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What you need to think about before you choose to go under the knife

Cosmetic surgery might be more common than ever - but these are the things you have to know before taking the plunge. By Lisa Salmon

Major industry: more than 28,000 cosmetic ops took place in 2017
Major industry: more than 28,000 cosmetic ops took place in 2017

Getting 'a bit of work done' isn't quite the taboo it used to be, and thousands of cosmetic surgery procedures are carried out in the UK each year. According to BAAPS, the British Association of Aesthetic Plastic Surgeons, more than 28,000 such surgeries took place in 2017 alone.

Going under the knife is a big step though - and weighing up the likely results, plus whether your bank balance can take the hit, aren't the only considerations.

All surgery carries a degree of risk, and before having an operation to reduce or increase your breast size, make your nose or tummy smaller, or any other procedure, it's important to be fully aware of these, and consider whether any individual lifestyle factors and pre-existing health conditions may affect the level of risk involved.

"Cosmetic surgery is a growing industry, but organising it isn't as simple as just calling up and booking yourself in," says Professor Marcos Sforza, an aesthetic surgeon at MyAesthetics (myaesthetics.uk).

"In some cases, you're making the decision to have the equivalent of a major operation, which means thorough research is required."

That research includes finding a good surgeon. The most reputable cosmetic surgeons are members of the representative bodies for maintaining excellent industry standards, such as the General Medical Council (GMC), ISAPS, BAAPS or BAPRAS.

And be aware that GMC guidelines stress all industry professionals must give patients time for deliberation, the necessary information about all risks and adequate time to reflect if surgery is really for them. It's a big step though - so don't ever feel pressured into making a decision.

Here, Sforza outlines five key health considerations for anybody thinking about pursuing cosmetic surgery.

1. Being a healthy weight

"Bear in mind that excess weight could put the body under more strain and at risk of certain side effects and complications from surgery," says Sforza.

Being overweight also increases the likelihood of sleep apnoea, where people stop breathing repeatedly during sleep.

This can complicate the administration of general anaesthesia, and anyone prone to it should tell their surgeon.

Cosmetic surgery results are generally best if your body mass index (BMI) is under 30, and Sforza advises: "If you're told by your doctor that your weight might impact the results of your surgery, think about losing weight under a doctor's supervision. Improving your health before surgery will make it as safe as possible, minimise chances of complications and quicken your recovery."

2. Allergies

It's imperative to inform your surgeon of any known allergies, because some dressings contain ingredients you may be sensitive to, such as acrylates, silicones, rubber and latex.

And it doesn't have to be a major allergic reaction to be worth mentioning - telling medical staff about any minor past reactions, such as irritations caused by silver or nickel in jewellery, bra clips or watch straps, can be useful, as it will help your surgeon build an accurate picture of how your body may respond to potential allergens.

"Most allergic reactions aren't serious but can be uncomfortable," notes Sforza, who says that sometimes extra treatment, such as topical corticosteroids or antihistamines, may be required.

3. Cigarettes and alcohol

Smokers will need to quit before surgery, and for a some time afterwards. Nicotine causes blood vessels to compress - and smaller blood vessels can reduce blood supply to organs and tissues, slowing wound healing.

Also, smokers can be at higher risk of complications, says Sforza.

Patients are advised to stop smoking completely for six weeks before and six weeks after surgery.

In addition, cutting out alcohol one to two weeks before surgery is generally recommended, because of possible interactions with anaesthesia and increased risks of bleeding.

It's important to discuss any recreational drug use with your surgeon too, as this can increase anaesthetic risks.

4. Pre-existing health conditions

Your surgeon will also need to know relevant things about your general health, including any other conditions you have. Two common examples are asthma and diabetes.

Any heart or respiratory conditions must be reported, stresses Sforza. Asthma needs to be well controlled beforehand to reduce the possibility of a flare-up. Get a check-up with your doctor at least a week beforehand, so you know you're in the best possible health. Those with more acute asthma may need to take inhaled bronchodilators or corticosteroids, or steroids by mouth before surgery to manage symptoms better.

As for diabetes - the better controlled it is, the better your chances of an excellent surgical outcome. If you're diabetic, hyperglycemia (high blood glucose) or hypoglycemia (low blood glucose) could be an issue and wound healing could be slower.

Tell your surgeon about any other medications you're taking, because they could have side effects that need to be considered.

5. Mental health

Nerves, sleep deprivation and recovery, which may involve some pain, lethargy and swelling, can be both physically and emotionally draining, so it's essential you prepare yourself as best you can.

"Surgery can be intimidating for anyone," advises Sforza. "After all, in some cases it's equal to a major operation, so even the most organised of us can feel apprehensive in the build-up."

Patients who've experienced mental health issues in the past may be asked to complete psychological screening prior to any surgery. This is just a precaution, so that there's a second professional opinion on how well you recognise the implications of surgery.

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