Patient guide · Deciding on surgery
Straight answers to the questions people ask us most: what plastic surgery is, how it differs from cosmetic surgery, the NHS, age and BMI limits, safety, costs and what happens at our hospital.
Medically reviewed by Dr Spyridon VlachosSpecialist Plastic Surgeon · FEBOPRAS · GMC 7522950
Last reviewed
Written by the Centre for Surgery clinical team
Key points
Plastic surgery is the surgical specialty that repairs, reshapes and restores the body. The name has nothing to do with plastic the material: it comes from the ancient Greek word plastikos, meaning to mould or give form[1]. It has two parts. Reconstructive surgery restores function and appearance after an injury, illness such as cancer, burns or a condition present from birth. Aesthetic surgery, usually called cosmetic surgery, changes the appearance of a healthy part of the body by choice[2].
This page answers the questions people ask us most, from that starting point to costs, safety and what happens at our hospital. Our hospital at Baker Street is rated Good overall by the CQC, and you can read about our surgeons, their training and their GMC numbers. If you are comparing surgeons, how to choose a plastic surgeon explains what “plastic surgeon” and “cosmetic surgeon” mean as titles, and the checks to make.
Cosmetic surgery is one part of plastic surgery: the part done to change how you look, because you want to, rather than to treat an injury or illness. A breast augmentation, rhinoplasty for appearance, a facelift or a tummy tuck are cosmetic operations. Some operations can be either: a breast reduction can relieve back and neck pain, a rhinoplasty can improve breathing, and skin removal after major weight loss can treat recurrent skin infections. Whether an operation counts as reconstructive or cosmetic matters mostly for who pays for it, which is the next question. Browse all our cosmetic surgery procedures.
Rarely. The NHS says cosmetic surgery is not routinely provided, and that it may be considered only where there is a clear physical or psychological need, for example very uneven breasts or no breast development, a nose that causes breathing problems, or surgery to repair damage after an illness, accident or birth defect[3]. Each case is assessed against local criteria, usually after a GP referral, and waiting lists can be long. Our guides explain the criteria for breast enlargement on the NHS, rhinoplasty on the NHS and skin removal surgery on the NHS. Private cosmetic surgery is self-funded.
Check whether you are likely to be suitable:
Am I likely to be suitable?
Most people are suitable to come for a consultation if they are 18 or over, have a BMI of 30 or less (up to 32 for facial surgery), are in good general health and can stop smoking and vaping for four weeks before and after surgery.
For people who are fit and well, with a properly trained surgeon in a regulated hospital, serious complications are uncommon. As one example, a study of 129,007 cosmetic surgery patients in the Aesthetic Surgery Journal ↗ found major wound infections in 0.46%, with smoking, diabetes, higher BMI and combined operations making them more likely[6]. In our 2025/26 reporting year we carried out 1,623 procedures, all as day cases, with a revision rate of 0.6%: see our clinical outcomes and patient safety figures. Cosmetic surgery risks covers every common complication, and is cosmetic surgery safe? gives the short answer.
The surgeon you see at your consultation is the surgeon who performs your operation, without exception. You are booked with a consultant who performs the procedure you are asking about, at the next available appointment. GMC guidance says the doctor who will carry out a cosmetic procedure must take your consent themselves and must not delegate it[4]. You can check any surgeon on the GMC register, and every surgeon’s profile on our site gives their GMC number.
A consultation costs £100, and the fee is redeemable against your surgery if you go ahead. After your consultation you receive a written treatment plan and an individual quote, which covers your surgeon, anaesthetist, the hospital and your routine follow-up. Compression garments, prescribed medicines and any laboratory tests on tissue removed are bought or charged separately, and confirmed in advance. Where TIVA is used instead of local anaesthetic with sedation, a supplement applies and is shown on your quote.
If you go ahead, a deposit secures your surgery date, and your patient coordinator explains the payment terms. Finance is available, subject to status. Our cosmetic surgery cost guides explain what affects the price of each operation.
Usually not. Private medical insurance generally excludes surgery done to change your appearance, because it is a choice rather than a treatment for illness. Some policies may cover an operation done for a medical reason, so check with your insurer before you plan anything. Read more in private health insurance and cosmetic surgery.
Often, yes, and it can mean one recovery instead of two, as in a mummy makeover or combined facial procedures. But combining operations adds to the risk. A 2015 registry study of 25,478 tummy tucks in Plastic and Reconstructive Surgery ↗ found the major complication rate rose from 3.1% for a tummy tuck alone to 10.4% when it was combined with liposuction and other body contouring[7], and combined operations also carry a higher risk of haematoma[8]. We limit any operation to five hours, and your surgeon may suggest doing some procedures in stages.
We use smooth or micro-textured implants, not macro-textured ones, and our implant warranty runs for ten years, covering grade III and IV capsular contracture and implant rupture. Cosmetic breast implants have not been found to increase the risk of breast cancer: a meta-analysis of seven cohorts found no increased risk in women with implants[9]. BIA-ALCL, a rare lymphoma, has been linked mainly to textured implants; read BIA-ALCL and breast implants. If you notice new swelling, a lump or a change in an implanted breast, book a consultation so a surgeon can assess it. See breast augmentation for more.
It depends on the operation. The changes from a rhinoplasty or ear correction are permanent. A facelift turns the clock back, but your face keeps ageing from its new starting point. Fat cells removed by liposuction do not come back, but the remaining ones can grow if you gain weight. Breast implants are not lifetime devices and may need replacing in future. Some operations can be partly reversed, for example by removing implants, but many cannot, which is one reason to take your time over the decision.
A later pregnancy or a big change in weight can undo some of the result of a tummy tuck, a mummy makeover or breast surgery, so it is usually wiser to wait until you have finished having children and your weight is stable. We operate on the breasts at least six months after a birth, and at least three months after you have completely stopped breastfeeding.
Results take time: swelling settles over months, so the final result is judged at around six to twelve months. If you are unhappy, talk to your surgeon at your review. They will examine you, explain whether anything can be improved and, if a revision is appropriate, what it would involve. Read what happens if you are not happy with your results and what to expect from revision surgery.
Wherever you have surgery, the same checks apply: a properly trained surgeon, a regulated hospital, a proper consultation and aftercare you can reach. Problems after surgery abroad are a growing concern in the NHS: a 2026 review in BMJ Open ↗ found reports of 655 patients treated in NHS hospitals for complications of surgery abroad, 265 of them after cosmetic surgery, most often after operations in Turkey, with infection and wound breakdown the commonest problems[10]. Read about the risks of cosmetic surgery abroad.
You do not need a GP referral: you can book a consultation directly. A video consultation is a good first step if you live further away, but a face-to-face consultation with an examination is always needed before surgery. Consultations take 30 to 45 minutes with the surgeon, and after it we recommend taking at least two weeks to think before you confirm a surgery date: the two-week cooling-off period. See your cosmetic surgery consultation and travelling to us for surgery.
Our hospital is at 95–97 Baker Street, London W1U 6RN. Baker Street station (Bakerloo, Circle, Hammersmith & City, Jubilee and Metropolitan lines) is a three-minute walk, and Marylebone station about ten minutes. Street parking is limited to pay-and-display bays; the nearest car park is NCP London Marylebone (NW1 5AR), about four minutes’ walk. The hospital has step-free access from the street, a lift to all clinical floors and a disabled WC. We are open 9am to 6pm, Monday to Saturday.
Almost all operations are day cases, so you go home the same day with a responsible adult, who stays with you for 24 hours. If you would like to stay nearby, we have arrangements with several hotels near Baker Street, and overnight nursing can be arranged in advance at an extra charge. See our hospital at 95–97 Baker Street and directions and parking.
Please tell us first: most concerns can be put right quickly, and our complaints policy explains how we handle them. If you are not satisfied, you can give feedback to the Care Quality Commission, raise a concern about a doctor with the General Medical Council, take independent legal advice, or get free advice from Citizens Advice.
There is no such thing as a silly question about surgery. The patients who do well are the ones who ask everything, understand exactly what they are signing up for, and take their time to decide.
Dr Spyridon Vlachos, Specialist Plastic Surgeon and medical reviewer
Guidance comes from the official sources listed.
No question matches that. Try another word, or ask a patient coordinator.
From the ancient Greek word plastikos, meaning to mould or give form. It describes reshaping the body, not the material plastic.
No. The name refers to reshaping. Some operations use medical implants, such as silicone breast implants, but most plastic surgery reshapes your own tissue.
Usually, yes, when it is done to change the shape of the tummy. It can occasionally be considered reconstructive, for example after major weight loss with skin problems, but the NHS rarely funds it. See can I get a tummy tuck on the NHS?.
Only on the NHS, where it is rarely available and only for a clear medical or psychological need assessed against local criteria, usually after a GP referral. Be wary of offers of free or heavily discounted surgery in return for social media posts.
Not during the operation: you are asleep under TIVA or numbed with local anaesthetic. Afterwards most people describe discomfort and tightness rather than severe pain. Combining TIVA with local anaesthetic has, in our pain audits, minimised and often removed the need for strong opioid painkillers. Read about anaesthesia for cosmetic surgery.
At our hospital, 18 or over. There is no fixed upper age limit: your health matters more than your age. See the age limit for cosmetic surgery.
For most operations, 30 or less, and up to 32 for facial surgery, with your weight stable. See BMI limits by procedure.
No. You can book a consultation directly. We may ask your GP for a summary of your medical history before surgery.
A consultation costs £100, and the fee is redeemable against your surgery if you go ahead.
Yes, once you decide to go ahead, a deposit secures your surgery date, and your patient coordinator explains the payment terms. You will never be asked to book surgery at your consultation.
Finance is available, subject to status. Your patient coordinator can explain the options.
Your surgeon, anaesthetist, the hospital and your routine follow-up. Compression garments, prescribed medicines and any laboratory tests on tissue removed are bought or charged separately and confirmed in advance.
Many changes are long-lasting or permanent, but your body keeps ageing, and weight change or pregnancy can alter the result. Breast implants are not lifetime devices and may need replacing in future.
Some operations can be partly reversed, for example by removing breast implants, but most cannot be undone. That is why we recommend taking at least two weeks after your consultation to decide.
Yes, a tummy tuck does not affect your ability to have children, but a pregnancy can stretch the muscles and skin again and undo some of the result. It is usually wiser to wait until your family is complete.
Any operation that cuts the skin leaves a scar, but surgeons place them where they are easiest to hide, and most fade over 12 to 18 months. Protect them from the sun for at least a year. See scar management after surgery.
Of the common operations, a tummy tuck, mummy makeover or Brazilian butt lift usually take longest: at least two weeks off a desk job and around eight weeks or more before the gym. See recovery after cosmetic surgery.
There is nothing you should hide. Be open about your health, medicines, smoking and what you hope surgery will change, so your surgeon can plan safely. See your cosmetic surgery consultation.
What happens at a consultation, how long it takes and the questions worth asking.
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Every step from enquiry to aftercare, and how long each one takes.
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Patient Library
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