The Consultation provides an initial meeting between you and the cosmetic surgeon to discuss your situation and considered procedure. This is an opportunity for both parties to ask questions and understand the motivation for the procedure, the expected outcomes and specifics such as preparation, technique and recovery.
A private consultation is a professional exchange of information between a potential patient and the surgeon providing the treatment. It is a vital element in the management of a cosmetic concern and the process is no different from any other form of healthcare delivery. The purpose of the consultation is to really understand the patient’s cosmetic concerns and to ensure that the expectations are realistic and technically possible to achieve. The consultation will also allow clinical confirmation that the patient is medically fit to undergo surgery. Also the patient will need to have the psychological “stamina” and maturity to be able to cope with all aspects of treatment. This includes not only the surgery but also the “down time” of recovery and the ability to deal with any possible complications both minor and major.
There has to be a two-way establishment of trust. Therefore during the consultation, a full medical history will be obtained (which includes information on any medication, allergies, smoking and past treatments). A clinical examination of the area of concern will take place and usually some photographs are taken. This may sometimes be useful to understand the patient’s concerns (for example photographs of the patient are used to point out features on the face or nose when planning a face lift or rhinoplasty). Before & after photos of previous patients are also helpful tools to demonstrate what can be achieved. However, examples from the past will always be only an echo or a guide to the prospective patient.
Occasionally special tests maybe recommended (such as ultrasounds scans or blood tests) depending on the problem. If surgery is recommended, a full explanation of how the procedure is carried out is given. Advise is also provided on how to prepare for the operation and what to expect during and after surgery. Information about local anaesthetic and sedation, possible complications and the expected recovery time will always be discussed. The decision to proceed with treatment requires experience and judgment by the surgeon and full understanding and insight by the patient of what is realistically achievable. The ultimate aim is that the patient is knowledgeable and comfortable with the proposed cosmetic management and will be able to give informed consent.
Mr Nishikawa’s private practice consultation fee is £100 and all consultations and surgeries are performed at The Westbourne Centre in Birmingham, UK.
What makes a good cosmetic surgeon?
This is a complex question in reality. Firstly a cosmetic surgeon must be a good doctor. Cosmetic surgery should be no different from any other form of healthcare delivery. To be a good cosmetic surgeon one should have had thorough training. Experience and judgement are the keys. Also an ability to have the emotional intelligence required to fully understand the needs and expectations of the patient and to make sure that there is no mismatch with what is possible.
How many cosmetic procedures do you perform each year?
I perform around 100 private cosmetic procedures per year working around my busy NHS and charity commitments, which account for another approximately 190 surgeries per year, mostly craniofacial and reconstructive in nature.
To accommodate the increasing number of people who want private cosmetic procedures, and who have patiently waited for me to be available, I have increased my private practice hours since April 2015.
The most popular procedures in my practice (which may not reflect average cosmetic trends) are Facial procedures (facelifts and rhinoplasty, blepharoplasties), Breast augmentation, Liposuction, lipofilling, breast reduction and mastopexy.
Can I see before and after pictures of patients considering the same procedure?
Most certainly! During consultation I am happy to share before and after photos with you of people who have had the same procedure(s) you are considering. By doing this during the consultation, and in person, I have the opportunity to relate the example specifically to your situation, highlighting outcomes and helping with expectations.
Where did you train to become a surgeon?
I have had a long training in surgery. I was a medical student at Cambridge University and did my clinical part at Kings College hospital in London. As a young doctor I experienced general surgery, orthopaedics as well as neurosurgery before entering a plastic surgery career. I was inspired by reconstructive plastic surgery but gradually came to realise that I could not manage deformity unless I could also deal with normal patients with cosmetic problems. I presently work at the Birmingham Children’s Hospital as part of the craniofacial team dealing with facial deformity. I also am one of the directors of The Westbourne Centre, which carries out cosmetic surgery. Once or twice a year I work for a charity called Facing Africa and we operate in Ethiopia for facial deformity.
Are you board certified?
Yes, I have been certified with the General Medical Council since July 1982 (GMC no: 2573614) and received my FRCS (Plast) in September 1995. I also hold a Master of Arts from Cambridge (MA) and medical doctorate for research into microsurgery and free radicals (MD).