what goes up must come down. Although the cliché is not generally applied to Victoria Beckham's assets, rumour has it that last year the Queen of WAGs allegedly went under the knife – not to make her breasts bigger or firmer, as is usually the case, but to make them smaller; closer, indeed, to how nature intended. Then there is Katie Price, aka Jordan, the poster girl for oversized breast implants. Last December, she flew to the US to have her 32FFs reduced to a rather more humdrum 32D. Courtney Love, meanwhile, has been completely upfront about her plans to go surgically back in time, so to speak. "I just want the mouth God gave me," she wrote on her blog. "It was perfectly cute."
There is nothing new about celebrities treating themselves as works in progress – their faces are their fortunes, botched or otherwise. But as plastic surgery increases at an alarming rate among us mere mortals (up 12.2 per cent from 2006 to 2007), surgeons have seen an upsurge in people going under the knife to repair damage caused by previous procedures. Somewhere along the line, this trend was dubbed "undo-plasty", and its prevalence has brought home what a complex and unpredictable business it is to have a nip and tuck.
When Georgina Graham booked herself in for some plastic surgery, all she wanted was a confidence boost after an altercation with a burglar had left a dent in her face. After much thought, she opted for a face-lift and – to repair the damage – for fat from her stomach to be injected into her cheek. Unfortunately, things did not go to plan. "The surgeon injected the fat too high in my face and it sat in a bag under my eye. I was left with really bad scars," she says. "I was pretty devastated."
In the end, the fifty-something Londoner chose not to have more invasive surgery ("I didn't want to go through all that again"), but undertook a course of injections with non-invasive specialist Dr Michael Prager. "He injected my face with something that dissolved the fat and then built the area back up." Unfortunately, Graham's scars are there to stay. And therein lies the truth about "undo-plasty" – there is often no such thing as "undoing" plastic surgery. There might be room for improvement, but there is no going back.
Plastic surgeon Alex Karidis believes the rise in "undo-plasties" has been misunderstood. "Plastic surgery has been on the increase over the past five years, so statistically you're going to have a higher proportion of people having problems," he points out. Having said that, Karidis concedes that "some patients' expectations are well off the radar... It's not an exact science, and people must realise their limitations."
Bristol-based surgeon Nigel Mercer has experience of this rising demand for repair work. "From infected breast implants to areas of skin that have died, in the past month alone we've had three patients admitted who had surgery done elsewhere for a variety of things," he says. Indeed, in November, the British Association of Aesthetic Plastic Surgeons (BAAPS), of which Mercer is president-elect, reported that a third of plastic surgeons had dealt with "much more" repair work in the past five years; in the past year alone, 14 per cent had seen nine or more patients requiring repairs after undergoing cheap overseas surgery. It's an issue that concerns Mercer. "I saw an advert recently for a clinic in Tunisia. You've never seen the surgeon, you've never seen the clinic and you don't know if the nursing staff speak English. You'd never go for a heart operation in a place like that, so why a face-lift?"
Despite BAAPS' concerns, Jane Wanniaratchy was pleased with her overseas repair work. The 42-year-old personal trainer flew to Prague last summer with Europa International to have her breast implants taken down a notch. Back in 2000, Wanniaratchy had a breast augmentation in the UK after breast-feeding had taken her cup size from a C to an A. "There was loads of empty skin," she says. "I just wanted the surgeon to fill it up, but when I woke up I was a size E. They were colossal." After seven years of being called "Jane Big Boobs", she booked herself in for a resize, and has never looked back.
Wanniaratchy admits that she was "a bit naïve" when she had her first operation. "The surgeon had done a few of my friends, but I wasn't really sure what I needed, so I just said 'Do what you think is best.' This time, I stuck to my guns." These days, she dishes out advice to women considering having breast implants: "It's good to speak to someone who knows what it actually entails."
With so many risks involved, it does seem, nevertheless, that people are ever-more ready to pay a heavy price – financially, emotionally and physically – to improve their appearance. "Like it or not, we live in a world where appearances are important," says Alex Karidis. As a result, the most pertinent issue for the industry to face is not one of ethics, but of standards. "It could be better regulated, there's no question about that," admits Karidis. "We need to tighten regulations – for the sake of the public."
A plastic surgeon's guide to getting it right
1. Make your own decisions The real expert on your appearance and your concerns is you. Do not let anyone else talk you into a procedure
2. Be informed Anyone considering any cosmetic procedure should ensure that they are fully informed and accept the limitations and risks –no surgeon or procedure is 100-per-cent risk-free
3. Be comfortable Make sure you feel comfortable with the surgeon and/or clinic you have chosen
4. Know your surgeon Many practitioners boast impressive sounding qualifications, but these can have little meaning. BAAPS can help you find an accredited surgeon in your area
5. Get the timing right Avoid surgery if you have recently experienced major life events, such as changing jobs, losing a loved one or the break-up of a relationship
6. Beware of 'free' consultations Avoid booking fees or non-refundable deposits. No reputable surgeon would normally impose any penalty for cancellations
7.Consider the location Do not travel a long distance for any surgery unless you are comfortable with follow-up arrangements and the management of complications which might arise
8. Talk to your GP Your doctor has no interest other than your welfare, so many GPs will be perfectly happy to independently advise patients
9. You can always change your mind Everything should be to your satisfaction and you have the option to cancel right up until the time you go to sleep for surgery
10. Take your time Undergoing any kind of surgery is a serious commitment, so make sure that the benefits outweigh the risks
Nigel Mercer is BAAPS' president-elect and a consultant plastic surgeon