Plastic surgeons exposed

The advertisements for cosmetic surgery in glossy magazines are undeniably seductive - the clinics appear high-class, the pictures show women with fabulous figures and then there's the lure of "easy-term"' payments. Yet how many of the thousands of patients who go under the knife in London each year - especially impressionable young women - find themselves convinced by a surgeon that they should spend a fortune on a procedure they don't really need?

London is the cosmetic surgery capital of Europe, and a Harley Street address may lead you to believe you will be visiting the top experts. Yet the truth is that private plastic surgery is an unregulated minefield and you may end up with a surgeon more interested in your bank account than your wellbeing.

Only last week, the Chief Medical Officer Sir Liam Donaldson made it clear he wanted a nationwide review after a survey showed that some clinics failed to make even basic checks on surgeons' qualifications and training, and that some clinics' safety procedures were woefully inadequate.

Sophie Harris is 22 and has an enviable size-10 figure. Although she sites her thighs as "a little chunky but muscular with hardly any fat", she adds: "It's not a problem and I'm quite happy to wear a bikini. I've never considered having liposuction."

But just how happy would surgeons be to subject her to surgery and take her money if she told them it was a niggling concern - and how confident would Sophie feel about the advice they gave her? We sent Sophie to four advertised clinics in Harley Street to find out. But first we asked one of London's premier cosmetic surgeons, Jan Stanek, for his view.

Mr Stanek says: "Liposuction to the inner thighs makes very little difference unless there are big lumps of fat and can cause problems as the skin is very thin in that area. If you remove the 'support' you can accelerate the ageing process as skin becomes less elastic and is likely to sag.

"If the thighs are strong and muscular there is little one can do - liposuction only works well if you have 'saddlebags' of fat on the outer thighs and on the backs of them. Some clinics prey on people's insecurities, and I hope Sophie is told to save her money and concentrate on specific exercises to tone her legs - that's the only advice I would give her.''

Rubican Medical Limited

Consultation: around 10 minutes.

Verdict: would not make a great difference but liposuction to inner thighs would give a better shape.

Cost: around £2,500.

I saw Mr Khan at the posh London Welbeck Hospital, off Harley Street. He kept me waiting an hour but when I finally saw him he was friendly and businesslike but clearly in a hurry. He scribbled down the briefest of details about my medical history and then asked me to show him my legs. It took only a few minutes with me turning round and him pinching a few areas for him to assess my 'problem'. He said that the outside of my thighs were muscular - and thus shouldn't be treated - but that there were some small fat pockets on the inside which could be treated.

He wasn't giving me a hard sell and told me that I should be realistic about the result which would not make an enormous difference but would give my legs a better shape. However, he did not try to talk me out of it and did not question whether I exercised or suggest that I try this to firm up the fat first.

We discussed the procedure which he ran through so quickly that I felt confused. He drew a quick diagram of my thighs but did not offer to show me any before and after photographs of other patients. He looked rushed and said: "If you have any questions either call me or come to see me again free of charge."

I was charged a £50 consultation fee. Because he had not taken a thorough medical history and had rushed through the procedure I did not have confidence in him. I felt that he was quick to say he could help me and therefore keen to take my money for a procedure that he admitted would make little difference.

Nulife

Consultation: five minutes.

Verdict: do some exercise.

Cost: nothing.

Surgeon Mr Paulo Cajano took one look at my legs and said: "Liposuction wouldn't work well enough to make it worth your while." He added: "A good surgeon should know when not to operate but be careful because there are those who will do it. Off you go, try a bit more exercise - your legs are fine."

Kensington House for Cosmetic Surgery

Consultation: Around 30 minutes.

Verdict: small areas on the outer and inner thighs and round my knees could be treated.

Cost: about £3,000.

Winston Shaer was unable to see me at Kensington House's Harley Street rooms, so I made the trip to his lovely house in Hampstead where he also consults.

Going through my medical history took a good half-hour - he was friendly and very thorough and asked me about my diet and whether I exercised (although not how much I did).

He talked to me in a fatherly way, ticking me off for smoking and discouraging me from eating too much red meat. We talked about the procedure very thoroughly, risks and the fact that he would try to put me off having this done if he didn't feel it necessary.

Mr Shaer did not mention anything about muscles but then drew marks on small areas of my legs which he said were the "most realistic" to treat; inner and outer thighs and around my knees. No one else had mentioned my knees.

I felt very comfortable with Mr Shaer - he even gave me a copy of his notes to take home. He told me to go away and think about it. However, contrary to what I had expected from his earlier comment, I did not get the impression that he was actually trying to put me off.

At the end of the day, I felt that he could have suggested I try harder with exercise, and that at my age I might have something better to spend my money on than surgery.

The Cosmetic Surgery Clinic

Consultation: around 30 minutes.

Verdict: areas on outer and inner thighs could be targeted.

Cost: £2,800.

Alan Kingdon was friendly and professional with up-market rooms. He looked at the thorough medical form I had filled in and asked me about my "problem", then took a look at my thighs. He didn't rush me but didn't take long to give his enthusiastic verdict - that two areas on the outer and inner thighs could be targeted. I was surprised he suggested the outer thigh areas as being suitable for liposuction as they were pretty muscly.

The benefits of exercise and diet were not addressed and although he did not rush me through the procedure, the details were brief with no risks or potential problems cited until I asked. But when he drew a detailed diagram showing me the result I could expect, I found myself becoming strangely interested. And when I left his office and the clinic manager Wendy showed me impressive before and after photographs of women of my age and size, I started wondering whether I could find the money to improve my thighs.

Despite the fact that I felt Mr Kingdon was too keen to say that I should have this procedure done, I was amazed that I was actually considering having an operation that I knew was completely unnecessary.