Where precision and compassion meet…
The Jonathan Britto philosophy of combining precision, craft, and patient-centred care, is woven through the entire client experience. From consultation to recovery, you can expect to feel relaxed, fully informed and confident of a positive outcome. We are delighted when we build long-term relationships with our patients and their friends and family, providing comprehensive and holistic care for confidence and healthy longevity, from inside-to-out and from outside-to-in!
You may have found us by the referral of a professional colleague, a friend who has had treatment with our team, or through myriad routes online. Your journey begins with your first contact with our office and our welcoming, knowledgeable, secretarial team . Whatever your interest, we will want to get to know you, your expectations and your views, so that we can build the trust to know whether we will be a ‘good fit’ to meet your aims and provide your care.
The journey begins with the “analysis phase” which is your opportunity to get to know us and our opportunity to welcome you, inform you, and understand what you want to achieve. There will be information that you want from us and information that we need from you, and the more complete and comprehensive this is the better the results will be. In short, we want to build trust so that we can be open with each other about the various aims and indications for your request, the alternatives we can propose so that you can compare the various risks and responsibilities, the recovery phase and the expectations of the results
The “Analysis Phase”
The analysis phase is a series of two or three pre-procedure consultations. The first, if you wish, is a complimentary remote video conversation with Jonathan so that you can “get onto the same page” as you lay out your thoughts about what you want to achieve, before you commit to coming to see us.
If you would like to receive a detailed written analysis, with a quote for treatment, Jonathan will meet you in the clinic for a face-to-face consultation. You are welcome to bring a friend or family member for support. The medical history and physical analysis in the privacy of the consulting room is an essential part of making the treatment plan. After this meeting you will receive a detailed plan and a written quote, together with a suite of information about our ‘twilight’ surgeries, relevant comments from prior patients, and some insights about the psychology and holistic care that is part of our commitment to you. The depth of experience within our team includes expert clinicians in the psychology of appearance change – and they are on hand for analysis and support both pre- and post-operatively.
As part of our holistic philosophy we will offer you a complimentary lifestyle medicine assessment – ‘Prepare and Repair’ – with advice for things you can effectively do to improve your pre-operative health and post-operative recovery.
If there are requirements for specialist scans, opinions from colleagues, or for blood tests and investigations, these will be arranged and the results reviewed by Jonathan and the team.
Before your procedure, and after you have read through the preparatory material at your leisure, Jonathan will invite you for a face-to-face or remote catch up… Jonathan recommends that you open a “procedure diary” on your phone, into which you can drop any questions that occur to you throughout your day. This conversation is to answer any questions you have, and to allow Jonathan to ask you about any reflections he has had to refine your care.
In truth, our door is always open, and Jonathan will be very happy to see you face-to-face or remotely if you have further questions about your requested procedure.
Procedures and Clinics
Our consulting suite is at 70 Harley Street and two locations in Essex. Day case procedures under “twilight” daycase conscious anaesthesia may be undertaken at our bespoke operating facilities in London, or Essex as required. All locations are have been specifically chosen for their high standards of private care, caring nursing, and state-of-the-art facilities.
Comprehensive post-procedure care is an important part of your experience, and like the procedure itself is tailored uniquely to you. Jonathan will have provided you with a comprehensive set of guidelines for your use at home, and a number that you can call at any time for a member of the team to respond. Clients have a variety of requirements to suit their own travel and work commitments and management of post–procedure care will be tailored to this as much as possible. Information relating to post-procedure care will be given prior to your procedure in straightforward step-by-step language. Jonathan and his team will advise you again and provide support during your time in the hospital or clinic. Regardless of procedure, all clients are advised to have a friend or family member with them for the first few days at home, and all follow-up appointments will be made for you before your procedure date.
Patient Reflection with Jonathan
The care was amazing. It was like being in a hotel bedroom with an ensuite. I was looked after very well by the nursing staff both before and after my operation. Mr Britto saw me before and after to make sure everything was going according to plan. I can honestly say that there was minimal pain and a little bruising, which you would expect. The swelling and bruising soon went and the affect was instant. My eyes and cheeks were amazing! What I noticed most was how open my eyes looked and how much better I could see. Mr Britto had taken before and after photos to highlight the difference.
My discharge after care was also excellent with many checks and consultations with Mr Britto and my face just improve more and more as time went by. The results are very natural looking and it has knocked years off of my face. In fact one young lady I know said that if she looked like me when she’s my age she would be over the moon! The whole experience has been very positive. I’m very grateful for the care and skill of a surgeon like Mr Britto.
Linda Alderson, November 2014
TWILIGHT DAYCASE ANAESTHESIA
Your surgery with ‘twilight anaesthesia’
“These days, and for the last five years, 95% of my ‘soft tissue’ facial surgery, and smaller other procedures are safely and comfortably done with the benefit of ‘twilight anaesthesia’. This means ‘conscious sedation’, where the patient is fully comfortable, without pain, and can undergo a surgical procedure with exquisite accuracy, a rapid recovery and minimal bruising and swelling. The technique has been developed with my colleague anaesthetists to allow me precise and responsive surgery in the animated face, for the best possible result. It has been a revolution in care and has wonderful feedback from my patients – for both the result and the experience!”
British Association of Aesthetic Plastic Surgeons
Online conference, October ’20
‘Twilight anaesthesia’ is an anaesthetic technique where a mild dose of intravenous sedation is offered to deliver relief of anxiety, a sense of sleepiness and relief of immediate short term memory. In combination with local anaesthetic at specialist points in the face, there is the ability to deliver precise surgery, without pain, and with gentle comfort and consciousness.
There is a ‘sedation continuum’ where the experience of the patient is in a ‘twilight state’, relaxed and sleepy but able to follow instructions in comfort. Some patients remember the instructions from our team during the surgery but have no memory of anything other than a gentle wake up. Most patients do not have a sense of the time that has passed, which is a very positive outcome.
Dr Paolo Barragia, and Dr Oliver Sykes, Consultant Anaesthetists
Appearance, Function, and Emotion
It is always a great pleasure when the planning and the procedure lead to a happy outcome and well-being of emotion. That is the best we can wish for for our patients. It is a mark of success and longevity in his surgical practice, that Jonathan’s results for his patients continue to receive their sustained support and consistently good reviews and testimonials.
Mind the Gap
Nonetheless, a gentle word of caution. All procedures that involve change of appearance carry great expectation for patients and families. This expectation can be overwhelming for all involved, particularly where there has been time taken to decide to proceed, or where finances have taken time to get together, or where there has been previous disappointment.
Good “analytics” and good care will narrow the ‘expectation gap’, but it is never completely closed. Such procedures take us from where we are – closer towards where we wish to be. The better the trust and communication between surgeon and patient, the more likely the ‘expectation gap’ will be closed.
Jonathan has been in practice for long enough to recognise that human patient expectation changes throughout the planning and recovery from all restorative, reconstructive and plastic surgical procedures. We know that this itself can open up the ‘expectation gap’.
It is therefore very important to have realistic expectations, and to share them with the care team. The individual vagaries of healing, the passage of time, or changes in personal expectation, mean that no aesthetic/appearance result can be guaranteed.
It is important to discuss these aspects of outcome at consultation for if there is an outcome that is adverse, complicated, or fails to meet expectation and this would bring such unhappiness as to be unbearable – then procedures with an aesthetic component in outcome may not be the right personal choice.
It is therefore important to consider what effect adverse outcomes may have on an individual basis (including the financial aspects), and to discuss any questions arising.
Questions to ask yourself include:
- How would I cope with a surgical result that was uncomplicated healed beautifully and provided a demonstrable change, but I was still not happy?
- How would I cope with an adversity of surgery (infection etc), that prolonged my recovery, brought additional cost, or changed the possibility of achieving my final desired result?
- Am I reconciled to the inevitability that a lovely surgical result with which I am extremely happy, will inevitably deteriorate with the passage of the years, ageing, and other health events in life?
Restorative, reconstructive and aesthetic surgery for appearance change brings tremendous gains in comfort, general health, and well-being. The well-being and quality of life gains have a positive effect on general and mental health. This is why we practise in a multidisciplinary environment of skin health, lifestyle medicine, and plastic surgery.
There is much to consider – reconstructive, restorative and aesthetic surgery can be positively life changing; and this is the great professional reward for our team and for all we do!