The Consultation

The consultation is perhaps the most significant step for anyone contemplating aesthetic or reconstructive surgery. With Jonathan Britto and Raj Ragoowansi, the consultation will be as individual as you are, and will take as long as necessary to give and receive as much information as needed to plan your care. We believe in an unpressured and relaxed exchange of information in understandable terms. We use photographs of our own cases, used with permission from our former and current patients to illustrate our advice and results. Our procedures are designed to achieve balance and harmony in the face, body and breast, for aesthetics or reconstruction, and where possible we will illustrate with examples that most closely resemble your own circumstances.

We will take a full medical and general health history from you, advising on your medications and the implications of smoking for your planned procedure. No facelift, breast rebalancing, or reconstructive procedure is the same, and we will advise the best option from a variety of techniques within each range of procedures.

We will listen, advise, and be realistic about what we can achieve. In pursuit of flawless results, we plan an optimal care plan and surgery, with comprehensive post-operative support, where patient care and safety are our top priorities.

By the end of the consultation we will have
- Understood your aims
- Assessed your health and formulated a plan
- Reached agreement over what can be achieved and with minimal risk

After the consultation you will receive a comprehensive letter of summary of the discussion, a written quote, information packs on all procedures discussed and will be able to decide on preferred date and hospital for your procedure. We will inform your GP as a professional courtesy only with your permission. We offer second consultations at no cost to discuss any questions which arise, and are happy to do this, as full understanding makes for confident and successful outcomes.

Photography

Aesthetic and reconstructive plastic surgery is a visual art, involving a honed appreciation of aesthetic form and physical function. We can best demonstrate this to you with photography, and we use plain photography, three dimensional image analysis, or more sophisticated scanning where necessary.

We pay great attention to photography for the analysis of results, distances, shadows and volumes, and this close quality control gives us the power to constantly refine our work – which is our practice philosophy and professional responsibility. We achieve comprehensive, harmonious rejuvenation without a ‘surgical look’, and have the results to prove it.

Confidently proceeding

Pre - Admission and Anaesthetic preparation

Depending upon your planned procedure and state of general health you will have a preadmission phone call or appointment at your hospital of choice where you will have a general health check which will raise any particular concerns for our Consultant Anaesthetists.

Day of Surgery

You will be greeted by the nursing staff who will be knowledgeable about your procedure and our practice. You will have a private ensuite room, in whichever of our central or regional practice hospitals you choose. All our hospitals uphold the highest quality standards of the UK Healthcare Commission.

You will be seen by Jonathan Britto or Raj Ragoowansi, and by one of our Consultant Anaesthetists, where any lingering questions will be answered. Final consents will be undertaken based upon information that has already been discussed in clinic, and surgical marking will be done.

You will be accompanied to theatre by your nominated nurse and will be greeted there by Mr Britto or Mr Ragoowansi and our Consultant Anaesthetist colleague, who will ensure smooth induction of anaesthesia or sedation as previously planned, and will be present to keep you safe throughout your surgery and to ensure a smooth recovery. Our team of anaesthetists are all UK NHS Consultants, with whom we regularly undertake both cosmetic and reconstructive plastic surgery. At the end of the operation you will wake up in the recovery room, and will transfer to your private room soon thereafter.

After your procedure

All our patients can be assured of our total commitment to their care throughout their recovery, included in the cost of their procedure. We will provide 24 hour administrative support (in emergency out of hours), and our clinical nurse specialist and the ward staff at your hospital base will field any initial clinical concerns, referring immediately to Jonathan Britto or Raj Ragoowansi when necessary. You will receive a call at 48 hours after your discharge from hospital to ensure that all is well, and will have a follow up appointment made to see your surgeon appropriately. Suture removal, where necessary, will be undertaken by one of our nursing team, usually in parallel with your surgeon’s clinic to be able to flag up any concerns which arise.

Routine outpatient follow up is arranged for as long as required and is included within the cost of your procedure. We want you to feel secure that your wellbeing remains our primary concern for as long as necessary before, during, and after your procedure.

Central London Practice

The Central London hub of our plastic surgery chambers is 101 Harley Street, in the centre of the one of the world’s premier medical districts. A discreet town house, established for multidisciplinary aesthetic care, 101 Harley Street provides a convivial and relaxed environment in which to discuss bespoke treatment plans, allow private examination, and see our portfolio of results across the aesthetic and reconstructive platform of our practice.

Jonathan Britto, Raj Ragoowansi and our associates consult at 101 Harley Street on a weekly basis and by private arrangement where necessary. All our consultations, by referral or following open enquiry are undertaken by Mr Britto and Mr Ragoowansi, whose individual and speciality interests within aesthetic and reconstructive plastic and hand surgery encompass a broad level of high quality service. All our consultations provide a ‘state of the art’ opinion, and we will advise holistically, on an individual and bespoke manner, against the background of your medical health and fitness. We do not ask you to see ‘cosmetic co-ordinators’ prior to a professional surgical consultation. Surgery in central London is undertaken at The Wellington Hospital, the Harley Street Clinic, and the London Bridge Hospital, as required.

Where necessary we will seek authoritative expertise from within our in - house team or associates from a wide range of other surgical, medical or supportive specialities; such as physiotherapy, orthopaedic surgery, plastic surgery nursing, or beauty therapy as required.

Regional Practices

Following enquiries from some of our clients we have successfully extended our service into several regional practice areas, to allow us to provide quality care close to home. To that end we consult and operate in Essex and Kent, and in are proud to have added to our referral base following an invited successful launch in Jersey and Guernsey. We continue to provide a service in Northern Ireland via our practice base in Belfast.

In each practice area our Practice Coordinator is on hand to field enquiries or provide clinical or administrative support on a local basis. Our Coordinators may see you to facilitate your care, and will improve rather than hinder your access to your surgeon as required.

We are located in Beckenham, Brentwood, Buckingham, Colchester, Redbridge, Sawbridgeworth and Stoke Mandeville. The map below indicates our many locations in the south of England and Channel Islands. In addition we consult in Jersey, Northern Ireland and the Middle East.

Aesthetic Surgery

Introduction

The defining principle of our approach to aesthetic surgery is to restore and refine balance to your shape and form. It is important to us to deliver change you can feel confident with. Our aim is to refresh and rejuvenate, by achieving a balance in the face and body that does not display the tell-tale signs of surgery.

We are frequently asked for combination procedures, such as abdominoplasty and breast rebalancing, or arm reduction and facelift. For such cases we design bespoke combination techniques to achieve lasting, comprehensive, and harmonious results, without a 'post -surgical' look

We believe in quality individual assessment and will pick the technique most suited to deliver the results you want against the background of your health and fitness. In consultation, we use photography and imaging to demonstrate our results that are relevant to you, and to plan your care. We provide full advice regarding both risks and benefits of all procedures, and we take professional responsibility to achieve quality outcomes. Our consultant anesthetists will provide the best techniques of sedation or anesthesia for maximum comfort and minimum downtime to complement the planned surgery. Our follow - up is complete, our commitment total, and our level of professional service is the pride of our team.

The Face

We take pride in a facial rejuvenation and recontouring service that combines the best of what surgical and non - surgical techniques can deliver. Our aim, as always, is to refresh and rejuvenate without the tell - tale signs of surgery. We often combine the best techniques of eyelid recontouring (eyelid tuck, blepharoplasty), face and neck lifts, and browlift to achieve an excellence of results that complement the adjacent aesthetic units of the brow, eyelids, face and neck.

Choosing from a range of strategies to suit the individual, we often combine non - surgical therapies, such as botox, chemical peels and fillers with contemporary surgical approaches. We seek to achieve a refreshed, harmonious, smooth contour with volume balance for smooth curves, minimal shadow, and symmetrical facial definition. Our strategies may address skeletal surgery such as in rhinoplasty (nasal reshaping), genioplasty (chin recontouring), or cheek augmentation; alone or in combination with soft tissue redefinition (such as 'volumetric' facelift).

Often, a component of this improvement may be in the quality of the skin itself, and in conjunction with our practice nurse, we will provide a comprehensive skin assessment and treatment programme. The balance of the face and hairstyle may be greatly influenced by the ear shape and position, and we provide a balanced ear setback and reshaping service. Many of our procedures may be done under general, local or twilight anesthesia, and our anaesthetic team is fully experienced in the best techniques for you, and your aesthetic aims.

For the Eyes
- Full range of eyelid reshaping
- Upper lid definition
- Outer corner uplift
- Lower lid eyebag removal
- Eyelid tucks
- Tear trough rejuvenation

For the Face
- Brow lifts
- Brow softening and feminisation
- A full range of facelifts
- Masklifts
- Miniface and jowl lifts
- Necklift
- Chin advancement and setback
- Cheek augmentation and implants
- Jaw masculinisation and feminization surgery
- Cheeklifts
- Brow and Orbital reshaping
- Facial liposuction, Fat transfer, and fat augmentation
- Lip augmentation
- Ear reshaping
- Ear setbacks

For the Nose
Full range of nasal reshaping
- Dorsal hump removal
- Tip defining surgery
- Nasal reconstruction Septoplasty for airway improvement

The Body Contour

Our body contour approach seeks to refine shape and provide muscle definition, often using a combination of open surgery and liposculpture with a tireless attention to detail. We are often consulted for combination procedures, such as breast rebalancing or augmentation with abdominoplasty, or mini – abdominoplasty, and thigh lift – liposuction combinations. Our approach to these bespoke surgeries is to deliver maximum effect for minimum discomfort and hidden scars. We use contemporary proven technologies, such as ultrasound guided liposculpture where required, and have assessed and incoporated newer technologies such as ‘SMART-lipo’, where they have a place.

All our body contour surgeries, including limb redefinition surgeries such as brachioplasty (arm reduction), and thigh lift, are planned meticulously, and undertaken with excellent anaesthetic support for maximum post operative comfort. We provide a programme of advice for postoperative recovery, and support garments to keep you comfortable and to sculpture postoperative swelling.

Procedures:

Stomach & Body
- Abdominoplasty (Tummy tucks) and mini-abdominoplasty
- Umbilicoplasty (Belly button reshaping)
- Liposuction – all body areas

Liposculpture
- Fat transfer, and fat augmentation
- Buttock lifts and augmentation
- Thigh lift

The Breast

In aesthetic surgery for the breast, be it for augmentation, reduction or breast uplift, we achieve a balanced symmetrical bust for a smooth feminine silhouette, sympathetic to your height, shoulder and waist.

We use only the highest quality breast implants, and offer a comprehensive breast follow up service. We will advise you on the breast implant to suit your aims, and body balance, and specifically on whether you are best served by an anatomical or pear - shaped implant or a round implant.

We demonstrate using image photography the best breast implant dimensions and size to suit you, and whether these should be placed under muscle, partially under muscle and breast, or breast alone.

We use minimal scar techniques, and our aim is a natural result. We offer a comprehensive breast health service, and enjoy using contemporary techniques of breast rebalancing for breast symmetrisation - of difficult breast asymmetry and conditions such as breast hypoplasia, tuberous or tubular breast and nipple asymmetries.

Procedures: The Breast
- Breast augmentation and reduction
- Breast uplift
- Breast asymmetry and symmetrisation
- Vertical scar breast rebalancing
- Tuberous breast remodelling
- Male breast reduction
- Nipple reduction, reshaping and reconstruction

Reconstructive Surgery

We provide a comprehensive service in reconstructive surgery. Our Plastic Surgery Directors, Jonathan Britto and Raj Ragoowansi, are acknowledged experts in their fields, and provide specialist opinions both within the UK National Health Service, and to private patients in the UK and overseas. We work in multidisciplinary teams where necessary, to achieve comprehensive total care, and we maintain good links with the major insurance companies for issues of complex reimbursement, to allow our patients to concentrate on recovery.

Facial Reconstruction

Our facial reconstruction programme involves the care of adults and children with facial asymmetries or defects following accidents, tumours, or birth anomalies. We routinely manage difficult skin cancers of the face and have wide expertise in specialized tumour removal and reconstruction of the eyelids, nose, ears, and face. Where necessary we use microsurgical techniques, and within our team can call upon a wide range of supportive specialists. Particular interests include the rehabilitation of facial nerve problems, facial palsy, and smile reconstruction. Our philosophy is for a total care to provide comfortable and functional results, with optimum aesthetic balance and hidden scars.

Hand Surgery & Limb Reconstruction

We provide a comprehensive hand, and upper and lower limb surgery service, with specialist physiotherapy backup and multidisciplinary operating where required. Within our hand team we manage all the common hand problems such as Dupuytren's contracture, carpal tunnel syndrome and other nerve compression syndromes, wrist pain, abnormalities of hand posture, the rheumatoid hand, and hand trauma. We receive referrals for a complex limb reconstruction service using microsurgical and perforator flap based reconstructions for soft, supple, and stable results.

Breast Reconstruction

Working with breast cancer surgeons, within the multidisciplinary environment including specialist breast nurses, we regularly undertake breast reconstruction, including partial and complex cases, using a wide range of contemporary techniques. Our breast reconstruction work is designed to suit the patient's health, fitness and lifestyle, aiming for rapid recovery and maximal quality aesthetic results.

Our Ethos

Jonathan Britto and Raj Ragoowansi are Consultant Plastic Surgeons with busy plastic surgery practices within major teaching hospitals of the National Health Service of the UK, treating patients with difficult clinical problems for cancer, birth asymmetries, and post - accident reconstruction. In addition we enjoy vibrant private aesthetic and reconstructive surgery practices as Directors of the 'Millimetre Perfect' team, at the London Chambers of Plastic & Cosmetic Surgery. Our aim, in all our roles, as doctors, surgeons, and teachers is to bring the highest quality of care to all our patients - in pursuit of flawless results.

We undertake to advise you on the best options for your care, be they surgical, non surgical, or combination approaches. We will be honest about the potential complications of each procedure we discuss, and your own specific risk factors where relevant. We will be honest about the balance of your expectation with the reality of anatomy and what our surgery can achieve! In the unfortunate event of a surgical complication, we will not 'wash our hands and disappear' but will take all possible steps to achieve the planned result. This is our professional ethos, and our personal pleasure to achieve the result you want.

Mr Jonathan A. Britto
BSc(Hons) MB MD FRCS FRCS(Plast)
Consultant Plastic Surgeon

Jonathan Britto graduated with First Class Honours from his Bachelor of Science degree and went on to complete his clinical studies and graduate in medicine from the University of London (Royal London Hospital) in 1990. He was awarded the ARC Prize in Rheumatology in this graduating year. He trained in basic surgery - in - general in London and Boston, USA, as a Clinical Fellow in Surgery to Harvard University. Higher training in general plastic surgery was undertaken in London, Essex, and Boston, USA, where skills in abdominal and breast contour surgery and general plastic surgical reconstruction were obtained. Further specialist training in aesthetic surgery, craniofacial surgery and the rehabilitation of facial palsy was achieved during extended international Fellowships in Toronto, Canada; and Paris, France. He is entered on the specialist register in plastic surgery of the General Medical Council (No. 3479993), and is a diplomate Fellow of the Royal College of Surgeons in plastic surgery.

Mr Britto is currently Consultant Plastic and Craniofacial surgeon at the St Andrew’s Centre for Plastic Surgery and Burns at Broomfield Hospital, Chelmsford, and the Craniofacial Centre at Great Ormond Street Hospital for Children in London. His practice at ‘GOS’ consists of the management of complex developmental craniofacial anomalies in children and adolescents. At St Andrew’s, he has established an adult craniofacial reconstruction service (for cancer & post –trauma care) where he uses a combination of aesthetic and microsurgical techniques. His particular additional interests are in the surgical rehabilitation of facial palsy, oculoplastic surgery for eyelid rebalancing and reconstruction, nasal reconstruction and rhinoplasty, and complex aesthetic surgery of the face.

Jonathan Britto maintains and enjoys a broad cosmetic surgery practice for bespoke breast augmentation, and breast reduction & rebalancing; as well as body contour work, including abdominoplasty, arm reduction and liposuction. He has a specialist practice in complex facial aesthetic surgery.

Jonathan Britto is a Syme Professor of the Royal College of Surgeons of Edinburgh and has been the recipient of various awards and grants, from the British Assocn of Plastic Surgeons, the Royal College of Surgeons of Edinburgh, and the Craniofacial Society of Great Britain. He has an MD in craniofacial development from the Institute of Child Health (London University), and has authored over 40 papers in various plastic and cosmetic surgical subjects. He has lectured by invitation nationally and internationally, organized and lectured on national courses for training surgeons, and written a surgical textbook and several plastic surgical book chapters.

Mr Raj H Ragoowansi
MB MSc FRCS(Plast)
Consultant Plastic, Aesthetic & Hand Surgeon

Raj Ragoowansi graduated in Medicine and Surgery from St Thomas’ Hospital Medical School, London with the final year elective spent at Harvard Medical School, Boston, USA. He was awarded the Smith & Nephew Surgical Prize for a dissertation on ‘Evolution of Sutures in Surgery’.

After completion of training in General Surgery and the Fellowship of the Royal College Of Surgeons of England (FRCS), higher training in Plastic and Reconstructive Surgery was undertaken in London, East Grinstead and Chelmsford. This involved specialist exposure in reconstructive surgery of the breast, face, hands and trunk. International fellowships in Hand and Wrist surgery were undertaken in USA, France and India. Formal Aesthetic Surgery training was acquired at the Royal College of Surgeons approved institutions; Wellington Hospital and King Edward VII Hospital, London.

Awarded several research and clinical grants from the British Association of Plastic Surgeons and British Society for Surgery of the Hand to study the molecular mechanisms and treatment of abnormal scar formation. He has authored over 25 papers in peer reviewed Plastic and Hand Surgery journals and has been invited to lecture on the Aesthetic Surgery faculty for the University of London.

In addition to providing a reconstructive surgery service in hands (trauma, nerve compression, rheumatoid arthritis) and breast (post mastectomy reconstruction, congenital asymmetry), specialist areas of interest include body contouring for patients after extreme weight loss, chest wall reconstruction following coronary artery bypass surgery and management of problem scars.

A ‘see and treat’ clinic for skin lesions is provided within a multi-disciplinary set-up.

Our Team

We are proud to lead a lively, small, and friendly team, which is personally committed to optimizing your experience with us. In the office, you will speak to Julie, Julie and Julia! For clinical queries, you may speak to Jayne, our clinical nurse specialist, whose 20 years of nursing experience in both aesthetic and reconstructive surgery can address all problems. Our local co-ordinator in Jersey, Susan, can facilitate most questions from the Channel Islands. Mark, our surgical associate in Northern Ireland and Eire is an expert in his own right in non - surgical aesthetics, and as a member of the Royal College of Surgeons, is well placed to field surgical queries which may arise. All our team know where and how to contact us directly, and will alert us to contact our patients directly and personally when required.

Contact Us

Central Chambers:
101 Harley Street, London W1G 7JQ

Regional Chambers:
4 Cherry Blossom Lane, Chelmsford Essex CM3 6JQ

Call Us on: 08700 41 88 04 or 01621 826 816

Fee Structure

We are committed to a transparent fee structure that will lay out clearly the surgical, anaesthetic and hospital fees for the planned procedures. Our fees reflect the complexity of the work required, and in most cases include any residual surgical work that may occasionally be secondarily required. If we recommend staged surgery (in more than one operation) to best or most safely achieve your aims, we will accommodate on fees.

For insurance based work, we retain good working relations with the health insurers to deal with the administration - whilst you concentrate upon speedy recovery.

Our policy is to offer you price - inclusive follow - up for as long as necessary and we maintain an 'open door' to see you as soon as possible upon request.

What's New

Millimetre Perfect Director, Jonathan Britto speaks at a new multidisciplinary forum at the Royal Society of Medicine.
- The Royal Society of Medicine recently hosted a one day symposium on the rapidly growing field of ‘Interventional Cosmetics’ with an international faculty of speakers. Jonathan Britto gave a concise lecture on ‘Facelift and Browlift’ summarizing his expertise in multi-planar facelifting and volumising facelifts, together with browlift techniques for the multidisciplinary audience, of general practitioners, surgeons, general dental practicioners and aesthetic physicians.

Teaching and Training the surgeons of the future……
- Raj Ragoowansi, Director of the Millimetre Perfect team at the London Chambers of Plastic and Cosmetic Surgery recently taught on the British Society of the Surgery of the Hand (BSSH) instructional course at the Royal College of Surgeons in London. The meeting was well attended and Raj’s lecture was delivered with his usual clarity and style.

The Royal College of Surgeons of London maintains a superb teaching and training environment, where Jonathan Britto lectures on applied anatomy courses of the head and neck for both aesthetic and reconstructive surgery applications

The British Association of Plastic, Reconstructive and Aesthetic Surgery (BAPRAS) continues to call upon the expertise of the Millimetre Perfect Directors, Jonathan Britto and Raj Ragoowansi.
- As one of only a handful of UK craniofacial surgeons with both adult and paediatric practices, Jonathan Britto delivered an hour lecture at the BAPRAS educational series meeting in Manchester on the state of the art of aesthetic craniofacial reconstruction, later taking questions and sharing the podium with Ian Jackson of the USA, one of the ‘founding fathers’ of the speciality.

Ar a similar meeting which he organized on behalf of BAPRAS in 2007, Jonathan Britto lectured on facial palsy surgery, and hosted a field of invited speakers on various subjects in head and neck cancer surgery.

The British Association of Aesthetic Plastic Surgery (BAAPS)
- The summer meeting in Chester was well attended this year, with an excellent array of speakers from the US and UK. The Directors of the Millimetre Perfect team were represented by Raj Ragoowansi who evaluated the various novel technical strategies on show for the Millimetre Perfect team.

Members

MillimetrePerfect members have access to a wide range of the interesting details, and 'tips and tricks' on each procedure, including preparation for procedures, technical notes of interest, recovery anecdotes and tips for a trouble free return to normal life and work.

There are also links to Jonathan Britto and Raj Ragoowansi's views on new technologies and treatments in aesthetic and reconstructive surgery, plus news on MillimetrePerfect forthcoming events.