In Search of Perfection

Created on 15th May 2009

The number of patients opting for revision surgery has seen a huge increase over the last year. Amy Lindsay explores the reasons behind the trend and gives you top tips on how to avoid a repeat procedure

The trend for revision cosmetic surgery procedures appears to be booming, with the number of patients having treatments re-done showing an increase of 10 per cent on last year. Is this due to a lack of surgeons with expertise, or perfection-seeking patients simply becoming more demanding of their surgeons?

While problems are unpredictable and can happen to patients in the hands of even the most skilled surgeons, the boost in the number of repeat procedures does seem to suggest a growing dissatisfaction with the results of cosmetic surgery procedures. The most recent statistics show that in around one case out of ten a second procedure is required, whether a minor amendment post-surgery, or a complete reworking of the first attempt.

"There has been a definite rise in revision surgery," confirms cosmetic surgeon Angelica Kavouni. "The most common revision procedures in my surgery are liposuction and breast augmentations, where there are visible deformities, asymmetry and bad scars. The rise in cosmetic surgery tourism and a bewildering lack of regulation are partly to blame," she adds.

One suggestion seems to be an increasing number of inexperienced surgeons - both in the UK and abroad - undertaking procedures. Because cosmetic surgery is a highly skilled, delicate profession, a specialist surgeon is undoubtedly the best bet when opting for an op.

"All qualified cosmetic surgeons have training in all aspects of cosmetic work, however most cosmetic surgeons have areas of ‘expertise' or their area of preferred procedures - make sure you ask to find out," advises Dr Kavouni.

Indeed many such specialist surgeons who are seeing a disturbing increase in revision procedures are warning the public against surgeons with a lack of experience.

Consultant ENT surgeon Dr Kalpesh Patel specialises in rhinoplasty surgery and has noticed a huge increase in revision rhinoplasty procedures over the past year. Over the last 12 months, revision procedures have made up 30 per cent of his work - an increase of 10 per cent on last year. "All cosmetic surgeons are qualified to perform rhinoplasty surgery, but are they all proficient?" he questions. "The majority of rhinoplasty outcomes are very pleasing but there are a handful of practitioners who shouldn't be ‘dabbling' in areas of surgery where they lack sufficient experience."

Another problem is patients seeking a bargain. "Some patients are looking for the cheapest deal and it is impossible to maintain standards when corners are cut,' warns Dr Kavouni. "As new procedures become popular with consumers, some practitioners feel the need to offer such treatments without having sufficient surgical training.  The UK definitely needs stricter controls and regulations."

The saying ‘practice makes perfect' certainly seems to ring true. But is the marked increase in revision surgery really down to maverick surgeons, or do patients simply have increasingly high expectations?

All surgeons stress that realistic expectations are a must when embarking on cosmetic surgery, as there are limits to what can be achieved with any procedure. The surgeon has to work with the supporting framework of your own skin and bone, so your skin texture and thickness, the amount of scar tissue from the previous surgery and your face or body proportions and contour all play an important part in what can be achieved.

"It can be difficult to measure a good or bad result," says Dr Patel. "All results are subjective and just because the patient doesn't like the result doesn't make it a bad surgery, as it could be technically perfect. It is however often obvious when a patient is left with practical problems or a visually non-aesthetic appearance."

Even in the hands of the best surgeons, the need for revision surgery will occasionally occur. Yoga instructor Lara Chandler, 25, agrees that more than one procedure is often a simple necessity to attain the desired result: "I initially had a nose job when I was 17, but I was a bit too young and my face hadn't finished changing from that of a teenager to adult," she says. "I had a second operation for a tip lift, but it just didn't sit right. I have now just had my third operation at the London Day Surgery Centre and the result has been great - I'm finally really happy."

"I have spoken to other rhinoplasty patients and they agree that sometimes it does take more than one operation to get the look you want," warns Lara. "I found that my features changed from the first op and I had to adjust the tip to match correctly. It shows that any type of cosmetic surgery can take a few attempts to achieve the desired final result."

Your chances of being satisfied with your surgery are undoubtedly higher if you're in the hands of an experienced, capable surgeon. However, make sure you go armed with realistic expectations, as expecting your appearance to be totally transformed by the addition of a Kylie bum or Angelina lips is only going to lead to disappointment.
CS&AM