I was appointed as Plastic & Reconstructive Surgeon at the Royal Devon University Healthcare and Torbay Hospital nearly 10 years ago.
I have been practising in reconstructive breast surgery, including micro-surgical breast reconstruction in my NHS practice and have also been working in the independent sector, both in Exeter and Mount Stuart Hospital in Torquay; this has included all areas of cosmetic surgery, comprising facial, breast and body contouring surgery.
I am the Chairman of the Specialist Training Committee for overseeing the training of Plastic Surgeons in the South West. I am also a member of the Peninsular Network for the treatment of skin cancers. I am a full member of the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Association of Aesthetic Plastic Surgeons (BAAPS).
I think with any patient making a decision to undergo cosmetic surgery or any procedure which is not essential for their physical health, then the key to this process is information and consent. Only by explaining in detail the likely outcome of surgery, and any possible risks, complications or side effects, can a patient make a decision which can be regarded as an informed consent.
This reflects GMC guidelines on best surgical practice. There should be no pressure from any surgeon or provider to encourage patients to have surgery as this is a decision they must make on their own when they have had a full explanation of everything which is involved. Importantly, this discussion must be with the surgeon who will perform the procedure.
Attention from the media can be both positive and negative. The cosmetic surgery industry has been unregulated for far too long and it is generally the unregulated side of cosmetic surgery, in particular the injectable treatments, that have come under increasing scrutiny and rightly so.
There has also been considerable publicity with regard to the PIP breast implant scandal and obviously legislation may be brought in to increase the regulation of manufacturers of any medical device.
Plastic surgery is a highly variable specialisation. Procedures range hugely in complexity from operations involving highly complex micro-surgical techniques to relatively straightforward excision of skin lesions.
Plastic surgery also involves all areas of the body, all sections of the community, including the very young and very old. Plastic surgery is the most general of all the surgical specialties in this regard. The ability to use experience and surgical techniques, tailored to each individual’s problem, is the challenge in plastic surgery in order to achieve the optimum outcome for each patient.
This range of procedures and variability was one of the main attractions to the specialty as no case is ever exactly the same as the one before or after it.
A situation is only stressful if an individual is unable to cope with the stresses and strains placed upon them. With good training, experience and a good team around you, including anaesthetist colleagues, nursing staff and office staff then there is no reason for the job to be stressful.
Most patients do not want to see stress in any healthcare professional, as this undermines confidence and really nobody should be doing a job which they find too stressful. As in all walks of life a little stress can focus the attention but too much stress will start to negatively impact on performance and can be avoided with good training and experience.
Living in this part of the West Country there are so many activities to do in away from work such as sailing, kayaking and enjoying the outdoors so there is plenty to do to get away from medicine. The coastline from the Exe estuary across to Torbay and Dartmouth are all my favourite locations, particularly for sailing.
Now we have a first class rugby team with Exeter Chiefs, there is also premiership rugby to watch.
There are also fantastic restaurants and the emergence of new micro-breweries in the region can only add to the attractions.
Upper eyelid surgery is usually performed to correct droopy or heavy lids that hinder a more youthful appearance and can in fact impair the upward and downward field of vision. Lower eyelid surgery is a more complicated procedure which is usually performed under general anaesthetic to remove eye bags which can give the appearance of tiredness.
This type of surgery tends to be carried out on those aged 45 or over, but can be carried out at a younger age as sometimes excessive fat in the lower lids or hooding of the eyes can be due to familial causes. Surgery can be performed under local or general anaesthetic and takes between one and three hours depending on what you have done. It is possible, and very common, to have both upper and lower lids operated on at the same time.
Scars from eyelid surgery are able to be extremely well hidden. Upper lid scars are hidden in the natural crease of the eyelid and in the crinkles at the corner of the eye. Lower lid surgery involves a scar just below the lash line which extends out to the crow’s feet at the side of the eye, but again can be very well disguised.
There will be some bruising and swelling post surgery but this will soon improve – nothing that could not be hidden by some rather nice sunglasses!
Patients who undertake eyelid surgery and very satisfied with the procedure and tend to feedback that friends and family comment on how well they look, without being able to pinpoint the exact reason why! Check out some of Mr Oliver's Blepharoplasty results.
It is important to chose your surgeon carefully to perform this procedure.
“Blepharoplasty or eyelid surgery is often complex surgery especially in the lower lids. Excessive skin in the upper lids is a little easier to correct and this can be done under a local anaesthetic.
Lower lid surgery is an intricate procedure as both the skin and fat around the eye may need refined to achiev the desired result. This type of procedure requires careful consideration and therefore you need to discuss with your surgeon the likely outcome and risks associated with surgery”
Mr David Oliver
Consultant Reconstructive & Aesthetic Plastic Surgeon
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