Mr. Andy Pay

FRCS (Plast), Consultant Plastic Surgeon

Consultation Number:
0800 849 6799

Cosmetic Surgery

This section gives a general overview of the various surgical procedures performed by Mr Pay – at the out patient consultation he will give you much more in depth information as well as providing you with literature to read about the operation, and the process, risks and realities of what is involved. He will also show pictures of previous patients (who have given prior consent) to illustrate particular points in greater detail.

Mr Pay generally meets patients twice before embarking on major operations – the second pre-operative and subsequent post operative consultations are free.

The popularity of plastic surgery is soaring and more and more doctors are trying to meet the demand for this specialty that has become an integral part of mainstream medicine. Any qualified doctor can call himself or herself a cosmetic surgeon, so the importance of finding a properly trained and certified provider is paramount.

Please select a procedure from the list below to learn more about it.

Eyelids (Blepharoplasty)
Facelift
Breast Lift (Mastopexy)
Breast Reduction (Mammoplasty)
Breast Enlargement (Augmentation)
Body Contour Surgery
Tummy Tuck (Abdominoplasty)
Liposuction/fat transfer
Prominent ear correction (pinnaplasty)
Labial reduction
Dermal Fillers and Wrinkle therapy

 

Eyelids (Blepharoplasty)
The operation to correct ageing of the eyelids is known as blepharoplasty. Our eyes are one of the most important features of our face and their appearance can be detrimentally affected by excess skin creases and eye bags. Surgery to correct problems around the eyes (upper and lower) is usually performed under a general anaesthetic (GA, patient asleep) and is most often a day case procedure. Recovery takes a week or two, complications are rare, but you should expect bruising and swelling to last perhaps 2 to 3 weeks.

Further information on blepharoplasty can be found at:
http://www.baaps.org.uk/content/view/73/60/

Facelift
A facelift is an operation to try and reverse the effects of ageing on the mid and lower face. This will not “stop the clock”, but it will help to “turn the clock back” and help to rejuvenate and refresh the face to make one look younger. It is often combined with other surgical procedures such as liposuction, brow lift and blepharoplasty to address the upper part of the face.

The operation is performed under a General Anaesthetic and takes between 3 to 4 hours to perform. Hospital stay is a day or two and recovery takes 2 to 3 weeks. Complications are rare, but you should expect bruising and swelling in the face and neck.

Further information on facelift surgery can be found at:
http://www.bapras.org.uk/cms_subcat/341/Facelift.htm
http://www.baaps.org.uk/content/view/74/60/

Breast Lift (Mastopexy)
This is an operation used for the breast that has adequate volume, but has drooped and requires an uplift procedure. There are many different methods of approaching this particular problem and the surgery will vary depending on the individual’s stature, breast descent (ptosis) and volume. The operation is performed under a General Anaesthetic, requires an overnight stay and recuperation occurs over a period of a couple of weeks. The surgery is often combined with an augmentation to increase breast cup size.

http://www.baaps.org.uk/content/view/64/60/

Breast Reduction (Mammoplasty)
The size of a woman’s breasts can be a significantly disabling feature for an individual and can profoundly affect them both physically and psychologically. An operation to reduce the breast size is usually performed under General Anaesthetic, and lasts 2 to 3 hours. Hospital stay is usually 1 to 2 nights and recovery takes place over a few weeks. Results are generally excellent, with most patients reporting a resolution of their symptoms by the first post operative review appointment at one week.

http://www.bapras.org.uk/cms_subcat/340/Breast-Reduction.htm
http://www.baaps.org.uk/content/view/63/60/

Breast Enlargement (Augmentation)
This is one of the commonest operations performed by BAPRAS cosmetic surgeons. With modern anatomical implants, the procedure has now become a tailor made, bespoke surgical service, where variations in patients’ own body shape can be taken into account when planning the operation. Surgery is performed under General Anaesthetic, and many patients are now treated as day cases although some require an overnight stay. Stitches are dissolving and the 4 to 5cm scar is hidden below the breast in the crease line. Recuperation generally occurs very quickly; most patients requiring only a week or sometimes two off work. It is generally recommended that a period of 3 to 4 weeks elapses before returning to strenuous activity such as sports or gymnasium activity.

http://www.bapras.org.uk/cms_subcat/339/Breast-Enlargement.htm
http://www.baaps.org.uk/content/view/65/60/

Body Contour Surgery
Patients often attend with concerns relating to a particular area of their body – this may be a result of weight gain or more commonly after a diet and exercise programme has resulted in weight loss. Many patients having Bariatric Surgery will notice that various areas such as arms, thighs and torso need attention after their surgery for weight loss. These problems can be addressed with various surgical procedures such as Brachioplasty (arm lift), thigh lift or removal of areas around the bra line or near the armpits. Unsightly folds of skin and fat can be removed depending on the exact nature of the problem. Surgery is performed under a GA, post op stay is usually 1 to 2 nights with recovery taking 2 to 3 weeks, depending on the extent of surgery undertaken.

This is highly specialised and individualised bespoke surgery. The best results are obtained by those with a wide experience and full training in all aspects of reconstructive and cometic plastic surgery.

For abdominoplasty – http://www.bapras.org.uk/cms_subcat/338/Abdominal-Surgery.htm
For liposuction – http://www.baaps.org.uk/content/view/61/60/

Tummy Tuck (Abdominoplasty)
This operation is one of the commonest cosmetic surgical procedures performed and is an excellent method of dealing with the unsightly overhanging tissue and stretch marks of the lower abdomen that typically can arise after pregnancy or weight gain/loss. The procedure takes about 3 hours under a general anaesthetic, with a 1 to 2 day stay in hospital. A corset or support garment is usually worn for 1 to 2 weeks post-op which helps to support the tissues and helps to reduce swelling. Recovery time varies but most patients are back at work at 2 to 3 weeks following the operation, depending on the nature of employment. Strenuous exercise in the gym or sports club should be re-introduced gradually from 3 to 4 weeks and ‘back to normal’ occurs at approximately 6 weeks post op.

For abdominoplasty – http://www.bapras.org.uk/cms_subcat/338/Abdominal-Surgery.htm
http://www.baaps.org.uk/content/view/62/60/

Liposuction/fat transfer
Liposuction is an excellent form of treatment for localised areas of fatty deposits that occur around the body (commonly tummy, flanks, thighs and back) that may be resistant to diet and exercise. It is certainly not an effective method to lose weight per se but is good at sculpting and changing body shape in certain areas. Most often this is performed under a General Anaesthetic, when small incisions are made in the skin adjacent to the area of intended treatment. The liposuction cannulae are inserted gently into the tissues and drawn smoothly backwards and forwards. Because they are blunt ended and have side facing apertures, they remove fatty deposits in a controlled manner and if used correctly have a low risk of complications. Bruising and swelling should be expected as part of the process and this generally persists for only a couple of weeks. A supportive garment is provided which is useful in helping to reduce swelling post op. Recovery is dependent on extent and site of surgery but generally takes between 2 to 3 weeks.

Fat transfer is a relatively new procedure whereby fatty deposits are harvested through a liposuction technique, processed and re-injected into other areas of the body. It is being increasingly used to augment areas of the body (face, breasts typically) that may require the presence of additional tissue because of asymmetry, trauma, tumour resection or for cosmetic/aesthetic reasons. Many centres (Mr S Coleman, NY, USA) report long lasting results (5 to 10 years) and it is becoming increasingly popular as a procedure to supplement other facial aesthetic procedures such as facelifting.

http://www.bapras.org.uk/cms_subcat/342/Liposuction.htm
http://www.plasticsurgery.com/new-york/new-york/doctor-s741.aspx

Prominent ear correction (pinnaplasty)
Ears that protrude or stick out from the side of the head is a surprisingly common phenomenon. It results in a lot of misery and upset for the sufferer, who will usually have experienced a considerable degree of teasing at school and throughout childhood. There are many different reasons why ears may protrude and equally many different operations to correct the problem, ranging from suture techniques to scoring of the cartilage and often requiring a combination of the two. Surgery generally is performed with patients asleep (General Anaesthetic), takes about an hour and a half to perform and usually involves an incision behind the ear, out of sight. Most surgeons use some form of head bandage for comfort (it contributes little to the set back procedure itself) for a week or two. Stitches are usually dissolving and do not need removing. Recuperation takes a week or two and any teasing or psychological problems resolve very quickly.

http://www.bapras.org.uk/cms_subcat/381/Prominent-Ears.htm
http://www.baaps.org.uk/content/view/70/60/

Labial reduction
Sometimes the appearance of the labia minora (the inner lips) around the vagina can be considered as being too large and many women become concerned about their aesthetic appearance, particularly when wearing tight clothing such as sportswear or swimming costumes. Occasionally excess tissue in the labial region can cause discomfort as prominent skin may become intermittently chapped and sore. Labial reduction is a relatively straightforward surgical procedure, most often performed as a day case, where excess skin folds are removed under a general anaesthetic. Stitches are used which are soft and dissolving, thus reducing any discomfort and the need for stitch removal. Patients can wash/bathe and shower normally after the procedure and no complicated dressings are used other than a clean sanitary pad. Recovery is generally speedy and return to work often occurs within a week or so, with gym and sporting activities recommencing within a couple of weeks. Complications are rare and normal sensation of the area should return within days. Sexual activity can recommence when comfort allows

http://www.baaps.org.uk/content/view/60/60/

Dermal Fillers and Wrinkle therapy
These are used extensively by Mr Pay in patients that are looking for more simple methods of facial rejuvenation than by surgical means. The commonest form of wrinkle therapy is by using Botox, a powerful agent used in small doses, that temporarily prevents muscles from working properly. Injected in small quantities into particular muscle groups, (generally around the forehead, bridge of nose and outer aspects of the eyes), the results can be dramatic at reducing wrinkling. The results last for some 4 to 5 months, at which time repeat therapy may be required.

Fillers act in a slightly different way by plumping up the tissues to soften wrinkles in the face. These are administered with local anaesthetic to make the injection therapy painless. Results are seen within a few days and can last for up to a year, with very little in the way of side effects. They are best utilised around the mouth, to soften lines and wrinkles, but are also used in the forehead and bridge of nose to refresh these areas.