Cosmetic surgery that leaves a scar: If a nose-job goes wrong, what can you do about it asks Esther Oxford

SUE MACY had her back to her boyfriend when he came in the door. She was cocking her face at the mirror, examining her rhinoplasty. When she turned round he stared. Then he sat. Then he laid his forehead on the table and sobbed.

Since that moment Ms Macy, 39, has spent pounds 15,000 trying to re-build her nose. It had been scooped out. She has had five 'corrective' nose-jobs since that first operation. Four were disastrous.

Ms Macy now knows that she is not the only one to have been disfigured by the same surgeon. She has spoken to five others in the same area. One woman has not been out in daylight for six years. None has sued. Why not? 'I was too humiliated. I just wanted my nose put right,' Ms Macy said.

Every year 40,000 people in Britain decide to have some sort of cosmetic surgery. In this 'stinking, deceitful industry', the results are a lottery, said John Terry, 49, who has worked in the cosmetic surgery industry for 16 years.

Many of the 'botches' occur from lack of training. Of the 200 practising cosmetic surgeons in Britain, approximately 50 have had no formal training in plastic surgery, according to the British Association of Cosmetic Surgeons. Other 'mistakes' are due to time-tabling: some surgeons are expected to do a dozen operations within a 15-hour working day.

But ask a surgeon why so many patients request revisions and most will put it down to a 'break-down in communication'. There is nothing technically wrong with the surgery, they say. The results are just 'not as the patient hoped'.

The industry is self-regulatory. Most surgeons practising cosmetic surgery belong to one of two organisation: the British Association of Aesthetic Plastic Surgeons or its rival the British Association of Cosmetic Surgeons. The BAAPS was not returning calls last week. But the BACS says it has struck members off its register. Who are the blacklisted and what did they do? 'Confidential', was the reply.

The Medical Defence Union has a list of surgeons who have been successfully sued. Will they release it in the interests of the public? 'No. We represent the interests of our members,' said a spokesman. Although 'cosmetic surgeons' can remain members of the Royal College of Surgeons, the college is keen to dissociate itself from the profession. 'The title 'cosmetic surgeon' does not mean anything,' said a spokesman. 'We do not accept responsibility for their work.'

And the Department of Health? 'There are no guidelines on cosmetic surgery,' was the solemn reply.

John Terry set up his first cosmetic surgery clinic in 1978. He had become disillusioned with the hair transplant industry; the success rate was too low. By law surgeons are not permitted to advertise their services. Mr Terry took it upon himself to find 'the damned patients' for them. He also provided an operating theatre and after-care facilities.

In return up for arranging the set-up, clinic owners siphon off up to 80 per cent of the surgeon's operating fee. In present day terms that amounts to an average of pounds 2,000 per patient.

With between 30-40 clients a week the business was 'lucrative', Mr Terry admits. But there was a downside: the cost of the 'glossies'. 'If a clinic spends pounds 80,000 advertising, they have to do 40 nose-jobs to get their money back.' Salesmen were hired. They sold promises of Little Venus bodies. 'The women came in thinking we were God', Mr Terry complained.

As clinic manager it was Mr Terry's job to find the surgeons. But 'top drawer' surgeons willing to work in a clinic which advertises are hard to find. Instead poorly skilled surgeons with 'nowhere else to go' were taken on. For some procedures a GP was used.

'Lots of mistakes happened. We invested pounds 20,000 persuading one man to to train as a cosmetic surgeon. He nearly lost one patient. We had nipples sloughed off . . . or patients saying: 'I feel very numb here'. Yes, we'd think. The surgeon probably caught a facial nerve with the forceps.

'When we could correct the surgery we would. But most of the time we never saw our patients again.'

After seven years, Mr Terry decided he had had enough. He sold the company, moved, then set up another clinic: the National Hospital for Aesthetic Plastic Surgery in Bromsgrove, just outside Birmingham.

Today the clinic is surrounded by fields and sheep. It has a swimming pool, a sauna, and private bedrooms for 12 patients. Mr Terry is building a pounds 3m-wing to house more operating theatres and a further 40 patients. It will, says Mr Terry, be the biggest 'aesthetic' surgery hospital in the world by the time he has finished.

Mr Terry has four freelance surgeons who use his clinic. But his pride and joy is Paul Levick, a fully trained plastic surgeon. For his first four years of service Mr Levick was paid to spend much of his time correcting the work done by his predecessors. Up to 100 of Mr Terry's former clients had their surgery revised free of charge.

Mr Terry still offers the guarantee of free 'revision' surgery. But he knows that only the most assertive and trusting of patients will come back for a second operation. 'If a person comes out with one breast 30 per cent bigger than the other they don't want to show the damned world. They feel foolish and duped and they don't like the feeling. Most barricade themselves in a darkened room and stay there.'

A telephone call to the General Medical Council confirmed this. According to its most up-to-date records, 1,301 complaints were received from the public between September 1991 and August 1992. How many were from patients upset by their cosmetic surgery? 'I don't think we've had a complaint to do with poor surgical procedures,' the spokesman said.

Sue Macy (not her real name) was not treated at Mr Terry's clinic. But she was one of those who 'barricaded themselves in a room' It was a year before her surgeon agreed to do her nose again. During those 12 months her relationship collapsed ('I got short tempered, I was crying all the time, I couldn't bear to have him near me'), she became an alcoholic ('I would drink a bottle of Martini a night') and she tried to commit suicide.

When the surgeon finally agreed to operate again, it was to build up the nose he had sliced out. He put a bridge in it. It collapsed after six weeks.

Sue thought she was going mad. She found another surgeon. The implant he put in lasted 10 weeks. The fourth operation was equally unsuccessful and unpleasant: her surgery was done in a private North London clinic under 'twilight anaesthetic' by mistake; she was aware of every needle, every cut. When she came round from the anaesthetic there was no bed for her. She was sent home that night.

After the fifth operation, Sue was desperate. Her nose was so infected that the implant was bursting out of it. She called an independent network for women and men considering cosmetic surgery and was referred to Edward Latimer- Sayer, a cosmetic surgeon. He put her on antibiotics then operated six weeks later. The rhinoplasty was a success. After five years, six nose-jobs and pounds 15,000, Sue Macy had the nose she wanted.

Edward Latimer-Sayer, who works at the Belvedere clinic, Abbeywood, is one of an estimated 50 surgeons in Britain who practise cosmetic surgery with no specialist plastic surgical training. A member of the Royal College of Surgeons, he spent four years as a general surgeon before leaving the NHS to become a private cosmetic surgeon in 1978. He learnt the trade by 'seeing a few operations' and having someone stand over him for 'a few more'.

'You don't need any specific training to become a cosmetic surgeon. You just need aesthetic sense, enough technique to do what needs doing, and the communication skills to find out what the patient wants', he said. He has been sued successfully four times, although he denied negligence.

At present Mr Latimer-Sayer is secretary to the British Association of Cosmetic Surgeons. He believes the 20 members - all of whom are qualified surgeons in 'various' specialities - are better equipped to do cosmetic surgery than formally trained plastic surgeons.

'I do four face-lifts a week', he said. 'Plastic surgeons are lucky if they do 12 a year.'

His big worry is a pool of about 30 cosmetic surgeons who have no training in plastic surgery and whose work is so poor that they have not been permitted to join the BACS.

'We don't like the results of their efforts. They don't do proper counselling with their patients and they won't train,' Mr Latimer-Sayers said shortly. 'They work in sleazy clinics.'

Asked what a 'sleazy' clinic was, he replied: 'They are usually non-purpose built. Many are only licensed for day- care surgery. The hygiene is usually appalling: dirt, blood, dirty swabs everywhere. Surgeons who work in such places would not get admitting rights anywhere else.'

(Photograph omitted)

Sport
Brazilian fans watch the match for third place between Brazil and Netherlands
world cup 2014Brazil 0 Netherlands 3: Dutch pile on the misery in third place playoff
Sport
Robin van Persie hands his third-place medal to a supporter
Van Persie gives bronze medal to eccentric fan moments after being handed it by Blatter
News
Ian Thorpe had Rio 2016 in his sights
people
Life and Style
Swimsuit, £245, by Agent Provocateur
fashion

Diving in at the deep end is no excuse for shirking the style stakes

PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
News
ebookA unique anthology of reporting and analysis of a crucial period of history
News
scienceScientists have developed a material so dark you can't see it...
News
Monkey business: Serkis is the king of the non-human character performance
peopleFirst Gollum, then King Kong - now the actor is swinging through trees in Dawn of the Planet of the Apes
Arts and Entertainment
Blackman: Landscape of children’s literature does not reflect the cultural diversity of young people
booksMalorie Blackman appeals for a better ethnic mix of authors and characters and the illustrator Quentin Blake comes to the rescue
Voices
Mrs Brown's Boy: D'Movie has been a huge commercial success
voicesWhen it comes to national stereotyping, the Irish know it can pay to play up to outsiders' expectations, says DJ Taylor
Arts and Entertainment
Curtain calls: Madani Younis
theatreMadani Younis wants the neighbourhood to follow his work as closely as his audiences do
Life and Style
Douglas McMaster says the food industry is ‘traumatised’
food + drinkSilo in Brighton will have just six staple dishes on the menu every day, including one meat option, one fish, one vegan, and one 'wild card'
Life and Style
Once a month, waistline watcher Suran steps into a 3D body scanner that maps his body shape and records measurements with pinpoint accuracy
techFrom heart rates to happiness, there is little this fast-growing, self-tracking community won't monitor
Sport
Mario Balotelli, Divock Origi, Loic Remy, Wilfried Bony and Karim Benzema
transfersBony, Benzema and the other transfer targets
News
Soft power: Matthew Barzun
peopleThe US Ambassador to London, Matthew Barzun, holds 'jeans and beer' gigs at his official residence. He says it's all part of the job
Sport
Joe Root and James Anderson celebrate their record-beaking partnership
cricketEngland's last-wicket stand against India rewrites the history books
News
Gavin Maxwell in Sandaig with one of his pet otters
peopleWas the otter man the wildlife champion he appeared to be?
News
Rowsell says: 'Wearing wigs is a way of looking normal. I pick a style and colour and stick to it because I don't want to keep wearing different styles'
peopleThe World Champion cyclist Joanna Rowsell on breaking her collarbone, shattering her teeth - and dealing with alopecia
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Information Security Manager (ISO 27001, Accreditation, ITIL)

£70000 per annum: Harrington Starr: Information Security Manager (ISO 27001, A...

C# Developer (HTML5, JavaScript, ASP.NET, Mathematics, Entity)

£30000 - £45000 per annum + Benefits + Bonus: Harrington Starr: C# Developer (...

C# Integration Developer (.NET, Tibco EMS, SQL 2008/2012, XML)

£60000 - £80000 per annum + Benefits + Bonus: Harrington Starr: C# Integration...

Biztalk - outstanding opportunity

£75000 - £85000 per annum + ex bens: Deerfoot IT Resources Limited: Biztalk Te...

Day In a Page

Iraq crisis: How Saudi Arabia helped Isis take over the north of the country

How Saudi Arabia helped Isis take over northern Iraq

A speech by an ex-MI6 boss hints at a plan going back over a decade. In some areas, being Shia is akin to being a Jew in Nazi Germany, says Patrick Cockburn
The evolution of Andy Serkis: First Gollum, then King Kong - now the actor is swinging through the trees in Dawn of the Planet of the Apes

The evolution of Andy Serkis

First Gollum, then King Kong - now the actor is swinging through the trees in Dawn of the Planet of the Apes
You thought 'Benefits Street' was controversial: Follow-up documentary 'Immigrant Street' has got locals worried

You thought 'Benefits Street' was controversial...

Follow-up documentary 'Immigrant Street' has got locals worried
Refugee children from Central America let down by Washington's high ideals

Refugee children let down by Washington's high ideals

Democrats and Republicans refuse to set aside their differences to cope with the influx of desperate Central Americas, says Rupert Cornwell
Children's books are too white, says Laureate

Children's books are too white, says Laureate

Malorie Blackman appeals for a better ethnic mix of authors and characters and the illustrator Quentin Blake comes to the rescue
Blackest is the new black: Scientists have developed a material so dark that you can't see it...

Blackest is the new black

Scientists have developed a material so dark that you can't see it...
Matthew Barzun: America's diplomatic dude

Matthew Barzun: America's diplomatic dude

The US Ambassador to London holds 'jeans and beer' gigs at his official residence – it's all part of the job, he tells Chris Green
Meet the Quantified Selfers: From heart rates to happiness, there is little this fast-growing, self-tracking community won't monitor

Meet the 'Quantified Selfers'

From heart rates to happiness, there is little this fast-growing, self-tracking community won't monitor
Madani Younis: Five-star reviews are just the opening act for British theatre's first non-white artistic director

Five-star reviews are just the opening act for British theatre's first non-white artistic director

Madani Younis wants the neighbourhood to follow his work as closely as his audiences do
Mrs Brown and her boys: are they having a laugh?

Mrs Brown and her boys: are they having a laugh?

When it comes to national stereotyping, the Irish – among others – know it can pay to play up to outsiders' expectations, says DJ Taylor
Gavin Maxwell's bitter legacy: Was the otter man the wildlife champion he appeared to be?

Otter man Gavin Maxwell's bitter legacy

The aristocrat's eccentric devotion to his pets inspired a generation. But our greatest living nature writer believes his legacy has been quite toxic
Joanna Rowsell: The World Champion cyclist on breaking her collarbone, shattering her teeth - and dealing with alopecia

Joanna Rowsell: 'I wear my wig to look normal'

The World Champion cyclist on breaking her collarbone, shattering her teeth - and dealing with alopecia
Bill Granger recipes: Our chef gives raw ingredients a lift with his quick marinades

Bill Granger's quick and delicious marinades

Our chef's marinades are great for weekend barbecuing, but are also a delicious way of injecting flavour into, and breaking the monotony of, weekday meals
Germany vs Argentina World Cup 2014 preview: Why Brazilians don't love their neighbours Argentina any more

Anyone but Argentina – why Brazilians don’t love their neighbours any more

The hosts will be supporting Germany in today's World Cup final, reports Alex Bellos
The Open 2014: Time again to ask that major question - can Lee Westwood win at last?

The Open 2014

Time again to ask that major question - can Lee Westwood win at last?