Cutting a dash with surgery

RESEARCH FIRST: Cosmetic surgery is costly and painful.

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Women and men throughout history have always found ways to change their appearance since the days of whalebone corsets and foot binding.

Modern approaches – tummy tucks, facelifts, liposuction, Botox, collagen implants, breast reduction or enlargement, eyelids and brow lifts – are easily accessible, finances permitting, but will still involve some pain. Breast reduction or implants can cost $16,000, eyelids $13,000, liposuction $20,000 and a tummy tuck $23,000.

It's mostly women who make up the clientele. Women's magazines, film stars and TV programmes like Nip/Tuck are responsible for some of the growth in demand. But it's not just women. Christchurch plastic surgeon Howard Klein says: "I do at least 50% to 60% more male breast reductions than I did five years ago."

Plastic surgeons are specialists who do not always choose to do cosmetic surgery. They may concentrate on patients with burns or cancer. Cosmetic surgeons or "appearance medicine specialists" may be GPs or other doctors with an interest in cosmetic surgery but are not usually plastic surgeons.

New Zealand doesn't gather figures on the numbers of cosmetic procedures but The New Zealand Foundation for Cosmetic Plastic Surgery estimates a 50% increase in demand over the past few years.

Cosmetic surgery can renew confidence and be life changing for some people who wish to change how they look or feel about themselves or if their appearance has been altered by illness or injury.

It's important to know what you really want and to be realistic and understand what you will get because it's a costly exercise and not all of it can be undone. A 2004 study showed that claims against cosmetic surgeons had leapt by 72%.

"Although a lot of us have a fair idea whether a car's a lemon or not, you don't necessarily appreciate whether a surgical procedure is the right one for you," plastic surgeon Stewart Sinclair says.

Choosing the right practitioner and making an informed decision requires a bit of research. Search out the right doctor, compare prices and clinics that specialise in the procedure that you want.

Arrive with a list of questions. Ask about their experience, qualifications, training and how many times they have done the procedure. And above all leave with realistic expectations.

Cosmetic surgery involves risk and there are potential complications. Ask for written information about your procedure and the before and after-care.

Think before heading overseas for surgery. There may be a free holiday and it may be cheaper but it's not always the wisest. You may not be able to check the surgeon's qualifications and what the aftercare is like – poor care can lead to infections. There is no medical injury cover by ACC for overseas surgery, and if something goes wrong that can mean another trip.

Barbara Docherty is a registered nurse and clinical lecturer at the University of Auckland School of Nursing.

The Medical Council of New Zealand www.mcnz.org.nz, 0800 286 801, has information on cosmetic procedures and certified practitioners. www.cosmeticsurgery.org.nz and www.plasticsurgery.org

Barbara Docherty is a registered nurse and clinical lecturer at the University of Auckland School of Nursing.

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