to breastfeed.

Some people have stubborn areas of fat – often on the abdomen, hips and thighs – which don’t respond to diet or exercise. Liposuction can effectively remove them. The operation can take up to five hours, depending on the area being targeted, and is performed under general anaesthetic.

How? Body fat is broken down and sucked out through small cuts in the skin by using a small stainless steel tube (a cannula) or fine catheter attached to a strong vacuum pump.

Risks? Numbness, uneven skin, internal or external burning.

Hair transplant
What is it? Male pattern baldness is thought to affect 90% of men over the age of 50, but hair transplant surgery can provide a permanent solution.

What’s involved? Hairfrom the areas of the head that are not prone to balding are transplanted into the thinning areas. The surgeon carefully grafts them into position at
a specific angle to emulate natural hair growth.

Risks? Some numbness and scarring can occur, and there is always the risk that some grafts won’t take.

Pec implants
Some men can work out extensively yet their pectoral muscles will fail to develop. Solid silicone implants can enlarge the appearance of chest muscles.

How? A small incision is made under the armpit and an endoscope is used to create a cavity under the pectoralis muscle. The muscle is not separated from its attachments to the rib cage or breastbone (as it is in female implants), and surgery is done under general anesthetic.

Risks? Displacement of implants, infection, numbness of the inner upper arm.

Six-pack sculpting
What is it?
Washboard abs that can usually only be achieved through gruelling workouts.

What’s involved? Abdominal etching is a kind of precision liposuction, where the surgeon
sucks out the fat that’s standing between the patient and the patient’s six-pack. However, a certain amount of body fat is necessary if the surgery is to be successful. Too little or too much and you’re not going to get the necessary definition.

Risks? Unnatural looking lines or scars, around the abdomen area and a build-up of fluid.

Real Life
‘Surgery was never about vanity; it was about resolving a complex’
Adil Rajput, a 36-year-old civil servant from Stockton on Tees had extensive facial sculpting and a neck lift last year.

‘I had surgery a year ago last March but I’d wanted to do it for a long time. It’s not the kind of thing you jump into. I do everything I can to keep in shape but there was nothing the gym could do for my face.

‘In the end, I had a neck lift, jaw implants, chin implants, liposuction to the face, fat taken off my tummy and put into my forehead, and the crease between my bottom lip and chin removed. The whole thing took six hours and two surgeons – Mr Ion and Mr Thuao from Aesthetic Plastic Surgery. One was in charge of soft tissue and one in charge of implants, and they’ve both supported me all the way through.

Pre- and post-surgery
‘When I first went to see Mr Ion, he helped me by using 3-D imaging to predict what the outcomes of various surgeries would be. And the post-operative support has been great. I still go to see them to check in with how I’m progressing. That’s been so important to me.

Sign of the times
‘I never wanted to look younger. I had a very weak jaw line and a weak chin and I wanted some structure to my face to give me confidence. We’re not living in the dark ages any more and these days if something affects your self-esteem, you can do something about it. I’m from the North East and a few years ago I’d have been laughed at for having this kind of surgery. But I’ve had a really positive response from everyone, and I think I’ve been quite inspirational to other men in my situation. It just shows how much times have moved on.

‘My wife was really supportive, too, and a few days after my surgery she came to London to have laser therapy for acne scarring so now we look like Barbie and Ken! My parents told me I didn’t need surgery but they don’t disagree with it, and my sister, Sarah, has been behind me all the way.

‘The surgery was pretty intensive because I had it all done at once. When I came out of the theatre, I looked like I’d done ten rounds with Mike Tyson! My face was swollen to four or five times its natural size, and I was like a monster. After a few days in hospital I checked into a hotel, and I think my face quite scared the staff.

‘But that’s all in the past. I have a new outlook on life. My hairdresser asked me to take part in a fashion show recently, which was brilliant.

I’d never have done that before. I’m still the chap who sat at the back of the class, but now I feel as good as anyone else. It was never about vanity; it was about resolving a complex and Mr Ion has helped me do that.’

Planning facial sculpting
An emerging area of plastic surgery, facial sculpting is primarily a matter of balancing or redesigning facial features to reflect how a patient would like
to look. Dr Lucian Ion from Aesthetic Plastic Surgery, has been developing a system of 3D photography and simulation to help his patients envisage how they want to look, so that they have realistic expectations of the outcome of procedures and to make certain that both patient and surgeon share the same vision.

Procedures such as liposuction, implants and reshaping of features can then be conducted with greater predictability of results.

3D imaging allows the surgeon to avoid misperception on both sides, and to create a chance for reflection and shape experiment before proceeding. Visit

useful contacts
Aesthetic Plastic Surgery Tel: 020 7486 7757,
BAAPS (The British Association of Aesthetic Plastic Surgeons) Tel: 020 7405 2234,
Bristol Plastic Surgery Tel: 0117 910 2400,
mybreast Tel: 0870 780 4000,
Plastic Surgery Associates Tel: 01603 250 368,
Rubicon Medical Tel: 020 7436 7117,
Transform Tel: 0800 655 6406,

Words: Charlotte Maugham | photographs: istock, getty, shutterstock


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