The Big Interview

By: Ruth Kerrison
Created on 11th August 2010

Consultant plastic surgeon Mr Bryan Mayou and his wife Susan, a leading dermatologist, founded Cadogan Clinic three years ago in order to fulfil their dream of offering the very best in cosmetic surgery, skincare and medical treatments under one roof

Q What inspired you each to get involved in aesthetics?

A Bryan: As a plastic surgeon, you’re always concerned with the aesthetic, and reconstructive work is satisfying, but it rarely gets the same level of appreciation from the patient. When you perform a facelift, you’ve restored a patient’s face back to the way it was when they were younger; they’re delighted and it’s nice to get that positive feedback.

Susan: My interest was born from concern that cosmetic procedures such as Botox, fillers and peels were being carried out by people who weren’t dermatologists or even doctors. Dermatologists specialise in treating the skin, and so I felt that we were the best qualified to be performing these procedures.

Q What were your reasons for launching Cadogan Clinic?

A Bryan: Throughout my entire career this has always been the ultimate dream, but while I was still practicing in the NHS I didn’t have the time. I’ve got a filing cabinet at home full of plans for projects that never quite made it – some even down to the architect’s drawings!

When I worked at the Lister Hospital I was very lucky because they’d built a new wing and I was able to claim a whole section of it for myself – it was called ‘the Mayou Clinic’ – but I was still restricted by having to use the hospital staff, all of whom had jobs elsewhere in the hospital too, and the hospital equipment, which meant I couldn’t always provide the perfect treatment for the patient.

We wanted to be able to offer patients something a bit different from what’s alreadyout there – a discreet, friendly, calming environment where we could offer a variety of medicallyendorsed treatments under one roof. This is a field where one sees many procedures promoted on the grounds of profit rather than proven efficacy. This is a medical rather than a beauty clinic.

Q There are a lot of very eminent surgeons and doctors working at Cadogan Clinic – how do you decide who should work for you?

A Bryan: We’re very lucky in that we’ve worked with the best over our careers, so we know them and we have really hand-picked everyone who works here.

Susan: We ask colleagues if they would like to work at Cadogan Clinic and when they come and see the standard of the facilities, they always say yes.

Q What do you think sets Cadogan Clinic apart from the competition?

A Susan: We are unique – a boutique clinic and not part of a large conglomerate and not on Harley Street.

Bryan: Yes, I think the location’s important – the rooms in Harley Street aren’t really suitable for this sort of work, and also this is a very convenient location for the more discerning clientele.

We’re on Sloane Street in the centre of London, right by Cartier and Tiffany’s, so as soon as you tell people that they know exactly where you are, because it’s where they come to go shopping.

Susan: Also it’s very discreet – if you saw someone coming in here you wouldn’t know they were coming to a medical clinic.

Bryan: And we really can offer the right treatment for the patient – in other clinics they have one or two machines and so they have to ‘sell’ the patient the treatment that machine can offer.

Here, for example, we have seven different liposuction techniques to choose from, so if the one that I perform isn’t right, I can refer the patient to one of my colleagues.

Why seven different techniques? Because these are the techniques that work best and one needs them to be able to best treat the various problems we see. Different techniques are best for different patients.

Q All procedures at Cadogan Clinic are performed as day surgery. Why did you decide to do that?

A Bryan: Because it’s more efficient for everyone: for the patient and for the surgeon. You’re not ill after cosmetic surgery, so why should you have to stay in hospital?

Years ago, you had to stay in hospital for ten days with your nose in a splint after rhinoplasty, but now that seems ridiculous. The only reason you ever need an overnight stay these days is because of the anaesthetic.

We’re very lucky here in that we work with a really marvellous team of anaesthetists who provide patients with exactly what they want. Some patients want to be relaxed and pain free, while others prefer to be asleep.

If patients prefer to be asleep, they are kept only just asleep. They wear a special band around their head to monitor their level of sleep so that they do not wake up in the middle of the operation but do not have any more anaesthetic than is necessary.

Most importantly, no one is sick or nauseated. It also means that we can perform all the operations here, which is a big thing – we don’t have to farm people out to another hospital, which most of the big clinic chains do.

And people feel more comfortable knowing that their operation will take place in the same building where they had their consultation, as it’s a familiar environment. They know the clinic and they know the staff.

Susan: Another big advantage of the day surgery is that there is no risk of contracting MRSA or any of the other superbugs. In three years, we haven’t had any problems with infections, and that’s because everything is kept extremely clean and no one is here for long enough to pass on infection to someone else.

Q Cadogan Clinic doesn’t only offer cosmetic treatments, you also have a big focus on skin cancer – is it true that you are the only clinic in the UK to offer same day results on mole screening?

A Bryan: I believe so, yes. We are certainly the only clinic in the UK to have the pathology lab on site.

Susan: Yes. We wanted to be able to give people quick answers when they have had something removed from their skin.

The people who come to us are city workers, high fliers. They’re used to getting fast results in the workplace and they expect that from their healthcare too, but it doesn’t usually happen elsewhere.

When they come in to have a mole removed at Cadogan Clinic, and we call or email them that evening with the results, they are amazed and delighted. Whatever the news, they’re just so pleased to know, and not to have to wait and worry.

Q Susan, you are a cofounder of the British Cosmetic Dermatology Group – what were your reasons for launching the group?

A Susan: Well we launched the group about ten years ago, so about the same time as I first got involved in cosmetic dermatology and my reasons for both decisions were much the same – I was concerned that beauticians and nondermatologists were offering treatments that should be carried out by dermatologists as we know more about the skin than anyone.

I also feel it is very important that all dermatologists have an awareness and understanding of cosmetic procedures; even if you have no intention of offering these treatments in your practice, you will very likely see people who will come to us if they have complications from procedures done elsewhere.

It is also very useful to have a body of like-minded professionals who can learn from each other, and we are all constantly learning, as you are in any medical specialty.

There is a large body of cosmetic dermatologists in the USA but there was no equivalent here until we started the BCDG.

Q How easy is it to work together as a husband and wife team?

A Bryan: It’s great, actually. A plastic surgeon is a surgeon of the skin and a dermatologist a physician of the skin. There is an overlap, but between us we extend the range and depth of our opinions, we can consult each other at anytime – although of course we try not to take our work home with us!

Susan: I love it and it enhances our service to the patients too. I have often had to refer patients for surgery and I know Bryan’s work so well, I’ve seen his results and I know how seriously he takes it, so I’m very happy to refer to him. Of course, if I feel it is in the patient’s best interest to see another plastic surgeon I can easily refer them to one of the others.

Also, if I need to get a second opinion, I can just walk into his office and ask. I couldn’t do that with any other colleague, but as my husband he can’t very well object!

Q What are your plans for the future of Cadogan Clinic?

A Bryan: We want to perfect what we have here. We plan to extend clinic space within this building to allow us to offer more treatments. We really want to get this place absolutely perfect, and then maybe we will think about starting up clinics elsewhere.

Mr Bryan Mayou was the senior plastic surgeon at Guy’s and St Thomas’s Hospital where he pioneered many microvascular surgical techniques and introduced liposuction into the UK 27 years ago.

He is a member of the British Association of Aesthetic Plastic Surgeons and has published more than 40 peerreviewed articles in the British Medical Journal and various general surgery and plastic surgery journals.

Dr Susan Mayou was a consultant dermatologist at Chelsea and Westminster Hospital and is co-founder of the British Cosmetic Dermatology Group and advisor to numerous cosmetics companies.

In clinical practice Dr Mayou sees children with eczema, teenagers with acne and adults for mole checks; provides treatment for skin cancer and performs non-invasive cosmetic procedures such as Botox and fillers.