1. You must be open about allergies

It’s important to tell your surgeon if you have sensitive skin and if you have any known allergies, as some dressings or medications contain ingredients which you may react to e.g. latex.

Even telling your surgeon about minor past reactions from silver or nickel in jewellery, bra clips, watch straps or waistbands, can provide them with useful insights about potential allergens.

Most allergic reactions are minor but can be uncomfortable and in some cases may need extra treatment like topical corticosteroids or antihistamines. So, it can be worth pre-empting and discussing any concerns with your surgeon in advance.


  1. You need to watch your BMI

Results are best for cosmetic procedures if your body mass index is under 30.

If someone is overweight or obese and planning to have surgery, it’s important to be aware that excess weight can possibly put the body under more strain and at risk of certain side effects and complications. These can result from the surgery itself or the anaesthesia which may be needed.

Being overweight also increases the risk of obstructive sleep apnoea, which can be a complicating factor in the administration of general anaesthesia. Anyone prone to this already must tell their surgeon during a consultation, so they can tailor surgery to individual needs.

Improving your health before surgery can help make it as safe as possible, decrease chances of complications and help you get back on your feet faster.


  1. You must quit cigarettes and cut back on alcohol

Many people don’t realise the importance of stopping smoking, before, and after surgery.

Nicotine causes the blood vessels to constrict, reducing them in size and restricting blood supply to organs and tissues which can slow down a wound’s healing post-surgery.

The complication rate risk for smokers has been reported to increase and according to a recent study, smokers needed 33 per cent more anaesthesiaduring an operation and 23 per cent more pain medication afterwards, compared to non-smokers.

The general advice is to stop completely for six weeks before and six weeks after surgery which includes all nicotine-containing products too.

Doctors also recommend cutting out alcohol one to two weeks before surgery, due to possible interaction with anaesthesia and increased risks of bleeding.


  1. Extra care is needed if you have certain health conditions:


If you are scheduled for surgery, make sure your asthma is well controlled before it takes place, as this minimises the possibility of an asthma flare-up before or during surgery.

Make sure you have a check-up with your doctor at least a week before the surgery to make sure you’re in the best possible health for a procedure to take place.

Those with more acute asthma may need to take inhaled bronchodilators, inhaled corticosteroids, or steroids by mouth before surgery to manage their symptoms better and ensure surgery is as safe as possible.


If you are diabetic then hyperglycemia (high blood glucose) or hypoglycemia (low blood glucose) could be an issue after surgery and wound healing could be slower and infection a greater risk.

However, the better you control your diabetes, the better your chances of an excellent surgical outcome. Keeping your blood glucose within the parameters your doctor recommends is key, as is optimum nutrition.

Make sure you eat lots of high-quality protein, which can help contribute to faster wound healing. It is important to try and keep stress to a minimum as well because this can elevate your blood glucose levels.



  1. Consider emotional aspects, too

Cosmetic surgery doesn’t just come with physical implications, there are important emotional aspects to consider as well.

Surgery can be nerve-wracking for anyone so even the most prepared of us can feel anxious in the run-up to it.

Worry, lack of sleep and recuperation that may include some pain, fatigue and swelling can be difficult to deal with physically andemotionally, so it’s important to be prepared.

Your surgeon has a duty of care to protect your emotional wellbeing, as well as your physical safety before surgery. If you’ve experienced mental health issues in the past, they may ask you to consider psychological screening first, prior to any surgery. This is a precautionary measure, so your surgeon has a second professional opinion on how well you understand the implications of surgery and if you will be able to cope with unexpected outcomes.

Your surgeon is responsible for providing you with honest and detailed information in your consultation, as to what your procedure will entail and what the recovery process will be like. They should do everything they can to ensure you are both physically and mentally prepared for a procedure.

Genuine online reviews can also be helpful here too, as you can read up about other people’s experiences and make a good judgement call as to whether surgery is right for you, what type of additional support you may need and how to access it post-procedure.


  1. Consider your post-surgery care, too

Health considerations are not only important prior to surgery, but also after surgery too. Note that after surgery you will need a constant caregiver for up to 48 hours after a procedure, who will be instructed by your surgeon and his/her team to assist with medication and any post-operative care.

Organising care for your children or pets is also highly recommended. Ask a relative, friend or enlist the services of a professional so you can focus on recovery.


  1. Most importantly, find the right surgeon foryou

The more scrupulous, face-to-face time that surgeons have with a patient, the better. Your chosen cosmetic surgery practice has a duty of care to support you every step of the way from the initial first consultation all the way through to the final stages of post-operative care.

They should be honest with you about what surgery could entail, and proactively make sure you are as prepared as possible, with realistic expectations. The latest GMC guidelines highlight that all cosmetic surgeons must give patients time for reflection and that patients need to have the time and information about risks, to decide whether to go ahead with a procedure.


The most reputable cosmetic surgeons are members of the representative bodies for maintaining excellent professional standards, such asBAAPSorBAPRAS.


A cosmetic surgery practice should never try to rush you into deciding or try to influence your decision by offering any last-minute ‘deals’ or discounts.

Concerns over aesthetic regulation heard in Westminster

Houses of parliament
Feb 19, 2019
The Government has admitted shortcomings in the regulation of non-surgical cosmetic treatments.

In a parliamentary debate held last week (February 12) in Westminster Hall, Jackie Doyle-Price, parliamentary under-secretary of state for mental health and suicide prevention, admitted that the Government had “some way to go” to making sure that all those administering non-surgical treatments such as injectables are performing treatments to high standards.

MP Alberto Costa put forward the debate. Costa, who is the MP for South Leicestershire has been campaigning to bring the issue to the attention of Government after being contacted by constituent Rachael Knappier, who experienced severe complications following a lip filler treatment by a beauty therapist – a story which has had significant media coverage over the past few months.

In January he raised the issue on topical debate programme Prime Minister’s Questions, tackling Prime Minster Teresa May about the growing concerns for patient safety and regulation. He then raised a debate on February 12 and was accompanied to Westminster Hall by Knappier and Safety in Beauty founder Antonia Mariconda.

Costa said it was “beyond belief” that a foreign substance could be injected by someone with no medical expertise. He added, “As MPs we have a duty to protect the health and safety of our consumers, so allowing them to make informed choices in respect of seeking treatment from professional beauticians. It is not the case of why people are having it done. It is that we need to regulate what is being done.”

May replied, stating, ”We recognise that this growth in non-surgical treatments does increase the need for consumer protection. We are currently working with stakeholders to strengthen the regulation and we are committed to increasing the safety of these procedures in a number of ways.

“For example, better training, robust qualifications for practitioners and clear information where people can make an informed decision about their care. We would urge anyone who is looking to have a cosmetic procedure to take the time to find a reputable, safe and qualified practitioner who is subject to statutory regulation or on a voluntary accredited register.”

Her comments were echoed by Doyle-Price during the February debate after he shared the experience of his constituent Rachael Knappier, who required urgent medical attention after dermal filler was injected into an artery in her lip. She received the treatment at a “botox party”. Doyle-Price said: “We need to do so much more in terms of public education to make sure consumers fully appreciate that there are risks with injecting things into one’s face and that they make sure someone doing that has the appropriate qualifications.”

However, she added: “In wishing to regulate this sector we do not want to undermine its dynamism and its competitiveness. What we really need to do is make sure that consumers are properly educated so that they can make informed choices about where they seek treatments.”

While she didn’t respond directly to Costa’s call for “the Government to at least consider setting out a cohesive and comprehensive plan to properly regulate the non-surgical cosmetic industry”, Doyle-Price did remind those in attendance of what has been done since 2013’s Keogh review, including the training and qualification framework; and the formation of the Joint Council for Cosmetic Practitioners: “We need to work closely with the JCCP so we can develop hallmarks for people to look for so they can be sure they’re obtaining a treatment from a regulated practitioner,” she said.

Doyle-Price also reiterated that as of May 2020, all dermal fillers will be regulated as medical devices under the Medicines and Healthcare Products Regulatory Agency. However, this doesn’t mean that the products will be prescription-only.


A patient with upper lid hooding, a very common development as we age. This can cause a cosmetic problem and can prevent the application of make-up in the upper eyelids, but it can also cause a functional problem with a restriction of vision. In some patients, this leads to headaches from the fatigue of the having to constantly raise the eyebrows. This patient shows the result of a bilateral upper lid blepharoplasty performed under ‘twilight anaesthesia’ on a day case basis. The surgery is performed conservatively to ensure that blinking is not compromised and to avoid an operated look.


A patient with marked upper lid hooding and lower lid ‘bags’ causing a tired appearance

The same patient 3 months following a bilateral upper lid blepharoplasty and a ‘chemical brow lift’using botulinum toxin injections (Azzalure injections) and a bilateral lower lid transconjunctival blepharoplasty with fat repositioning (scarless cosmetic lower eyelid surgery)



The lower lid is being pulled down away from the eye to show a plug in the inferior punctum

Punctal plugs can improve dry eye symptoms and reduce the frequency of instillation of artificial tears in patients with a dry eye. Open the blog below and then click on the link  to see a punctal plug being placed in a patient. This requires no anaesthetic injections, only a drop, and takes seconds to do.


MAYWOOD, Ill — June 28, 2018 — A study published in The Ocular Surface is providing further evidence that floppy eyelids may be a sign of sleep apnoea.

Charles Bouchard, MD, Loyola University, Maywood, Illinois, and colleagues reported that 53% of patients with sleep apnoea had upper eyelids that were lax and rubbery. The most severe cases of sleep apnoea were associated with the most pronounced cases of floppy eyelids, but this association was not strong enough to be considered statistically significant.

Lax, rubbery eyelids are found in people who have lax eyelid condition, lax eyelid syndrome (lax eyelids plus conjunctivitis), and floppy eyelid syndrome (lax eyelid syndrome in obese young men).

A patient with floppy eyelid syndrome with typical drooping of the eyelashes (lash ptosis) 

It’s unclear why sleep apnoea is linked to floppy eyelids. One theory suggests the condition is associated with low-grade inflammation that causes degradation of elastin, a protein that allows skin and other tissues to resume their shape after stretching or contracting.

“Obstructive sleep apnoea is a severely underdiagnosed disease, and without treatment leads to increased morbidity and mortality,” the authors concluded. “It is the duty of today’s ophthalmologist to be diligent in making the diagnosis of lax eyelid syndrome in the ophthalmology clinic. They are in the unique position to identify patients at risk for obstructive sleep apnoea and address this critical public health problem.”




Protect yourself from the adverse effects of excessive sun exposure. Many people are unaware of the serious risks associated with sunburn which increases your risk of melanoma, a potentially lethal form of skin cancer. It also greatly increases your risk of other forms of skin cancer including rodent ulcer (basal cell carcinoma), which we are seeing in younger and younger patients. Excessive sun exposure also results in premature aging of the skin, premature cataracts and increases your risk of the development of age-related macular degeneration.

A lower lid basal cell carcinoma (rodent ulcer) in a young patient


Many benign skin and eyelid lumps/bumps/lesions including chalazia (meibomian cysts – as seen in the photograph above) are no longer being removed under the NHS (read the article about this published in the British Medical Journal today). At Face & Eye we have a team comprising consultant eye surgeons, a consultant dermatologist, and a specialist oculoplastic nurse practitioner who can treat these problems quickly and efficiently. Visit for information about the costs.

A benign upper lid papilloma

Click here to read the article from the British Medical Journal  bmj.k2903.full


Mr Leatherbarrow gave a presentation at the annual congress of BOPSS in Dublin about his experience of facial fat grafting over the course of the last 20 years, and his more recent experience since 2012 with micro fat grafting and nanofat injections of the area around the eyes. Mr Leatherbarrow spoke about the use of fat grafting in patients seeking facial rejuvenation, alone or to supplement the effects of cosmetic eyelid surgery (particularly in those patients who prefer to avoid dermal filler injections), and in patients with facial scarring and hollows following trauma. Microfat injections have become popular for the management of lower lid dark circles and tear trough defects.




Specialist Treatment

Contact us now to find out how we can help you with your eye, eyelid, facial or skincare needs. You will find our website contains a great deal of helpful information about what we do. We welcome email enquiries.

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