How to choose a cosmetic surgeon in the UK

Choosing a cosmetic surgeon comes down to three areas: the surgeon’s training and registration, the regulation of the hospital, and the way the consultation, consent and aftercare are handled. In the UK, any registered doctor can legally perform cosmetic surgery; being on the Specialist Register is strongly recommended by the Royal College of Surgeons but is not currently a legal requirement for private cosmetic work. That is why checking matters.

1. The surgeon is on the GMC register with a licence to practise, and on the Specialist Register in plastic surgery or the specialty relevant to your operation.
2. They have specialist surgical qualifications, such as FRCS (Plast) for plastic surgeons, and ideally Royal College of Surgeons Board Certification in the area of cosmetic surgery you need.
3. They belong to a relevant professional association, such as BAAPS or BAPRAS, which you can check on the association’s own website.
4. The hospital or clinic is registered with the CQC (in England) and you have read its latest rating and report.
5. You meet the operating surgeon before you book, and they, not a coordinator or salesperson, take your consent.
6. There is a two-stage consent process with at least two weeks between your consultation and deciding to go ahead.
7. You have a written, itemised quote that states what is and is not included, including aftercare and revision.
8. There is no pressure: no discounts, time-limited offers, packages or deposit demands on the day.
9. Aftercare and complications are clearly covered, with a named contact out of hours.
10. The surgeon has appropriate indemnity for the procedure in the UK, and any implants will be recorded on the national registry.

The rest of this guide explains each check, how to do it, and what to ask. It aligns with the NHS advice on choosing who will do your cosmetic procedure.

The single most useful check is the GMC register, which is free and takes a minute. Search by name or GMC reference number and look for three things: that the doctor is registered with a licence to practise, whether they are on the Specialist Register and in which specialty, and whether there are any conditions, undertakings or warnings on their registration.

The Specialist Register

A doctor joins the Specialist Register after completing specialist training (or an equivalent route) in a particular field. For most cosmetic surgery of the breast, body and face, the relevant specialty is plastic surgery. Some procedures are also performed by surgeons in other specialties, such as ENT surgeons for nose surgery, ophthalmic surgeons for eyelid surgery, or breast surgeons for some breast operations. What matters is that the specialty covers the operation you are having and that the surgeon does it regularly.

Being on the GP Register, or registered with no specialty, does not mean a doctor is trained as a surgeon. The Royal College of Surgeons advises choosing a surgeon on the Specialist Register for the area in which they are practising.

FRCS (Plast)

FRCS (Plast) is the Intercollegiate Specialty Board fellowship examination in plastic surgery, taken towards the end of higher surgical training. It shows a surgeon has passed the exit examination in plastic surgery in the UK and Ireland. Other specialties have their own FRCS exams, such as FRCS (ORL-HNS) for ENT surgeons. MRCS, or an older general FRCS, is a basic surgical qualification; on its own it does not show specialist training, which is why the Specialist Register entry matters more than the letters after a name.

Royal College of Surgeons Board Certification

The Royal College of Surgeons of England runs a voluntary Cosmetic Surgery Board Certification scheme, supported by the four surgical royal colleges and the surgical specialty associations. Certified surgeons are on the GMC or Irish Medical Council Specialist Register and have shown that their training and experience meet the standard for a specific area, such as cosmetic breast surgery, the face, the eyelids or body contouring. You can search the register of Board Certified surgeons. Not every well-qualified surgeon has applied, so absence from the list is a prompt to ask, not proof of a problem.

BAAPS and BAPRAS membership

The British Association of Aesthetic Plastic Surgeons (BAAPS) and the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) are the two main professional bodies for plastic surgeons in the UK. Full membership of either generally requires specialist training in plastic surgery. BAAPS focuses on aesthetic surgery and runs a national audit; BAPRAS covers reconstructive and aesthetic plastic surgery. Check membership on the association’s own website rather than relying on a logo.

Titles in adverts

UK advertising guidance gives some titles a specific meaning. The Advertising Standards Authority expects a surgeon described as a “consultant” to have held a substantive NHS consultant post (not a locum post) or equivalent, and one described as “qualified” to be on the Specialist Register in a relevant surgical specialty. If a clinic uses these words, you are entitled to ask what they are based on.

Experience

Ask how many of your specific procedure the surgeon performs each year, what their complication and revision rates are, and whether they audit their results. Ask to see before-and-after photographs of their own patients, taken in consistent lighting and positions, and representative of typical results rather than the most striking.

In England, every hospital or clinic that carries out surgery must be registered with the Care Quality Commission (CQC). Search the CQC website by the hospital’s name or postcode, check that the location where you will have surgery is registered, and read the most recent rating and report. Providers must display their current rating, with the date and a link to the report, on their premises and website.

Look at the rating for the specific site, not only the provider as a whole, and check the date. A site that is “registered, not yet rated” is not necessarily a concern, but you can ask when it was last inspected. Read the parts of the report on safety and on leadership (the CQC calls this “well-led”), which cover staffing, infection control, emergency arrangements and governance.

Elsewhere in the UK, the equivalent regulators are Healthcare Improvement Scotland, Healthcare Inspectorate Wales and the Regulation and Quality Improvement Authority in Northern Ireland.

Questions about the hospital:

• Is there a resident doctor on site overnight, and critical care support or a transfer arrangement if needed?
• Who is the anaesthetist, and are they a consultant on the Specialist Register in anaesthesia?
• If I need to return to theatre, where would that happen and who would pay?
• Does the hospital submit data to national registries and audits?

The Breast and Cosmetic Implant Registry

If your operation involves a breast implant, it should be recorded on the national Breast and Cosmetic Implant Registry (BCIR), run by NHS England. The registry opened in October 2016 and records breast implant and implant removal operations by NHS and private providers in England, Scotland and Northern Ireland, so that patients can be traced if there is a product recall or safety concern about a specific implant. All providers of breast implant surgery are expected to take part. Ask your surgeon to confirm your details will be submitted, and ask for the implant make, model, size and batch in writing.

A good consultation is unhurried, happens face to face with the surgeon who will operate, and leaves you with more information than you had, not a date in the diary. Expect it to include:

• Your reasons and expectations. Why you want surgery, why now, and what you hope will change. A good surgeon will explore this carefully and may suggest waiting, or a non-surgical option, if surgery is unlikely to meet your goals.
• Your health. Medical history, medicines, smoking, weight stability, previous surgery and, where relevant, plans for pregnancy or breastfeeding.
• Examination and measurements. Photographs taken with your consent for your medical record.
• Options, including not having surgery. The alternatives, their advantages and disadvantages, and what each would realistically achieve.
• Risks, explained for you. The common and the serious risks of the procedure, how likely they are, and how your own health affects them.
• Recovery. Time off work, driving, exercise, childcare and when the final result will be visible.
• Written information. A summary of what was discussed, the proposed operation, and the quote.

Some clinics use a nurse, coordinator or virtual appointment as a first step for general information. That is fine, but it does not replace a consultation with your operating surgeon, and it should never be where the decision is made or consent is taken.

Bring someone with you if you would like, and bring your list of questions (below). It is reasonable to ask for a second opinion from another surgeon.

For cosmetic surgery, consent should be a process, not a signature. Both the GMC and the Royal College of Surgeons set out what this means in practice.

• The operating surgeon takes consent. GMC guidance for doctors who offer cosmetic interventions says the doctor who will carry out the intervention must discuss it with the patient and seek consent personally, and must not delegate this responsibility.
• Time to reflect. The GMC requires doctors to give patients the time and information they need to reach a voluntary and informed decision. The Royal College of Surgeons Professional Standards for Cosmetic Surgery describe a two-stage consent process with at least two weeks between the stages, so you have a cooling-off period after the consultation before you commit.
• Clear costs. The GMC says doctors must be clear about what is included in quoted prices and what other charges might be payable, including possible charges for revision or routine follow-up.
• No inducements. The GMC says doctors must not use promotional tactics that could encourage an ill-considered decision, and must not offer their services as a prize. The Royal College standards say surgeons should not use financial inducements such as discounts or time-limited offers.

In practice, this means your first consultation should not end with a surgery date that is only days away. You should leave with written information and time to think. At a second appointment, the surgeon confirms your decision, answers remaining questions and you sign consent. You can change your mind at any point before surgery.

Ask clearly about deposits: when you pay one, whether it is refundable, and at what point it stops being refundable. A deposit that is non-refundable before you have had your cooling-off period is a warning sign.

A written quote should list every fee you are expected to pay, say what happens if something goes wrong, and say how long the price is valid. Headline “from” prices are a starting point; compare quotes line by line.

• Surgeon’s fee: Named surgeon who will operate; no substitution without your agreement.
• Anaesthetist’s fee: Included or billed separately; consultant anaesthetist named.
• Hospital and theatre fees: Hospital name; number of nights; what happens if you need to stay longer.
• Consultations: Consultation fees, and whether they are deducted from the surgery fee.
• Implants or devices: Make, model and any manufacturer warranty, with its conditions.
• Tests: Blood tests, scans, ECG or other pre-operative checks.
• Garments and dressings: Compression garments, bras, dressings and medicines to take home.
• Follow-up: How many reviews, with whom, and for how long.
• Complications: Who pays for a return to theatre, readmission or treatment of a complication, and for how long after surgery.
• Revision: Whether revision surgery for an unsatisfactory result is covered, on what terms, and at what cost.
• Deposit and cancellation: Amount, when it becomes non-refundable, and cancellation terms.
• Validity: How long the quote is valid for.

If you use finance, the lender and total amount payable should be clear, and finance should never be used as a reason to decide quickly. For how iQonic prices and finance work, see pricing and finance.

Most concerns show up before you ever reach the operating theatre. Be cautious, and consider walking away, if you see any of the following.

• Discounts and deadlines. Percentage-off offers, “limited slots”, seasonal sales, countdown timers, two-for-one deals or surgery as a prize.
• Pressure. Being asked to pay a deposit on the day, being told the price will rise if you wait, or being offered a surgery date within days of your first consultation.
• No meeting with the surgeon. The first time you meet the person operating is on the day of surgery, or consent is taken by a coordinator, nurse or salesperson.
• Vague credentials. The clinic cannot give you the surgeon’s full name and GMC number, or the surgeon is not on the Specialist Register for a relevant specialty.
• Unregistered premises. Surgery offered somewhere that is not CQC-registered (in England), or the clinic cannot tell you which hospital you will be in.
• Language that plays down risk. Claims that an operation has no risks, leaves no scar, needs no recovery time or comes with a promised result. All surgery has risks.
• Selective or edited photographs. Before-and-after images with different lighting, poses or make-up, or only the most dramatic results.
• Packages and bundles. Multiple procedures packaged together for a single price without individual assessment, or marketing aimed at new mothers or at people’s insecurities.
• Unclear aftercare. No named contact for problems after hours, or complications described as “not our responsibility”.
• Social media only. The practitioner is found mainly through influencer posts or direct messages, with little independent information.

The NHS also advises against paying before a consultation, group-discount or voucher-site offers, and treatments at home or in hotels.

Print this list or save it to your phone, and take notes during your consultation. The questions are adapted from Royal College of Surgeons and NHS guidance.

About the surgeon

1. What is your GMC number, and are you on the Specialist Register? In which specialty?
2. Are you Board Certified by the Royal College of Surgeons for this area of cosmetic surgery?
3. Which professional associations do you belong to?
4. How many of these operations do you perform each year?
5. What are your complication and revision rates for this procedure, and do you audit them?
6. Can I see before-and-after photographs of your own patients with a similar starting point to mine?

About the operation

1. Is surgery the right option for me, and what are the alternatives, including doing nothing?
2. What exactly will you do, and where will the scars be?
3. What result can I realistically expect, and how long will it last?
4. What are the most common risks, and the most serious? How likely are they for me?
5. What type of anaesthetic will I have, and who will give it?
6. If implants are used, which make and model, will they be recorded on the national registry, and will they need replacing?

About the hospital and recovery

1. Which hospital will I be in, is it CQC-registered, and what is its rating?
2. How long will I stay, and what happens if I need to stay longer?
3. How much pain should I expect, and how will it be managed?
4. When can I return to work, drive, exercise and fly?

About cost, aftercare and complications

1. What does the quote include and exclude?
2. Who do I contact out of hours if I am worried, and who will see me?
3. If I have a complication, who treats it, where, and who pays?
4. If I am unhappy with the result, what is your revision policy?
5. How many follow-up appointments are included, and for how long?
6. Are you insured to perform this operation in the UK?
7. What is your complaints procedure?
8. Do you have any financial interest in the hospital, clinic or products used?

Good aftercare is planned before surgery, not arranged after a problem appears. Before you agree to surgery you should know who will look after you, for how long, and what happens if something goes wrong.

Aftercare and continuity

GMC guidance expects doctors offering cosmetic interventions to make sure patients have follow-up, have the contact details they need if complications arise, and have written information about the procedure and any medicines or devices used, so that another doctor could take over their care if necessary. Ask for a named contact who is available out of hours, not only a general helpline.

Complications and revision

Every operation carries risk, and even with excellent care some patients will need further treatment. Find out in writing whether treatment of early complications, such as a haematoma needing a return to theatre, is included in the price and for how long. Ask separately about revision for an unsatisfactory result, which is often treated differently from a complication.

Insurance and indemnity

Your surgeon should have indemnity cover appropriate to the procedure and to private practice in the UK, and the hospital should have its own cover. The Royal College of Surgeons advises confirming that your surgeon is fully insured to carry out the procedure in the UK and asking what the cover includes. Standard health insurance does not usually cover cosmetic surgery or its complications, so check your own policy.

If something goes wrong

Contact your surgeon and hospital first. If you are not satisfied with the response, you can take a complaint about an independent hospital to the Independent Sector Complaints Adjudication Service (ISCAS) if the provider subscribes to it, share concerns about the service with the CQC, and raise concerns about a doctor’s fitness to practise with the GMC. In an emergency, call 999 or go to A&E.

We wrote this checklist to be useful whichever clinic you choose, and we expect to be held to it ourselves.

• Surgeons. Surgery is performed by consultant plastic surgeons. Each surgeon’s profile on our surgeons page lists their qualifications, professional memberships and GMC number, so you can check the register yourself.
• Your operating surgeon, from the start. Your first consultation is in person with the surgeon who would operate, at 15 Harley Street, London, and costs £100. A virtual consultation with a patient advisor is free if you would like general information first.
• At least 14 days to reflect. There are at least 14 days between your first consultation and consent, which your surgeon takes personally; further consultations are always available. Under our terms, the deposit is non-refundable once the 14-day reflection period has ended.
• Written quotes. Quotes are written after your consultation and valid for three months, with the cost itemised.
• Hospitals. Surgery takes place at partner hospitals, including Fitzrovia Hospital in London, which is registered with the CQC and has not yet been rated.
• Records and implants. Your records are held in the Adoreal patient portal. Breast implant operations are submitted to the Breast and Cosmetic Implant Registry.
• Aftercare. Every patient follows a structured aftercare programme, with 24/7 access to the care team through the Adoreal app.

Read more on safety and standards and your journey, or book a consultation when you are ready.