The Patient Journey

Where precision and compassion meet…

It’s thirteen years since I had my face lift. I wish to thank you for making me so much happier with myself over this time. You said at the time, you cannot stop the ageing process, but I am told still how well I look. And it is all down to you.

I hope you and your family are well . Thank you once again, Maureen S

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”

Immediately after my initial consultation with Mr Britto I felt relaxed and confident that he would deliver the results i wanted to achieve. We discussed in length my expectations, the procedure in its entirety, recovery and aftercare. I couldn’t be happier with my new natural, youthful look. I would highly recommend Mr Britto and would most certainly use his services again.

Verified patient – Doctify

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.

I first met Mr Jonathan Britto in April 2016. I had been considering facial surgery for sometime and decided to book a consultation not really knowing what to expect, he explained the various procedures that would be suitable for me and also sent by email a detailed report which I found very informative so that on my next visit I had a great many questions. He took his time and answered them all fully, I was never rushed or pressurised into making a decision and his manner was always professional yet friendly and approachable.

Having decided to go ahead I was booked in to hospital for a date that suited me and had surgery in Oct 2016, the excellent care continued after I left hospital with regular check ups and the reassuring knowledge that help and advise were only a phone call or email away. I am now nine months post surgery and I still have easy access to see Mr Britto in the clinic if I wish to. Waiting times have always been well within acceptable levels and if there is a slight delay it is in a comfortable waiting room. I am delighted with my choice of surgeon and with the results achieve and I would not hesitate to recommend him to others.

Verified Patient – Doctify

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.

By the time it comes to the procedure, each of my clients feels that they know me, and all feel confident, comfortable and ready to make lasting, positive change.

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

On my initial consultation Mr Britto listened to my concerns and explained very comprehensively exactly what I could have done. He explained that he wanted to create a good aesthetic balance in my face as my concern was that I didn’t want one half of my face looking obviously worked on and the other looking older because of the contrast. My major concern was not only the hooded eyes but also my lower lids as they were becoming bagged and shadowed and that I had a limited budget. He showed me examples of his work on his laptop which helped me to see what could be achieved. At no point did I feel pressured. That initial consultation was money well spent as Mr Britto wrote me a letter detailing everything that we had discussed and encouraging me to get in touch with any concerns or question that I may have had. Of course I had some concerns which I was able to discuss in detail via email. Mr Britto’s answers were always very clear, detailed and understandable.

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

TWILIGHT DAYCASE ANAESTHESIA

Your surgery with ‘twilight anaesthesia’

I was nervous the morning of my surgery.. Which was actually yesterday..I had a lower face and neck lift..

The nurses were incredibly attentive..I was prepped for surgery.. The anaesthetist and Jonathan Britto came to see me to clarify any last-minute questions or wishes that I may have.. I have had other procedures with Mr Britto so I new I was in good hands..The anaesthetic I was about to have is called Twilight anaesthetic. It was the best experience I have had in surgery..You are awake but in the most peaceful place..You can hear, you can speak, you can move if requested with not one bit of pain..It really was amazing..Today I feel completely myself.. of course a little sore from my surgery..I don’t have the normal sore throat and fuzzy feeling I would experience with a general anaesthetic which can stay in your system for days..

Looking forward to enjoying how my lower face and neck used to look..

Thank you to everyone who looked after me yesterday, Leah

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!

Jonathan Britto
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.

FAQs

What if I feel pain, discomfort, or anxious?

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.

Will I remember the experience?

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.

Is ‘twilight anaesthesia’ safe?

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.

Does ‘twilight’ improve my surgery outcome?

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, neck, and eyelids.

Sedation has the unique potential of letting the interaction between patient and surgeon to happen when it is most needed, and therefore to achieve the care of the finest detail to its excellency.

Dr Paolo Barragia, and Dr Oliver Sykes, Consultant Anaesthetists

I could not be more pleased with the outcome I have had, only 4 weeks in after a lower face and neck lift, I am delighted with the massively improved and natural look that Jonathan Britto has achieved. In addition, his ‘bedside manner’ instilled confidence and certainty that I would be happy with his approach, and I was thankfully proved 100% right! I would also note that I haven’t felt the need to take any pain killers at all post surgery, no pain whatsoever.

Verified Patient

Appearance, Function, and Emotion

I don’t hesitate in recommending Jonathan Britto to anyone considering cosmetic surgery. I had a face / neck lift 3 weeks ago and am truly delighted with the results. My friends comment that I look really well, but cannot work out what I’ve had done. I feel physically and psychologically rejuvenated. Mr Britto took time to find out what it was I wanted to achieve, and then delivered EXACTLY what he said he would.

Verified Patient, Doctify

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.

Mr Britto did an amazing procedure on me and I am delighted. Mr Britto is a very skilled and caring surgeon and I am amazed at the wonderful after care he provides. Over and above this Mr Britto is a kind and caring person and I feel he has my best interest a heart. Thank you

Mind the Gap

Following a difficult experience, I had the privilege to meet Mr Jonathan Britto and his team in London. Should words of feelings be difficult when we consider our journey and how we perceive our image compared to our dreams … then I could only highly recommend a visit to this “house of excellence”.

Verified Patient, Doctify

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!

I had surgery with you 10 years ago and I received an excellent result with everything, obagi blue peel, breast uplift and upper eye-lift. You have reinstated my faith back in cosmetic surgery.

I had surgery on the 5th of November this year with you and by the the 7th of November the spring was already back in my step and this is what surgery should do. You corrected the terrible large thick scars on the front and back of my ears that a surgeon gave me in Turkey a year ago and gave me the most fantastic pain free endoscopic brow lift along with an obagi peel.

My confidence is back and I look younger and fresher and naturally so too, you should be a blueprint for many surgeons. Your staff were exceptionally knowledgeable and hospitable to me during the whole process too. You are incredible. I’m extremely grateful to you and your team for putting the smile back on my face and helping me feel confident again after an awful encounter in Turkey previously. Any future surgery will only be done by you. You are a genius.

Verified Patient – Doctify

So happy with the outcome of my surgery. Mr Britto listened and responded sensitively to my concerns. He was so patient with me. Thank you. From a forever grateful patient. I have recommended him without reservation to colleagues and friends.

Where precision and compassion meet…

The “Analysis Phase”

Procedures and Clinics

Patient Reflection with Jonathan

TWILIGHT DAYCASE ANAESTHESIA

FAQs

Appearance, Function, and Emotion

Mind the Gap

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