Plastic surgeon, Sheffield

Safer cosmetic surgery

Mr Morritt takes patient safety very seriously. He has introduced a number of changes in his practice to ensure that all patients having plastic surgery or cosmetic surgery under his care are treated in the safest possible way. Mr Morritt continuously monitors his patients outcomes from surgery. He also attends courses and conferences to stay up to date with the latest guidelines and techniques. Consequently his complication rate for cosmetic surgery and plastic surgery is exceptionally low.

IMPROVING SAFETY BEFORE COSMETIC SURGERY

Physical fitness before having cosmetic surgery

Fit patients with an ‘ideal’ body weight have fewer problems with general anaesthetics and surgery than those who are unfit and overweight. Fit patients also recover more quickly following surgery.  Mr Morritt recognises that some patients do not enjoy going to gyms or simply don’t have spare time in their busy lives. However, even simple lifestyle modifications such as increasing the amount of walking during the day do have beneficial effects on fitness and body weight and are therefore highly recommended.  In order to protect patients from unnecessary risks and improve safety, cosmetic surgery is rarely performed on anyone who is clinically obese (Body Mass Index (BMI) > 30). There are exceptions to this when it would simply not be possible for patients to reduce their BMI’s below 30 for physical reasons.

Read here for NHS information about healthy diets and losing weight

Effect of pre-existing medical conditions and medications on the safety of cosmetic or plastic surgery

Conditions such as high blood pressure or diabetes increase potential complications from cosmetic surgery/plastic surgery and anaesthesia. Mr Morritt normally writes to your GP to ensure that your treatment for any pre-existing medical condition is optimised before undertaking surgery. It is useful to bring a list of your regular medications with you to your consultation with Mr Morritt.

It is essential to stop taking some tablets before surgery as they are known to increase the risks of bleeding following surgery:

  • Over the counter medicines – stop 1 month before surgery
  • Herbal remedies e.g. arnica – stop 1 month before surgery
  • Non-steroidal tablets e.g. aspirin, ibuprofen or voltarol – stop 10 days before surgery and do not take following surgery

Smoking and effects on cosmetic surgery or plastic surgery

Mr Morritt asks all of his patients to stop smoking and all nicotine products e.g. patches for a minimum of 6 weeks before and after surgery in order to reduce the risk of potential complications.  Read here for NHS advice on stopping smoking.

  • All wounds need oxygen to heal but smoking reduces the amount of oxygen getting to wounds and can therefore cause wound healing problems such as delayed wound healing, infection and skin loss (necrosis)

Failing to stop smoking before some cosmetic surgery procedures such as tummy tucks (abdominoplasty) or breast reductions can have disastrous effects where large areas of tissue die (necrosis). This may cause delayed wound healing or require reconstructive plastic surgery and give a poorer cosmetic result.

IMPROVING SAFETY DURING COSMETIC OR PLASTIC SURGERY

WHO Surgical Safety Checklist

Mr Morritt takes uses the World Health Organisation (WHO) Surgical Safety Checklist routinely before undertaking any operation in the operating theatre. This checklist has been shown to improve patient safety during surgery by reducing deaths and complications. Mr Morritt was one of the first people in the UK to introduce the WHO Surgical Safety Checklist into his Practice and has published research in this area.

Anaesthetic

Mr Morritt only operates with Consultant anaesthetists who either work in, or who have recently retired from the NHS and are named on the GMC specialist register for anaesthesia.

RECOVERY AFTER COSMETIC OR PLASTIC SURGERY

As a general rule Mr Morritt advises his patients to take things easy following surgery. This is particularly important in the first 2 weeks following cosmetic surgery or plastic surgery. The specific recommendations vary on an individual basis and according to the procedure.  You will be looked after by experienced nursing staff and seen by Mr Morritt every day that you are in Hospital. After discharge, you will be seen regularly in the dressing clinic by the nursing staff to make sure that you are making good progress and that the wounds are healing well. You will also have regular follow up appointments following the surgery with Mr Morritt.

Mr Morritt advises that patients do not take any painkiller tablets/herbal remedies etc after the surgery that have not been prescribed by his team as many tablets have potential side effects that may increase the risk of problems following surgery such as bleeding.

Cosmetic surgery and COVID-19

With time we are gaining knowledge about the potential impact of COVID-19 on surgery and general anaesthetic.  I have personally performed numerous cosmetic surgery and other plastic surgery operations since the arrival of COVID-19. My experience has been that cosmetic surgery and reconstructive surgery can be performed safely and there is no sign of an increased complication rate compared to pre-COVID times.  This is in strictly controlled environments with stringent infection control policies, PPE, and the rigorous COVID testing of patients and staff.  Patients are required to self isolate before and after surgery to minimise risks.

Published data suggest that developing COVID-19 at the time of an operation could potentially lead to a risk of death of 19%.  Certain patient groups are at greater risk of developing severe illness with COVID-19. These include the elderly, male, BAME background, chronic heath problems e.g. diabetes, obesity and high blood pressure, those with chronic respiratory disease e.g. asthma and COPD, and those who are immunocompromised. All patients who want surgery are risk assessed and for those in high risk groups a recommendation is made to defer surgery until the COVID-19 situation has improved.

Other links

Read more about BAAPS Consumer safety guidelines

Read more about the Review of the regulation of cosmetic interventions (Department of Health)