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PUBLISHED: 11:51 24 April 2008 | UPDATED: 15:07 20 February 2013



Certain types of 'cosmetic' surgery are now harder to obtain through the NHS, but some of these operations can totally transform lives.

Robert Morris, Consultant Plastic Surgeon at the Nuffield and Derriford Hospitals in Plymouth, talks about 'moving blocks of tissue around' using microvascular surgery as if it were the most normal thing in the world.

To me it sounds nothing short of a minor miracle and, in truth, that is probably what attracted him to this particular branch of surgery during the later stages of his medical training. It isn't just the fact of performing reconstructive surgery that gives a sense of professional satisfaction, it's more the lasting psychological effects on the patient, which is far more rewarding.

There is a certain amount of artistry involved as opposed to pure science, which is another great attraction. Rob specialises in breast reduction, augmentation, uplift and reconstruction, liposuction, facial surgery, abdominoplasty, sarcoma (a form of tumour) and general plastic surgery. In other words - the 'clinical' side of plastic surgery.

A public misconception

There is a general public misconception, he says, that plastic surgery is just 'cosmetic' surgery, but this is far from the truth, although there is a definite blurring of boundaries. What people generally look upon as plastic surgery is pure 'cosmetic' surgery - the aesthetics of body shaping - whereas Rob's main role in the NHS is in the functional side. He is, in fact, Derriford's lead clinician in sarcoma resection and reconstruction. And, although 'clinical' in this sense means the nuts and bolts of reconstructive surgery, there are psychological benefits that should not be overlooked.

Nowhere can this be more evident than in breast surgery. With the NHS increasingly short of cash, over the last five to ten years care trusts have significantly reduced the amount of what they judge to be pure 'cosmetic' surgery operations that can be performed on the NHS, and this means breast reduction, augmentation and liposuction, as well as the more minor, non-invasive procedures such as Botox and facial-filler treatment.

This has meant a consequent increase in private treatment for conditions that would otherwise have been available on the NHS, and Rob, along with his consultant colleagues, spend a large part of their week working in private clinics. In Rob's case this includes the Nuffield Hospital.

Success stories

Success stories emanating from the Nuffield relate to a sense of relief on the part of the patient and an overwhelming increase in personal confidence. It is, Rob said, a common thing for patients to come back to him and say 'You don't know how you have changed my life for the better'. It really is extremely satisfying, he said.

He quoted me a couple of graphic cases where breast reduction had quite a profound psychological effect on his patients. One woman, who had lived her life with an over-large bosom out of deference to her husband's preference but who, with a new partner and a supportive GP, eventually had a breast reduction and involuntarily burst into tears at the sheer relief. The operation subsequently transformed her life. Another classic case was where a middle-aged single woman with a large chest, who eventually had a reduction, confided to him that she had never married because of what she saw as a physical impediment to a lasting relationship. The psychological effects of breast surgery should not be overlooked: they are a major motivating factor.

They can be no less motivating in the case of women who have not been so well endowed, even to the extent of feeling uncomfortable undressing in front of partners or friends, and avoiding sporting environments. In these cases breast augmentation can increase self-confidence immeasurably, and abdominoplasty, performed on women who have lax stomachs through childbirth, will have similar psychological as well as physical benefits.

As in any surgery, however non-invasive, there are certain elements of risk and any reputable consultant or clinic will always be at pains to point them out to patients. That said, cosmetic surgery is now almost the norm for those who can afford it and certainly a boon for patients for whom the NHS is no longer an option, with lasting psychological benefits that should not be overlooked.


For more information call the Nuffield Clinic on (01752 775861.


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