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 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 medical plan – ‘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.
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.
Your surgery with “Twilight anaesthesia”.
The beauty of the ‘Twilight technique’ is that your consultant anaesthetist, who is extremely knowledgeable about the surgical steps, is present throughout your surgery and will anticipate points at which you might feel stressed. Such stresses are dealt with before they occur. Your depth of ‘twilight sedation’ is entirely bespoke, monitored, and anticipated so that the benefits of the technique allow the best quality outcome, with your total care and comfort throughout.
Different patients have different memories of the sedation experience. One of our patients was happily singing ‘Suspicious Minds’ along with the soundtrack of the surgery – yet did not remember anything other than the instruction to open and close her eyes for reasons of surgical accuracy!
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.
Of course. We regularly audit outcomes, and patient experience, and there have been no adverse events related to the ‘twilight technique’ in our practice. The consultant anaesthetist and team are present throughout, with the necessary equipment to manage proactive and responsive safety. ‘Twilight’ allows less ‘intervention’ for heart and lungs and reduces the risk of sickness and nausea. There is no need for a breathing tube, and no throat discomfort afterwards. You will need to be accompanied by a responsible adult for the first night after twilight sedation procedures, and to refrain from responsible decision-making or complex tasks for a full day. There is no prolonged ‘post anaesthetic downtime’ and full conscious, comfortable, recovery is swift.
There is no doubt! The initial recovery period is stable and comfortable with no shift of blood pressure. This means that the bruising and swelling is less, and the risk of a bleed post-surgery is extremely low. With the addition of the surgical precision in the animated face, this makes for technical developments, and outcomes that get better and better for the youthful shape of the face.
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.
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:
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!
