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REVISION SURGERY VS FURTHER (NEW) SURGERY – POLICY DEFINITION

Understanding Outcomes & Revision Eligibility

At Bella Vou, it is essential that patients clearly understand the distinction between a revision procedure and a further (new) procedure. These are not interchangeable, and they carry different clinical and financial implications.

Furthermore, while our Consultant Plastic Surgeons strive for the highest standards in surgical precision, aesthetic outcomes, and patient care, it’s important to understand that no surgical result can be guaranteed, and no outcome is ever "perfect”.

This policy exists to ensure transparency, fairness, and clarity, and to prevent misunderstandings arising from assumption, expectation, or retrospective reinterpretation of the agreed surgical plan.

1. Realistic Expectations

  • Perfect symmetry is not possible: All human bodies are naturally asymmetrical. Cosmetic surgery can improve balance and proportion but cannot create absolute symmetry.
  • All surgery leaves scars: Scarring is an unavoidable part of any surgical procedure. Our surgeons aim to minimise and conceal scars, but results vary depending on skin type, healing, and genetics.
  • Specific sizes and measurements are not guaranteed: Whether it’s a cup size, waist measurement, or facial contour, final results are influenced by your natural anatomy and how your body heals.
  • Results take time to settle: Swelling, firmness, and tissue position can take up to 12 months or more to fully stabilise.
  • Healing is individual: Scar formation, swelling, and tissue response differ from person to person and cannot be fully predicted.
  • Minor irregularities are normal: Slight differences or small contour irregularities are expected in surgical results and not considered surgical complications.

2. Definition of a Revision Procedure

A revision is a further surgical intervention that is clinically necessary to correct a problem directly arising from the original procedure, where:

  • the agreed surgical plan was appropriately performed,
  • accepted surgical standards were met,
  • appropriate post-operative care was followed, and
  • the outcome has not resulted in an clinically acceptable outcome as reasonably expected by the surgeon.

A revision relates only to correcting a complication or technical issue associated with the original surgery. It does not include enhancement, upgrading, or changing the aesthetic objective which the patient only following treatment express clearly to the surgeon.

3. Definition of a Further or New Procedure

A further (new) procedure is any surgery that:

  • adds to, alters, extends, or upgrades the original surgical plan,
  • introduces techniques, implants, grafting, or procedures not originally agreed, or
  • reflects a change in patient preference, anatomy, lifestyle, or expectations after surgery.

Further procedures are not revisions and are chargeable.

4. Outcome vs Expectation

A revision is not triggered by dissatisfaction alone.

A procedure is not a revision simply because:

  • a patient hoped for a different result,
  • expectations evolved after surgery,
  • a result did not align with an unspoken assumption,
  • personal taste, fashion, or self-perception changed over time.

Bella Vou surgeons operate strictly within the documented and consented surgical plan, which is defined collectively by:

  • the consultation discussions and clinical examination,
  • the agreed procedure description and consent documentation, and
  • the surgical markings applied on the day of surgery, which visually and precisely reflect the surgeon’s understanding of the agreed procedure, informed by those consultations and discussions.

Surgical markings form a critical part of the operative plan. They provide a clear, contemporaneous visual confirmation of what is intended to be performed and are based on:

  • the patient’s anatomy as assessed on the day of surgery,
  • the outcomes discussed and agreed during consultation,
  • the clinical judgement of the surgeon within safe and appropriate limits.

Patients are given the opportunity to review and discuss these markings prior to surgery. Proceeding with surgery following marking confirms the patient’s understanding and acceptance of the operative plan as marked.

Retrospective beliefs about what should have been done—where they differ from the documented plan, the surgical markings, or the agreed scope of treatment—cannot redefine the original procedure or convert a change in preference into a revision.

5. Illustrative Examples (Non-Exhaustive)

The following examples are provided to aid understanding and are illustrative only.

Breast Surgery

    • A patient has a breast uplift (mastopexy) performed without implants as the patient confirmed implants were not desired. After surgery the patient expresses a wish for greater upper-pole fullness requiring implants. This would be a new procedure.
    • A Patient underwent a successful breast augmentation where implants were correctly placed and properly functional. After surgery the patient requests to change size, projection, or profile. This would be a new procedure.
    • A patient has a successful areola reduction with normal healing. Later the patient requests a revision due to tissue stretching or relaxation. This would be a new procedure.
    • A Patient has a fat transfer and later decides that they would additional fat grafted into an area that was not part of the original plan. This would be a new procedure

Body Contouring

    • A Patient has a liposuction procedure as agreed by the surgeon. The patient then requests additional liposuction or contouring due to dissatisfaction, despite appropriate initial treatment. This would be a new procedure.
    • A Patient has a standard tummy tuck as planned with the surgeon. The patient then requests a revision to a fleur-de-lis abdominoplasty, where this was not originally planned. This would be a new procedure.
    • A Patient has a successfully tummy tuck. The patient then requests a revision tummy tuck following pregnancy, weight gain, or weight loss after the original surgery. This would be a new procedure.

Intimate Surgery

    • A patient has a labiaplasty and the result heals as expected. The patient then requests a revision labiaplasty to achieve greater reduction or reshaping. This would be a new procedure.

Facial & Neck Surgery

    • A patient has an Ear pinning (otoplasty) surgery where the result heals as expected. The patient then requests a revision surgery for further repositioning to achieve a different aesthetic preference rather than to correct a complication. This would be a new procedure.
    • A patient has a facelift or a neck lift surgery where the result heals as expected. The patient then requests facial tightening due to ageing or tissue relaxation over time. This would be a new procedure.

6. Time, Ageing, and Physiological Change

Procedures arising from:

  • natural ageing,
  • pregnancy,
  • weight fluctuation,
  • hormonal or lifestyle changes,

are not revisions, as these factors are external to the original surgery and not attributable to surgical failure.

7. Clarifying Expectations and Shared Understanding

Cosmetic surgery outcomes depend not only on surgical technique, but on a shared and explicit understanding of the intended result.

Bella Vou makes every reasonable effort to explain what a procedure can and cannot achieve. However, patients are responsible for actively confirming that their expectations are clearly understood and aligned before proceeding.

Patients must not assume that surgeons will automatically interpret subjective terms such as “bigger,” “smaller,” “fuller,” “flatter,” “natural,” or “as much as possible” in the same way they personally do. These descriptions are inherently subjective and can be understood differently.

By way of illustration:

  • In breast surgery, patients must ensure they fully understand and accept what size, projection, and fullness can realistically be achieved by the agreed procedure. A later desire for more volume, upper-pole fullness, or a different look—where this requires implants or additional techniques—is not a revision.
  • In liposuction and body contouring, patients must understand that fat removal is selective and conservative, designed to improve contour rather than eliminate all fat or to debulk. Residual fat, asymmetry, and natural tissue behaviour are expected.
  • In fat grafting, patients must understand that volume retention is variable and cannot be guaranteed.

If there is any uncertainty, ambiguity, or assumption, the patient is expected to raise this and seek clarification before surgery. Proceeding without resolving such matters will be taken as confirmation that the patient understands and accepts the agreed surgical plan and its limitations.

A later realisation that the outcome differs from what a patient imagined, but not from what was agreed, does not constitute a surgical error, failure of care, or grounds for revision surgery.

8. Final Position

A revision is limited to correcting a problem with the original surgery.

Any procedure that:

  • enhances or upgrades the result,
  • changes size, volume, projection, or contour,
  • introduces new techniques or materials, or
  • addresses changes occurring after surgery,

will be classified as new surgery and will incur additional costs.

9. Requesting a Revision

To be considered for a revision procedure:

  • Requests must be made in writing within 6 months of the original surgery date
  • Clearly outline your concerns and areas of dissatisfaction and provide photographs to illustrate area of concern
  • You must attend a face-to-face consultation with your original surgeon
  • Before and after photographs will then be reviewed along with your medical notes from the consultations within a multi-disciplinary team held once per month to assess your medical needs and concerns.
  • Revision procedures will only be considered if your surgeon deems the request clinically appropriate
  • In cases of scar revision, a minimum of 12 months of healing time is required before re-intervention

Note: If you fail to attend your follow-up consultations or refuse proposed timings on more than one occasion, a revision may not be offered.

10. Revision Consultation Process 

Your surgeon will:

  • Assess whether your expectations are realistic
  • Determine if your healing is complete or ongoing
  • Evaluate whether your result is within the expected surgical outcome
  • Review your adherence to post-operative instructions
  • Discuss whether a revision is justified and what risks, limitations, or benefits it may involve

Surgeons are not obliged to offer revision if risks outweigh potential improvements; tissue quality is poor, or expectations cannot be reasonably met.

11. Fees for Revision Surgery 

  • Revision fees
    Up to 1 year after your original operation, where your operating surgeon agrees that further surgery is clinically appropriate and Bella Vou approves, corrective revision surgery (including theatre time, nursing care, and hospital costs) may be provided at no additional cost to you

12. Other Revision terms 

  • Non-Refundable Ancillary Costs
    Bella Vou does not reimburse travel, accommodation, or loss of earnings for the patient, a chaperone, or any accompanying individual related to revision surgery.
  • Lifestyle and Physiological Changes
    We cannot offer complimentary aftercare services or revision procedures in cases where changes in appearance are due to lifestyle factors such as weight fluctuation, pregnancy, illness, or natural ageing. These factors may affect the aesthetic outcome originally achieved by surgery.
  • Clinical Limits and Judgement
    If your surgeon determines that the outcome of your procedure falls within the accepted range of normal surgical results, no complimentary revision will be offered. You may still request further procedures, but these will be subject to standard charges
  • Changing Clinical Guidelines
    Bella Vou may update its clinical guidelines periodically. These updates may affect criteria for surgery and revision, including eligibility based on medical conditions, body mass index (BMI), medication usage, and mental health status. A planned or revision procedure may be declined if it no longer meets our clinical standards.
  • Revision Timing
    It may take up to 12 months post-surgery for your final result to stabilise. A formal assessment for revision will not be undertaken until this period has passed, unless urgent medical circumstances require earlier review.
  • Surgeon Responsibility
    The duty of care for all concerns relating to dissatisfaction with the results of your procedure rests solely with your original Consultant Plastic Surgeon. This includes the assessment of clinical outcomes and the determination of whether revision surgery or any other clinical resolution or any other contemporaneous resolution is appropriate. By proceeding with any treatment, you agree and acknowledge that any such arrangements are matters to be resolved between you and your independent surgeon and not by Bella Vou as the healthcare facility provider.

If any revision surgery or alternative resolution is agreed upon in response to concerns about the clinical care or outcome, such agreement is made directly between the patient and the original treating surgeon. Only the original operating surgeon is obligated to provide or arrange such care if deemed clinically appropriate. Other surgeons within Bella Vou are not required or expected to assume responsibility for patients they did not originally treat including providing care without cost.

Bella Vou, as a provider of surgical facilities and support services, is not responsible for negotiating or delivering resolution or corrective treatment arising from dissatisfaction with the clinical care or outcomes provided by your independent surgeon.

  • Alternative Surgeon Review
    If your original operating surgeon becomes unavailable through retirement, migration or relocation, Bella Vou may offer you at it’s sole discretion, another of it’s ‘in clinic’ surgeons for a second opinion review. This surgeon is not obliged to operate but will provide a second opinion  Bella Vou will not meet the cost of any external specialist that you may wish to see. Geographic Relocation
    If you move to another region, you are responsible for travelling to Bella Vou or your operating surgeon’s location for follow-up care. Bella Vou does not cover travel costs in such cases.
  • Travel to Available Locations
    If your surgeon no longer consults from Bella Vou, you may be required to attend another site for further care. Associated travel costs are not reimbursable.
  • Investigations and Imaging
    If scans or other investigations (e.g., MRI, ultrasound) are required beyond 28 days of your original procedure, costs will not be covered by Bella Vou unless directly related to a known surgical complication.
  • External Revisions
    Bella Vou is not responsible for procedures or corrective surgery performed by any external provider unless pre-authorised by Bella Vou in writing.
  • Overnight Stay for Revision
    If your original procedure was performed as a day case and your revision requires an overnight stay, this additional cost is your responsibility unless stated otherwise in writing.
  • Implant Manufacturer Warranties
    Some implant manufacturers may offer additional coverage in the event of rupture or capsular contracture. Specific warranty documentation will be provided where applicable.
  • Capsular Contracture
    Up to 2 years from the date of surgery, revision will be approved (if clinically appropriate) where Baker Grade 3 or higher capsular contracture is diagnosed. Requests to change implant type or size during revision may incur additional fees.
  • Confirmed Implant Rupture
    If an implant rupture is confirmed by ultrasound or MRI within 2 years, revision surgery may be provided (subject to surgeon and Bella Vou approval). Patients should also review their implant manufacturer’s warranty.
  • External Implant Removal
    If implants are removed by another provider and found to be ruptured, Bella Vou is not liable for any resulting clinical or financial consequences. Patients should contact the implant manufacturer to explore their warranty entitlement.
  • Patient Limitations and Custodial Status
    Bella Vou is not responsible for providing or resuming aftercare in cases where a patient is unavailable due to imprisonment or residing outside the UK. Missed aftercare due to these reasons will not be recoverable.

COSTS NOT COVERED

  • Travel, hotel accommodation, time off work, or childcare
  • Personal expenses relating to recovery
  • Revisions performed outside Bella Vou (unless pre-approved)

SCHEDULING & TIMING FOR REVISION SURGERY

  • One surgery date will be offered after approval. If declined, a second option will be provided.
  • If you decline both dates, no further scheduling will be offered.
  • Excessive delays or non-medical deferrals may lead to withdrawal of revision eligibility.

Rescheduling Revision Surgery

  • At least 4 weeks' notice is required to reschedule
  • Last-minute rescheduling (under 4 weeks) for non-medical reasons will void the revision offer
  • Medical deferrals must be supported by a valid doctor’s letter or certificate

Procedures Not Considered Revisions

The following are considered new or elective surgeries and not eligible as part of the revision policy:

  • Further fat grafting not planned initially
  • Areola reduction due to stretching post-surgery
  • Capsular contracture or implant rupture
  • Implant exchange for size or profile preference
  • Additional liposuction or body contouring for dissatisfaction
  • Repeat tummy tucks post-pregnancy or weight gain
  • Converting a tummy tuck to a fleur-de-lis

Any procedure related to ageing, pregnancy, or weight fluctuation after surgery

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