Last year was a bumper year for cosmetic surgery in Britain, with plastic surgeons performing three times as many procedures as they did in 2003. But closer analysis of the figures reveals that the industry is not as recession-proof as it first appears. The number of patients seeking surgery plummeted in the last quarter - a downward trend that is likely to have accelerated in the first three months of this year.

Some will see this as a good thing - after all, cosmetic surgery is rarely essential or life-saving, and in many cases not even life-enhancing - but the current financial squeeze worries me. It may have put some people off in the short term, but they are likely to go ahead eventually and just be much more price-aware, and herein lies my concern. Cosmetic surgery is not something you should buy on price alone.

You generally get what you pay for, and I don't know of a single cosmetic surgeon at the top of his or her game who offers free consultations, zero-interest loans, cheap ops abroad, two-for-one offers and discount incentives for encouraging a friend to get something done. As the recession bites, the more aggressive the dubious marketing campaigns become - such as the clinic (one of the country's best-known cosmetic surgery providers) that sent my 20-year-old daughter Charlie an unsolicited letter offering her pre-holiday liposuction for the “ultimate bikini figure”.

Cosmetic surgery isn't something you should opt for because you have been given a gift voucher, offered a cut-price deal, or because a marketing guru has played on your sensitivities. It requires careful consideration and planning to ensure that you end up with the right surgeon, doing the right operation.

Breast enhancement, the most common procedure performed in the UK, is a good example. While a new bust can transform a woman's image and self-confidence, it's rarely a one-off commitment, as any decent surgeon more interested in the outcome rather than profit should explain.

Most implants eventually develop problems that require further surgery. If you are unlucky this can be within a year or two of the first operation (one patient of mine has had three sets of implants in as many years), but even if everything goes smoothly and lasts ten years or more, further surgery will be required.

The implant may not age, but your surrounding bust will, and what looks good in a 30-year-old rarely looks right in a woman in her fifties. To be fair, most of my patients who have undergone cosmetic surgery are thrilled with the results, but there are recurring themes among those who are not - they tended to let their wallets and purses rule their brains, and/or they chose a particular clinic rather than a particular surgeon.

Suffice to say that it is a minefield out there and while good cosmetic surgery can transform your life, substandard work can ruin it. Here are the tips I have been handing out to my patients for the past few years in the hope that they will steer clear of the cowboys and get the results they want...

See a decent surgeon. Choose your surgeon on the basis that he or she is a member of a dependable organisation such as the British Association of Aesthetic Plastic Surgeons.

Go by personal recommendations rather than fancy ads, two-for-one offers, or cheap finance deals. If someone you know has undergone the procedure that you are interested in and speaks highly of the surgeon then put him or her on your shortlist.

Check that your chosen doctor is listed as a plastic surgeon on the GMC Specialist Register at www.gmc-uk.org and/or is a member of the British Association of Aesthetic Plastic Surgeons. Visit its website - www.baaps.org.uk - for information on the various procedures available and contact details of their members.

Go for someone who specialises in the type of surgery you want. Just because someone is good at nose jobs does not mean he's the man to see for breast implants. And get at least two opinions to compare advice and prices.

Make sure your initial appointment and assessment is with the surgeon who will be doing the operation. If a clinic tries to fob you off with anyone else, go elsewhere.

A good surgeon will talk you through the pros and cons of the various procedures you are considering, and may suggest a cool-off period, and possibly even a repeat consultation, before asking you to commit. More business-orientated clinics will ask you to get your credit card out at your first visit.

Avoid anyone offering free initial consultations - you will pay for it the end, one way or another.

Have realistic expectations and don't try doing too much at once. Total makeovers make exciting TV but are the antithesis of good practice. The best surgery is subtle and refreshes rather than radically alters your appearance.

Don't be pressurised into having anything done. If you really can't live with your bust as it is then get it enhanced (or reduced). But if it is your partner that keeps going on about it, then leave your bust as it is and change him.

Never forget that, even in the best hands, cosmetic surgery can go wrong. In the event of complications such as infection or scarring, good follow-up is essential so think twice before going abroad.

Smokers should try to quit before surgery as smoking impedes healing - so much so that most surgeons will refuse to do a facelift unless patients stop because the risks of failure are too high.

I have drawn up a shortlist of leading surgeons throughout the UK that I refer to. It is not definitive, but every surgeon on it is respected in his or her field and meets the required standards.