In a series focusing on medical specialisms, the BBC News website meets Mr Norman Waterhouse, who talks about plastic surgery.
'There are worries for the future'
Plastic surgery is a branch of surgery concerned with the repair, restoration, or improvement of lost, injured, defective, or misshapen parts of the body chiefly by transfer of tissue.
WHAT IS YOUR JOB?
I am a consultant plastic surgeon at Chelsea and Westminster Hospital and at Harley Street, London.
I run a large facial surgery unit in the NHS and I deal with all sorts of facial problems from congenital problems to cancers of the face.
In my private practice I largely carry out aesthetic and cosmetic surgery.
WHAT IS THE MOST COMMON CONDITION?
In the NHS the bulk of my work is dealing with broken cheeks and broken eye sockets.
In the past this was mainly from road traffic accidents, but now because of seat belts this is less the cause. Now the cause is mainly young men assaulting other young men.
In my cosmetic work I mainly deal with face-lifts, people looking for facial rejuvenation.
WHAT IS THE MOST COMMON PROCEDURE?
The most common condition for us in our NHS unit is facial trauma and so our most common procedure is to fix this.
Plastic surgeons deal with the commonest cancers of the face, such as melanomas.
People think it is very esoteric, but we deal with all the commonest conditions in children such as split lips and cleft lip and palate.
WHAT IS THE HARDEST THING ABOUT YOUR JOB?
The hardest thing I think for me as a facial surgeon is the fact that whatever I do has such a massive impact on people's lives.
The face is always visible, but on the other hand I can make their faces look like they used to after they have had cancers, or an accident.
WHAT IS YOUR MOST SATISFYING CASE?
That has to be helping children with severe facial deformities.
I remember one little girl whose father carried her round in a blanket because she was so badly disfigured.
She had facial clefting, her eyes were grossly far apart, she had no real nose and a cleft. She came to us from Afghanistan when she was six.
After the operation I remember her father walking down the Fulham Road, in London, proudly showing her to everyone.
She now looks pretty good and writes us letters.
WHY DID YOU CHOOSE THIS SPECIALTY?
I felt when I was training that I was always removing things from people and I felt that I would rather be putting things back and it was this sort of ethos that made me want to be a plastic surgeon.
From my first day as a senior house officer I said, 'That is exactly what I want to do.'
IF YOU HAD YOUR TIME AGAIN WOULD YOU CHANGE YOUR SPECIALTY?
No, I think that I am extremely lucky.
In the NHS I have become mostly disillusioned and I hate wading though administration, but I still think I am privileged in what I do.
HOW DO YOU SEE THE ROLE DEVELOPING IN THE FUTURE?
In the NHS I think there is a growing realisation that plastic surgery is an essential service and this will be seen at a district level.
When people think of plastic surgery they tend to think it is making breasts bigger and lifting backsides, but plastic surgery is also essential for treating people with congenital deformities, after road accidents etc. And we treat the victims of war and disasters like the Pakistan earthquake.
In aesthetic surgery there has been an increase in demand and I see bad things happening here. All sorts of inappropriate people are trying to pass themselves off as plastic surgeons and there are real anxieties about the future. It has never been a more worrying time.
CV - Mr Norman Waterhouse
1978: Graduated from Birmingham University Medical School
1988: Completed accreditation and gained the Specialist fellowship in Plastic Surgery (FRCS Plas)
Since 1996: Has organised the Annual Instructional Course in Cosmetic Surgery at the Wellington Hospital
September 2005: Was appointed first ever specialist tutor in aesthetic surgery