Your Cosmetic Surgery Consultation

What happens at a plastic surgery consultation?

A plastic surgery consultation is where you and a surgeon work out whether an operation can give you the change you want, which operation, and what it would involve for you. It is a medical appointment, not a sales meeting: you leave with information, not a commitment. Before you come, it is worth checking your surgeon’s qualifications and going through our pre-consultation checklist.

At our hospital on Baker Street, a typical consultation runs like this:

1. Arrival. Our front-of-house team checks you in, confirms your details and measures your height and weight. Clinics occasionally run a little late, because some patients need more time.
2. Your patient coordinator. They collect you, confirm what you have come about and stay with you to help afterwards.
3. Your history. The surgeon asks about your health, medicines and supplements, allergies, previous operations, smoking and what you would like to change and why.
4. Examination. The surgeon examines the area, takes measurements and, with your consent, photographs for your medical record. A chaperone is available on request.
5. Options and realistic results. The surgeon explains what is possible, what is not, the techniques that suit you and where the scars would be. For breast surgery this includes sizing with sizers or sample implants. You will see before and after photos of the surgeon’s own patients with a similar starting point.
6. Risks and recovery. The common and serious risks for your operation, how much time off you would need and when you could drive, exercise and lift.
7. Your questions. As many as you have. There are no silly ones.

1:39

Video: Mr Metin Nizamoglu on having realistic expectations for plastic surgery (1 minute 39 seconds)

How long is a consultation with a plastic surgeon?

Most first consultations take 30 to 45 minutes with the surgeon, plus a little time with your coordinator before and after. Revision consultations, about surgery done elsewhere, take longer because the surgeon reviews your previous operation notes. A revision consultation costs £250, and unlike the £100 consultation fee it isn’t redeemable against surgery. We hold consultations six days a week, including Saturdays.

Who will I see at my consultation?

You see the surgeon who would perform your operation, supported by your patient coordinator. This matters: GMC guidance says the doctor carrying out a cosmetic procedure must discuss it with you and seek your consent themselves, and must not delegate that responsibility^[1]. The Royal College of Surgeons and BAAPS give patients the same advice: talk to the surgeon who will perform your procedure before you agree to it^[2][3].

You are booked with a consultant who performs the procedure you are asking about, at the next available appointment, and that consultant is the surgeon who operates if you go ahead. Some providers book patients with an adviser and introduce the surgeon only on the day of surgery; we do not.

How much is a plastic surgery consultation, and why is it not free?

A consultation at Centre for Surgery costs £100, and the fee is redeemable against your surgery if you go ahead. A follow-up consultation about the same procedure, if you want to talk it through again before deciding, is included.

We do not offer free consultations because a proper consultation is a medical assessment with a consultant, not a sales conversation. Patient groups and surgical associations warn that free consultations are often used to put people under pressure to book or pay a deposit on the day^[3]. A fee keeps the appointment about whether surgery is right for you.

Virtual or face-to-face consultation?

If you live outside London, a video consultation is a good first step: the surgeon can discuss your goals, give a preliminary view of your suitability and answer most questions. It cannot replace an examination, so a face-to-face consultation at Baker Street is always needed before surgery. If you are coming from further away, our guide to travelling to us for surgery explains how the consultation and your pre-operative appointment can usually be combined into one visit.

Questions to ask your plastic surgeon

Write your questions down before you come. People forget a great deal of what they are told in medical appointments: a review in the Journal of the Royal Society of Medicine found that 40–80% of medical information is forgotten almost immediately, and that almost half of what people do remember is wrong^[4]. Taking a written list helps: in a review of 16 studies, giving patients a list of questions before an appointment increased the questions they asked and how much they recalled afterwards^[5]. Bringing a friend or partner gives you a second pair of ears.

Tick the questions you want to ask, then print the list or copy it into your phone. Your ticks are saved on this device.

Some operations have questions of their own. Choose yours below to see them, then read the treatment page for more detail.

How your surgeon checks surgery is right for you

Part of the consultation is the surgeon checking that surgery is safe and sensible for you, which is a professional duty: GMC guidance says doctors must consider a patient’s vulnerabilities and psychological needs, and satisfy themselves that the request is voluntary^[1]. Expect questions about:

• Your general health and medicines, including the pill, HRT, blood thinners and herbal supplements.
• Your weight. Complications rise with BMI, and many operations have a BMI limit: see BMI limits for cosmetic surgery.
• Smoking and vaping. Smokers have higher rates of wound breakdown, infection and tissue loss, so we ask you to stop all nicotine four weeks before surgery and four weeks after^[6].
• How you feel about your appearance. A 2022 meta-analysis in the Journal of Plastic, Reconstructive and Aesthetic Surgery found that around one in five people requesting cosmetic surgery screened positive for body dysmorphic disorder, a condition in which surgery rarely helps^[7]. Your surgeon asks about this gently and routinely; read more about body dysmorphic disorder and cosmetic surgery.
• Timing, including work, childcare, holidays, pregnancy plans and breastfeeding.

Be open about all of it. Leaving out smoking, a medicine or a previous operation does not change your risk; it only stops your surgeon planning for it.

What happens after your consultation?

Your patient coordinator sends you a written treatment plan and an individual quote, usually by the next working day. A quote covers the surgeon, anaesthetist, hospital and your routine follow-up; compression garments and prescribed medicines are bought separately and confirmed in advance. See what a cosmetic surgery quote includes.

We then recommend taking at least two weeks to think before you confirm a surgery date. This two-week cooling-off period is the standard recommended by the Royal College of Surgeons, BAAPS and the NHS, rather than a legal rule, and we recommend it to every patient^[8][9]. Use it to reread your plan, talk it over, and come back with more questions if you need to. If you go ahead, a deposit secures your date and your coordinator explains the payment terms; finance is available, subject to status. The rest of the process is set out step by step in the cosmetic surgery patient journey.

Red flags at a cosmetic surgery consultation

The Keogh review of cosmetic interventions recommended prohibiting time-limited deals and financial inducements, and the Royal College of Surgeons’ standards tell surgeons not to use them^[10][8]. If the provider is overseas, read about the risks of cosmetic surgery abroad too.

I would much rather a patient brought a list of twenty questions than went home with one unanswered. The consultation is the point where we decide together whether surgery is right, and it only works if you tell me everything and ask everything.

Dr Spyridon Vlachos, Specialist Plastic Surgeon and medical reviewer

References

Regulatory guidance comes from the official sources listed.

1. General Medical Council. Guidance for doctors who offer cosmetic interventions: communication, partnership and teamwork. In effect from 1 June 2016.
2. Royal College of Surgeons of England. Your consultation with the surgeon.
3. BAAPS. Consumer safety guidelines.
4. Kessels RPC. Patients’ memory for medical information. J R Soc Med. 2003;96(5):219–222. doi:10.1177/014107680309600504
5. Brandes K, Linn AJ, Butow PN, et al. The characteristics and effectiveness of Question Prompt List interventions in oncology: a systematic review of the literature. Psychooncology. 2015;24(3):245–252. doi:10.1002/pon.3637
6. 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
7. Salari N, Kazeminia M, Heydari M, et al. Body dysmorphic disorder in individuals requesting cosmetic surgery: a systematic review and meta-analysis. J Plast Reconstr Aesthet Surg. 2022;75(7):2325–2336. doi:10.1016/j.bjps.2022.04.098
8. Royal College of Surgeons of England. Professional Standards for Cosmetic Surgery. April 2016.
9. NHS. Before you have a cosmetic procedure. Last reviewed 22 May 2023.
10. Department of Health. Review of the Regulation of Cosmetic Interventions: final report (the Keogh review). April 2013.