Mr Ross has been hitting the headlines again with the news that one of his patients has gone on to a modelling career.
A glamorous grandma is about to start a career in modelling at the age of 64 after undergoing so much cosmetic surgery she was scouted by modelling agents. Barbara Lewis from Radcliffe, Greater Manchester, had a blepharoplasty, tummy tuck, and arm lift with leading plastic surgeon Dr Gary Ross.
Click here to read the full article.
Gary Ross recently became the first in the country to be officially endorsed to perform cosmetic surgery by the Royal College of Surgeons (RCS). You can read more about this on the National Health Executive website.
The RCS has previously been vocal in its opinions on regulating cosmetic surgery, as last month it backed a Private Members’ Bill that had been tabled to look into the issue. And today, Gary Ross, a plastic, reconstructive and aesthetic surgeon at the BMI Alexandra Hospital in Cheadle, has become the first to receive the new accreditation.
It is an honour to become the first cosmetic surgeon in the United Kingdom to certify in cosmetic surgery through the RCS. The certification process aims to provide a quality assurance for patients looking to undergo a cosmetic procedure. All surgeons should be encouraged to certify through the RCS and help to raise the professional standards.
The Royal College of Surgeons (RCS) has also published its own set of professional standards, specifically for cosmetic surgery and has launched the new certification for cosmetic surgeons.
Surgeons performing cosmetic surgery should be certified in the area in which they practise.
The operating surgeon should lead the consultation with the patient to outline the risks of the procedure, likely outcome and to provide the information that will help them decide whether or not to undergo surgery. The operating surgeon must also obtain written consent from a patient themselves – and not delegate it to a colleague.
Patients should be offered a cooling off period of at least two weeks before they consent to an operation to give them time to reflect on a decision.
Surgeons must make sure they have appropriate indemnity insurance to cover the procedures they are undertaking.
Surgeons should refrain from using financial inducements such as time-limited offers and discounts.
Stephen Cannon, Vice President of the RCS and Chair of the Cosmetic Surgery Interspecialty Committee, said:
‘Our professional standards for cosmetic surgery, coupled with the GMC’s new guidance, will raise the bar and make absolutely clear what we expect of all surgeons working in the private sector.
‘The message to surgeons and doctors working in the cosmetic surgery industry is simple: if you are not working to the surgical standards we have set out today, you should not be treating patients at all. We will do everything in our powers to protect patients and to stop unscrupulous individuals from practising.
As part of the new certification scheme the RCS will enable patients to more easily search for a surgeon who has the necessary skills and experience to perform the procedure they are considering.
Cosmetic surgeons will certify in areas of specialism that are within their scope of practice.
In certifying in these areas Mr Ross has demonstrated to the RCS his training, clinical / professional skills and experience meet the professional standards set by the RCS for a surgeon that performs cosmetic surgery.
Clicking on the links will open the videos in a new window.
Like the majority of silicone implants the implant shell is comprised of silicone and the shell can be either smooth or textured. However it is the inside of the implant where the new technology exists. Microsphere enhanced silicone gel replace the traditional silicone gel / saline. These borosilicate microspheres exhibit superior biological, mechanical, and chemical properties, such as
crush resistance, biocompatibility, inertness, and chemical resistance, making them a preferred biomaterial for demanding medical applications. Utilizing microspheres enables a substantial reduction of the implant’s weight, up to 30%, when compared with conventional silicone-filled implants of equal size. Simultaneously, their presence reduces the volume of gel required to fill the implant, further lowering its silicone content.
B Lite implants are 30% lighter to traditional breast implants and as such patients will not only weigh less for the same breast size but will have breast implants that are less likely to alter the breast and chest wall.
Gravitational weight can cause implants to bottom out and to drop down the chest wall and having a lighter implant may decrease this problem. This is an important consideration not only in breast augmentation but also in breast augmentation performed at the same time as a breast lift or mastopexy. Heavier implants have been linked to breast droop / ptosis and thinning of the breast skin / envelope with increased risk of breast atrophy and compromising tissue vascularity. Heavier implants are also thought to induce chest wall deformities due to the pressure effect on the chest wall directly and lighter implants are perceived to be less likely to cause this unfortunate complication. A lighter implant is a technological advancement.
As there is less silicone in the lightweight implants there is less chance of gel bleed over the life of the implant. Due to the patented microsphere-gel adhesion no separation and leakage is believed to occur in case of implant rupture. This is a major technological advancement.
It is believed that B-Lite gel is more transparent under mammography than normal silicone allowing more of the breast to be viewed – which will be of benefit to women especially those undergoing breast screening.
Finally it is perceived that a lot of postop pain and recovery is down to the pressure effect of the implants in the immediate postop phase. As the implants are 30% lighter this may also lead to a similar decrease in the amount of pain postoperatively. A reduction in pain postop can lead to earlier mobilisation and less down time from the procedure.
Please click here to read a peer reviewed article on B Lite implants and click here to view the B Lite breast implant catalogue.
To make a consultation with Mr Ross regarding B Lite implants please call 0161 401 4064.
This week iWantGreatCare announced the recipients of the iWGC Certificate of Excellence 2017. This award recognises excellence by those individuals and surgeries who have put patient experience at the centre of their care. By receiving regular reviews throughout the year and maintaining a high average score, they truly deserve to be acknowledged for this fantastic achievement.
The healthcare industry both in the UK and worldwide is changing and is embracing the role that patient feedback has to play in improving services for all. iWGC wants to enable all those who work in healthcare to easily collect real-time, continuous feedback. The Certificates of Excellence acknowledges those who are leading the way in patient care and experience and the publicly available reviews will allow others to see what 5 star care is.
By gathering patient feedback to improve their services, they not only receive constructive suggestions for improvement but also heart-warming comments, written by patients who took time out of their day to say thank you.
Patient reviews are a particularly good resource for patients wishing to undergo plastic surgery procedures, for those researching treatments and surgeons. Mr Ross is not only the most highly rated plastic surgeon in the UK but also the highest rated surgeon of any discipline in the UK.
It is a great honor that Mr. Gary Ross has been listed as one of only 500 doctors from around the world who has been awarded the prestigious Real Self 500 Award 2016!
Mr. Ross has been named in the real self top 500 for the last 3 years and is the only plastic surgeon in the UK to have achieved this accolade.
The Real Self 500 award is based on three criteria: the quantity and quality of patient reviews, engagement with the Real Self community via questions and answers, and the sharing of before and after treatment photos.
The full list of awarded doctors is available at https://www.realself.com/RS500
The Real Self 500 Award honors the top rated and most engaged board-certified aesthetic doctors who consistently demonstrated a commitment to patient education and positive patient outcomes throughout 2016. This elite group of doctors has excelled at sharing their expertise, free of charge, with tens of millions of Real Self community members actively searching for information and the right provider.
What is Real Self? It is the largest online destination to get informed about elective cosmetic procedures and to find the right doctor or clinic. More than 9 million people visit Real Self each month to find out which treatments and providers live up to their promise of being “Worth It.” Real Self is powered by unbiased experiences shared by consumers for hundreds of treatments, ranging from simple skincare to highly considered cosmetic surgery. Offering millions of photos and medical expert answers, Real Self has become the essential resource and service for those seeking to find the right doctor or clinic.
Tom Seery, Founder and CEO of RealSelf. “Our research shows that more than 95 percent of patients expect a practice to engage with them online. These doctors are leading the way in terms of their online engagement and focus on empowering patients with good information.”
Mr. Ross aim as a plastic surgeon is help patients to be empowered to make their own decision of whether plastic surgery is right for them. He always encourages those considering any treatment to invest a lot of time in research. This includes researching a range of surgeons and their professional background as well as the benefits and potential risks. By completing in depth research on a procedure and fully understanding aspects such as the recovery period, patients can make an informed decision. Real self is a valuable online resource for patients.
The MSc in Skin Ageing and Aesthetic Medicine at the University of Manchester is an intensive course that looks at all aspects of skin science and skin aging. Selection is competitive and the aim is to train future leaders in aesthetic practice by offering a high quality programme at an internationally recognized institution. A basic requirement is a medical or dental degree. Over three years only the best will succeed and will be able to apply these enhanced knowledge and skills in helping to empower patients.
MSc in Skin Ageing and Aesthetic Medicine is a patient focused course and you obtain a perspective in the whole field of aesthetics enabling you to deliver an unbiased overview and deliver evidence based care. So what that means for you as a patient by choosing a practitioner with an MSc in skin aging – you will be given the most appropriate treatment options for your aesthetic and cosmetic concerns.
MSc in Skin Ageing and Aesthetic Medicine is a programme taught by experts across all fields including dermatologists, plastic surgeons, oculoplastic surgeons, maxillo-facial surgeons, dentists and psychologists in addition to skin ageing and wound research basic scientists.
Looking youthful is a social requirement and is in increasing demand. Avoiding the pitfalls is essential. If you want the best quality look for a dedicated professional. When it comes to your face quality should be your priority.
Further details regarding the MSc in Skin Aging at the University of Manchester are available at:-
https://www.manchester.ac.uk/study/masters/courses/list/09805/msc-skin-ageing-and-aesthetic-medicine/course-details/
Did you know that fillers can cause blindness?
Has your cosmetic practitioner every heard of central retinal artery?
Have you heard of the use of hyalase in cosmetic medicine?
Do you know what a granulomatous reaction is?
The answer to these questions is likely to be no.
Further details regarding the MSc in Skin Ageing and Aesthetic Medicine at the University of Manchester are available at:- https://www.manchester.ac.uk/study/masters/courses/list/09805/msc-skin-ageing-and-aesthetic-medicine/course-details/
On the 6th July 2016 the French Regulator: ANSM issued a press release regarding cases of Anaplastic Large Cell Lymphoma that have been identified in France in women with breast implants1. Concerns have subsequently been widely reported in the media.
Mr Ross would like to reassure patients that breast implant related Anaplastic Large Cell Lymphoma (Bi – ALCL) remains a rare condition that has been identified in 250 patients worldwide, with to date 8 deaths reported. According to BAAPS it appears that there are at least 13 cases identified in the UK. It is estimated that 100 million women have had breast implant insertion worldwide. (Current estimated incidence 1:400,000 and mortality of 1:12,500,000.)
ALCL (anaplastic large cell lymphoma) is a rare type of non-Hodgkin lymphoma that was first reported in 19972. ALCL is diagnosed in approximately 1 in 500,000 women in the US annually, while ALCL involving the breast is even more rare (affecting ~3 in 100 million US women annually).3 ALCL is characterized by abnormal growth of large T-cells3 .These cells can appear in the skin, soft tissues, lymph nodes, bones, soft tissues, lungs, or liver, whereas cutaneous ALCL, limited to the skin, typically has a favorable prognosis.4-6
ALCL in women with breast implants generally presents as a late seroma (ie, developing at least 12 months after the most recent surgery)5-9 or palpable mass. Lymphoma cells are found in the seroma fluid or in the fibrous capsule rather than in the breast tissue.3 Like cutaneous ALCL, ALCL in women with breast implants generally has a favorable clinical course.5,11 In most cases, women presenting with seroma with or without severe capsular contracture have had positive outcomes after surgical removal of the implant.5,11 Some evidence, however, suggests that ALCL patients presenting with a mass have an increased risk of relapse or refractory disease.5 Complete surgical excision of lymphoma, implants, and the surrounding fibrous capsule is the optimal approach for the management of patients with BI-ALCL11.
In the US, the FDA tracks reports of ALCL in breast implant patients through the Manufacturer and User Facility Device Experience (MAUDE) database. This publicly-available system includes voluntary reports of adverse events from healthcare professionals and consumers (since 1993) and mandatory reports from manufacturers (since 1996), importers (since 1993) and user facilities (since 1991).10 ALCL cases occurring within the UK should be reported to the MHRA12.The relationship between implants and Bi-ALCL is also being investigated in France and Australia1, 13. The French medicines regulatory agency, which has given manufacturers until July 2017 to prove their products are safe or face having them banned.
Because the surgical findings associated with ALCL are extremely variable, clinical experts recommend that fresh seroma fluid and representative portions of the capsule be examined pathologically when ALCL is suspected.3,10
It is Mr Ross’s routine practice to send pathological specimens of the capsule for analysis in all cases of implant removal or implant based revisionary surgery. For patients with late onset seroma fluid is always sent for analysis and a total capsulectomy is recommended. This provides valuable reassurance to patients and all patients treated by Mr Ross for late onset seromas +/- mass have all been treated with total capsulectomy.
While tracking an ALCL case may be straightforward in women who have had only one breast implant, interpreting the case history becomes more difficult when patients have had multiple implants. One of the difficulties in determining causation is that many of those patients who have presented with breast implant related ALCL have had many different forms of implants at various time frames.
Although both smooth and textured devices have been reported10,14 it is believed that ALCL may be more common in textured implants and specifically in aggressively textured implants15. There is evidence emerging that subclinical infection may a contributing cause15.
When looking at the numbers of cases of ALCL it is important to compare this number against the worldwide numbers of implants per company and this requires prospective accurate data collection through an implant registry.
In Mr Ross’s practice all patients will receive the details of their implants and the implant details are recorded on the hospital registry. The UK is currently developing a breast and cosmetic implant registry that will allow identification of possible trends and complications relating to specific implants16.
Although Bi-ALCL is extremely rare it is important that patients understand that there is a risk currently being investigated worldwide. As part of the consent process all patients must be aware of the risk of Bi-ALCL17. Although Mr Ross has implanted thousands of breast implants he is not aware of any cases of ALCL in his practice. For all breast implant removal cases and implant revision cases Mr Ross always sends a sample of the capsule for pathological analysis. In the case of late onset seroma fluid is always sent for analysis patients and in this scenario patients undergoing implant removal / replacement have all been treated with total capsulectomy.
1. 14. Agence Nationale de Sécurité du Médicament et des Produits de Santé. https://ansm.sante.fr/S-informer/Actualite/Lymphome-Anaplasique-a-Grandes-Cellules-associe-aux-implants-mammaires-LAGC-AIM-Point-sur-les-investigations-en-cours-Point-d-Information Accessed July 11th 20162. Keech JA Jr, Creech BJ. Anaplastic T-cell lymphoma in proximity to a saline-filled breast implant. Plast Reconstr Surg. 1997;100:554–555.
3. US Food and Drug Administration. Anaplastic large cell lymphoma (ALCL) in women with breast implants: preliminary FDA findings and analyses. January 2011. Available at
https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm239996.htm. Accessed July 11th 2016
4. Stein H, Foss HD, Dürkop H, et al. CD30+ anaplastic large cell lymphoma: a review of its histopathologic, genetic, and clinical features. Blood. 2000;96:3681–3695.
5. Thompson PA, Prince HM. Breast implant-associated anaplastic large cell lymphoma: a systemic review of the literature and mini-meta analysis. Curr Hematol Malig Rep. 2013;8:196–210.
6. Ferreri AJM, Govi S, Pileri SA, Savage KJ. Anaplastic large cell lymphoma, ALK-negative. Crit Rev Oncol Hematol. 2013;85:206–215.
7. Spear SL, Rottman SJ, Glicksman C, Brown M, Al-Attar A. Late seromas after breast implants: theory and practice. Plast Reconstr Surg. 2012;130:423–435.
8. Brody GS. Brief recommendations for dealing with a new case of anaplastic large T-cell lymphoma. Plast Reconstr Surg. 2012;129:871e–872e.
9.Taylor CR, Siddiq IN, Brody GS. Anaplastic large cell lymphoma occurring in association with breast implants: review of pathologic and immunohistochemical features in 103 cases. Appl Immunohistochem Mol Morphol. 2013;21:13–20.
10. US Food and Drug Administration. MAUDE – Manufacturer and user facility device experience. https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm481899.htm Accessed July 11th 2016
11. Clemens MW, Medeiros LJ, Butler CE et al. Complete Surgical Excision Is Essential for the Management of Patients With Breast Implant-Associated Anaplastic Large-Cell Lymphoma. J Clin Oncol. 2016 Jan 10;34(2):160-8.
12. Medicines and Healthcare Products Regulatory Agency. Medical device alert. Available at https://www.gov.uk/drug-device-alerts/medical-device-alert-breast-implants-report-cases-of-anaplastic-large-cell-lymphoma-alcl Accessed July 11th 2016
13. Australian Government. Department of Health Therapeutic Goods Administration. https://www.tga.gov.au/committee-meeting-info/acsmd-meeting-statement-meeting-9-9-april-2015 Accessed July 11th 2016
14. Adams WP Jr. Discussion: Bacterial Biofilm Infection Detected in Breast Implant-Associated Anaplastic Large-Cell Lymphoma. Plast Reconstr Surg. 2016 Jun;137(6):1670-2.
15. Hu H, Johani K, Almatroudi A, Vickery K, Van Natta B, Kadin ME, Brody G, Clemens M, Cheah CY, Lade S, Joshi PA, Prince HM, Deva AK. Bacterial Biofilm Infection Detected in Breast Implant-Associated Anaplastic Large-Cell Lymphoma. Plast Reconstr Surg. 2016 Jun;137(6):1659-69.
16. Health and Social Care Information Centre https://www.hscic.gov.uk/bcir Accessed July 11th 2016
17. Clemens MW1, Miranda RN, Butler CE. Breast Implant Informed Consent Should Include the Risk of Anaplastic Large Cell Lymphoma. Plast Reconstr Surg. 2016 Apr;137(4):1117-22.
Gary Ross is one of 100 doctors to receive the prestigious RealSelf 100 Award, out of nearly 13,000 board certified specialists with a presence on RealSelf — the online community helping people make confident choices in elective cosmetic procedures.
The medical professionals that made the 2015 RealSelf 100 are recognised both for having an outstanding record of consumer feedback and for providing credible, valuable insights in response to consumer questions.
Mr Ross is the only UK based plastic surgeon to have gained Top 100 status and the only UK surgeon to have been named in the Top 100 for 2 years running.
For a full list of the top 100 please click below.
