I have a breast lump. I have a nipple rash. Why is my nipple inverted? I have a skin rash on my breast. I have a dimple in my breast. What causes breast lumps? Do I have breast cancer? These are worries that many women share in relation to a symptom new or old, a strong family history of breast or other cancer, or a previous personal history of breast cancer. I work as part of a team who aim to diagnose and treat breast symptoms as quickly, efficiently and effectively as possible. We use a complete set of modern investigation methods to reach an accurate diagnosis to put your mind at ease, or treat as soon as is possible. We won't hide any truths, avoid any conversations, or keep any information from you. I perform simple and complex surgery for breast cancer, benign breast conditions and high breast cancer risk.

Oncoplastic surgery merges the principles of sound cancer surgery, in which cancerous tissue is removed, with those of plastic surgery which reconstructs an area following surgery. In oncoplastic breast surgery, plastic surgery techniques such as breast reduction or breast lift are used at the time as cancer surgery to restore a natural, aesthetic appearance to the breast shape. I am a big proponent of "drainless mastectomy surgery". I have worked hard to develop skills I use to ensure aesthetic mastectomy closure, safe therapeutic mammoplasty (breast lift) and techniques to close breast tissue to hide defects created in removing unhealthy/cancerous tissue. I undertake implant breast reconstruction, but I also work with plastic surgeons to combine sound cancer surgery with state of the art microsurgical operations to reconstruct the breast from a patient's own tissue.

There are a few operations we perform very regularly for breast cancer. The decision between which operation may be one that is forced upon us, or it may be one within which you have control of the most suitable way for you. The common operations I perform are: A mastectomy: all breast tissue and the nipple are surgically removed and the skin is closed as aesthetically as possible. I would normally not leave a drain in for mastectomy patients. A wide local excision: the breast lump and a cuff of healthy breast tissue (usually 1cm in all direction) are surgically removed. These operations are combined with additional procedures to check for signs of cancer spread to armpit (axillary) lymph glands: Sentinel lymph node biopsy: if there is not felt to be any spread to axillary lymph nodes, a radioactive colloid is injected into the breast to demonstrate which is the first axillary lymph node which drains the breast. This node is called the sentinel lymph node. This will check for certain the spread to these nodes. Axillary lymph node dissection: if there is evidence of spread to the lymph nodes, an operation to clear cancerous lymph nodes from the armpit is undertaken. The number of lymph glands that are found in this operation can be anything from 10 to over 50!

When a breast has been removed because of cancer (mastectomy), this is a difficult life event that has many repercussions outside of the consideration of "safe cancer surgery". Loss of femininity, change of body shape, obvious deformity are just a few. It is possible to reconstruct a breast similar in appearance to a natural breast. A breast reconstruction can be performed as part of the breast removal operation (immediate) or could be performed months or years later (delayed). I am a big proponent of patient choice within these decisions, and I feel that allowing a patient to make a decision that suits them is an essential part of the process of good surgical practice. It also pays back in the longer term with patient satisfaction and improved psychological outcomes. There are two methods of breast reconstruction: one involves using an implant; the other uses tissue taken from another part of your body. There may be medical or cancer related reasons why one of these methods is more suitable for you or, in other cases, you may be given a choice. Implants A breast implant is inserted either underneath or between the chest muscle (pectorals) and skin. This is a three to four hour surgery followed by a two to three day stay in hospital. Flap Reconstruction A skin flap taken from another part of your body, such as your stomach or back, is used to reconstruct the breast. This is a more complicated operation than having an implant, would involve a plastic surgeon, and may take up to 10 hours and require a 5- to 7-day stay in hospital.

I have been trained to perform both simple and complex breast surgery for benign breast conditions, such as lump removal for fibroadenomas, papillomas, skin lesions and lipomas, and to investigate nipple discharge. All of these procedures are undertaken with the highest regard for aesthetic satisfaction.