Cosmetic Surgery Patient Journey

The cosmetic surgery process at a glance

Cosmetic surgery is planned in stages, and each one has a purpose: to check the operation is right for you, to give you time to decide, and to get you ready so the day itself goes smoothly. Knowing what is coming helps. In a randomised trial of 450 day-surgery patients in the World Journal of Surgery ↗, clear information before surgery, tailored to what patients wanted to know, reduced anxiety and raised satisfaction^[1]. Here is the whole journey at our hospital on Baker Street, from your first call to your final follow-up, whichever of our cosmetic surgery procedures you are considering.

1. Enquiry Call 020 7993 4849 or send the form. A patient coordinator answers your questions and books your consultation.
2. Consultation Face-to-face with the surgeon who would perform your operation.
3. Treatment plan and quote In writing, usually by the next working day.
4. Cooling-off We recommend at least two weeks to decide before you confirm a surgery date.
5. Getting ready Pre-operative checks, stopping smoking and some medicines, and arranging your support at home.
6. Surgery day Most operations are day cases under TIVA or local anaesthetic with sedation.
7. Going home With a responsible adult, written instructions and your follow-up booked.
8. Aftercare Nurse checks, a review with your surgeon, and support until your final result.

From first enquiry to surgery usually takes four to eight weeks. It can take longer for complex or revision surgery, or if you need to stop smoking or reach a target weight first. If you are still deciding whether surgery is right for you, our cosmetic surgery FAQs answer the common first questions.

Step 1: Your enquiry

Call us on 020 7993 4849 or send the enquiry form. A patient coordinator talks through what you are hoping for, your general health, your timing and whether you smoke or vape, so that any obvious barriers to surgery come up before you pay for a consultation. Sometimes the right answer is to do something first, such as stopping smoking or losing weight, and occasionally it is that surgery is not the answer. If you live outside London you can start with a video consultation; our guide to travelling to us for surgery explains how to keep the number of trips down.

Step 2: Your consultation

You see the surgeon who would perform your operation; you are never passed to another surgeon. They take your medical history, examine you (a chaperone is available on request), explain the options and risks, and show you realistic results, including before and after photos of their own patients. For breast augmentation, sizing with sizers or sample implants is part of this appointment. A consultation costs £100, redeemable against your surgery. What happens at your consultation explains it in detail, and our pre-consultation checklist helps you prepare.

Step 3: Your treatment plan and quote

After your consultation your patient coordinator sends you a written treatment plan and an individual quote, usually by the next working day. Read it carefully: GMC guidance expects you to have the time and information you need to make a voluntary, informed decision, and to be told you can change your mind at any point^[2]. Compression garments and prescribed medicines are bought separately and confirmed in advance. Finance is available, subject to status.

Step 4: The two-week cooling-off period

We recommend taking at least two weeks to think before you confirm a surgery date. The Royal College of Surgeons’ professional standards describe consent as a two-stage process with a cooling-off period of at least two weeks between the stages, and the NHS advises that you should be offered one after any consultation^[3][4]. It is best practice rather than a legal rule, and we recommend it to every patient. Use it to reread your plan, talk it over and, if you want, come back for another consultation. Read more about the two-week cooling-off period.

How long after a consultation is surgery?

Usually at least two weeks, because we recommend a two-week cooling-off period. Once you decide to go ahead, most operations take place three to eight weeks after booking, depending on theatre availability and on any preparation you need. Work backwards from a date in mind: you will need to have stopped smoking for four weeks before surgery, and to have time off work and support at home afterwards. Our guide to choosing your surgery date includes a planner that turns your preferred date into a dated checklist.

Step 5: Getting ready for surgery

Once you book, a deposit secures your date and our clinical support team takes over the preparation. They arrange your pre-operative assessment, which may include blood tests or an ECG if your doctor requests them, and with your permission ask your GP for a summary of your medical history; we request this for everyone having TIVA or sedation.

• Stop smoking and all nicotine four weeks before surgery, and stay stopped for four weeks afterwards. Smokers have significantly more wound breakdown, infection and tissue loss after surgery^[5]. Read more about stopping smoking before surgery.
• Stop aspirin two weeks before surgery, unless it is prescribed for your heart or after a stroke: never stop a prescribed medicine without checking with your GP or surgeon.
• Arrange your responsible adult, someone over 18 who will take you home by car or taxi and stay with you for 24 hours. We cannot discharge you without one.
• Get your home ready, with food in, comfortable front-fastening clothes and pillows to keep you propped up.

The full list, including fasting, is in preparing for cosmetic surgery. If you feel unwell in the days before, tell us: here is what happens if you are unwell before surgery.

Step 6: What happens on the day of surgery

Arrive at your admission time with your escort, who drops you off so our nurses can brief them. Your escort cannot wait in the hospital, but should keep their phone on and stay within 20 to 30 minutes of Baker Street; the recovery nurse calls them when you are nearly ready to go home.

1. Admission. A nurse confirms your details and your escort’s, gives you a gown and checks your blood pressure, pulse and oxygen levels.
2. Your anaesthetist. They go through your health and the anaesthetic with you, and may give you a tablet beforehand to reduce sickness and pain and help you relax^[6].
3. Your surgeon. They confirm the plan with you, mark the surgical areas and take photographs.
4. Theatre. A theatre nurse walks you in. The team checks your name, date of birth, allergies and operation, places a small cannula, usually in the back of your hand, and attaches monitors.
5. Your operation. Under TIVA or local anaesthetic with sedation, depending on the procedure.

TIVA, total intravenous anaesthesia, is given through a drip rather than as a gas. In a 2024 meta-analysis of 317 trials in eClinicalMedicine ↗, it reduced sickness after surgery by around 40% compared with gas anaesthesia, with similar overall safety^[7]. Most operations are day-case surgery, so you go home the same day.

Step 7: Recovery and going home

You wake in our recovery area with sterile dressings in place, looked after by recovery nurses. You can go home once you are drinking, your pain is controlled, any sickness has settled and you have passed urine. Before you leave, the nurse goes through your written instructions with you and your escort, gives you the surgeon’s emergency number and the out-of-hours contacts, and books your first nurse review. We send a discharge summary to your GP unless you ask us not to. Your responsible adult takes you home by car or taxi, not public transport, and stays with you for 24 hours.

Step 8: Aftercare and follow-up

Depending on your operation, you may be seen the next day; this applies to procedures such as rhinoplasty, facelift, breast augmentation and tummy tuck. Our nurses then see you regularly, with your first dressing check usually five to seven days after surgery, and you have a review with your surgeon at around six weeks. If a nurse has any concern, your surgeon is contacted directly, and there is no charge for being seen again. How long recovery takes depends on the operation: see recovery time by procedure and our full guide to recovery after cosmetic surgery.

Coming from outside London

Many of our patients travel to Baker Street. You can usually combine your consultation and pre-operative appointment into one visit, we have partner hotels nearby, and overnight nursing can be arranged if you are staying locally, at an extra charge. Same-day travel home is usually fine, but your surgeon advises case by case. Our guide to travelling to London for surgery covers the details. Our hospital is rated Good overall by the CQC^[8].

Patients often tell us the waiting is the hardest part. Knowing exactly what happens at each step, and who you will see, takes most of the worry out of it.

Dr Spyridon Vlachos, Specialist Plastic Surgeon and medical reviewer

References

Guidance comes from the official sources listed.

1. Wongkietkachorn A, Wongkietkachorn N, Rhunsiri P. Preoperative needs-based education to reduce anxiety, increase satisfaction, and decrease time spent in day surgery: a randomized controlled trial. World J Surg. 2018;42(3):666–674. doi:10.1007/s00268-017-4207-0 ↗
2. General Medical Council. Guidance for doctors who offer cosmetic interventions: communication, partnership and teamwork ↗. In effect from 1 June 2016.
3. Royal College of Surgeons of England. Professional Standards for Cosmetic Surgery ↗. April 2016.
4. NHS. Before you have a cosmetic procedure ↗. Last reviewed 22 May 2023.
5. Sørensen LT. Wound healing and infection in surgery: the clinical impact of smoking and smoking cessation: a systematic review and meta-analysis. Arch Surg. 2012;147(4):373–383. doi:10.1001/archsurg.2012.5 ↗
6. Royal College of Anaesthetists. You and your anaesthetic ↗. 7th edition, 2026.
7. Kampman JM, Hermanides J, Hollmann MW, et al. Mortality and morbidity after total intravenous anaesthesia versus inhalational anaesthesia: a systematic review and meta-analysis. EClinicalMedicine. 2024;72:102636. doi:10.1016/j.eclinm.2024.102636 ↗
8. Care Quality Commission. Centre for Surgery, Baker Street: inspection report ↗. Published 16 May 2023.