Aesthetic and reconstructive plastic surgery, like various other medical specialist treatments and operations, slowed down – or depending on urgency – stopped altogether when the COVID-19 pandemic was at its’ height.

In part two of this double article, prominent consultant plastic and reconstructive surgeon, Mr Kelvin Ramsey, discussed the changes to plastic surgery procedures during the pandemic and what happens if patients experience COVID symptoms close to their operation date.

How has the process of surgery changed during COVID?

The pandemic has changed the health service, both the private and the NHS sectors, permanently, I would suggest. Not only are patients consulted about the risks from the virus pre-operatively, but also the patient pathway in the hospital setting includes appropriate PPE measures to ensure the safety of the patients and the staff. They are routine measures now.

Unless coronavirus completely disappears, I think these measures are going to be with us for many years to come. Essentially from a patient point of view, we will lead them through every step of the way so they don’t need to worry about remembering anything. They will be guided throughout the process and they should be reassured that they should be no more likely to be exposed to coronavirus within a hospital environment than they will walking down the street with the measures that have been put into place.

Will I be able to have surgery if I have symptoms of COVID-19 around the time of my procedure?

This is a very important question. The early data that came out of China in Spring 2020, and then further data that came from the entire international surgical community in the early stages of the pandemic did show, that if you have coronavirus at the time of an operation, this is dangerous. You were likely to get much worse symptoms from coronavirus if you were recovering from an operation, because your immune system is slightly impaired.

Therefore, we take many precautions to make sure that patients are isolated pre-operatively. At the moment, in the vast majority of hospitals this is between three days and a week. And there are testing procedures to ensure that you don’t have coronavirus when you come into hospital for your surgery.

There are a number of questionnaires that patients are asked to complete to ensure they don’t have any symptoms at the time of their surgery, just to make sure we don’t let anyone slip through the gaps and expose a patient to an operation when they have the virus.

A further follow-on question is, ‘If I have COVID, and I’m testing positive but I’m asymptomatic, can I still have the operation?’, I’m afraid the answer is no, because you may be asymptomatic at present but once you’re in the postoperative period you may become symptomatic and more unwell.

Another consideration from that, is ‘How long do I have to wait, if I’ve got COVID, for my next surgery.’ And in my practice, the answer to that question is at least seven weeks. This is because we know that, from the long-term data, you will have fully recovered. Also, you aren’t as likely to have an adverse outcome from your surgery especially if you’ve waited seven weeks from the resolution of your symptoms and have a negative test result. Of course if the surgery is more urgent and cannot be delayed by such a period, then an individual patient tailored decision is made.

To discuss your options at this time further, call 020 3764 0399 to arrange a consultation with Mr Kelvin Ramsey.

Alongside his plastic and reconstructive work at the Royal Marsden, Mr Kelvin Ramsey has been helping out in the hospital’s vaccine clinic in his spare time, to ensure that as many of our patients and staff are offered a vaccine as soon as possible.

Cancer patients, specifically those receiving active treatment in the form of chemotherapy, immunotherapy or bone marrow transplant, have been categorised since the start of the pandemic as extremely vulnerable. These cancer treatments can lower normal immunity, and this can be a problem with administering certain types of vaccines, known as ‘live’ vaccines. The COVID vaccines that are currently available are not live vaccines and have all been deemed safe for cancer patients.

As a frontline healthcare working, Mr Ramsey received his first COVID-19 vaccine at the end of December. He strongly encourages his patients to take up the offer of vaccination when offered. For more advice, call 020 3764 0399 to arrange a consultation with Mr Ramsey.

Mr Kelvin Ramsey was delighted to appear in the Tatler Beauty and Cosmetic Surgery Guide 2019 in the category of UK’s best breast surgeon. Alongside five other plastic surgeons, Mr Ramsey was recommended for his meticulous breast reconstruction work, explaining to the publication his aim is to “put these ladies back to where they were before they had cancer, both physically and emotionally”.

His experience in breast reconstruction and background in microsurgery also informs his cosmetic breast surgery work and he advocates “a gentle, natural-looking augmentation”.

On Monday, BBC Panorama’s programme focused on medical implants, after working with the International Consortium of Investigative Journalists and a large number of media organisations around the world including the British Medical Journal, who had highlighted what they feel to be regulatory deficiencies in bringing medical implants to the healthcare sector and their subsequent surveillance in patients.

In light of this programme, the British Association of Aesthetic Plastic Surgeons (BAAPS), of which I’m a member, has released a statement focusing on breast implant safety and giving advice to any previous or prospective patients: “As a result of the media attention regarding medical devices, many of our patients will be understandably concerned and we publish a statement by our partners, the International Collaboration of Breast Registry Activities (ICOBRA), to clarify some questions around the safety of breast implants.”

Please click here to read the full BAAPS statement on breast implant safety.

Breast cancer‐related lymphoedema (BCRL) presents a significant healthcare burden and adversely affects the quality of life of breast cancer survivors. Mr Kelvin Ramsey has just had his series of lymphaticovenous anastomosis surgery for breast cancer-related lymphedema published in the British Journal of Surgery.

This is the first UK series of this type of technique and is paving the way to a randomised controlled trial which will start in 2019.