Working As A Plastic Surgeon In Today’s NHS

Recently, a TV film production company came to our hospital to record a series about surgeons and the operations we do. Having spent over 20 years as a NHS consultant in Plastic surgery I was intrigued when the production team came to speak to me about my work. It occurred to me that what I see as routine and ordinary is, for the greater part, unknown to most people and is to some extent a hidden world. The production team was looking for innovative procedures and techniques, and I wondered if they would think that what I did would fit the bill.  As our conversation started I began to tell them of the work I do and why I felt so inspired by my patients.

My work in plastic surgery covers a broad spectrum including trauma. For the years of the Afghanistan war we received the military casualties and would spend hours in theatre trying to fix the broken bodies of young fit people whose lives had been changed forever.  Thankfully that is over now but it has left an indelible mark on all of us who were privileged to treat such brave and stoical people. Before, during and after that time the routine work carried on, so I described some of the more common and complex operations I do. I am one of the breast reconstruction team offering reconstructive surgery to women who have had or are at high risk of breast cancer.

There are many ways to rebuild a breast and we offer all options, allowing women to choose the solution that will be best for them. One of the most popular is called the ‘DIEP (deep inferior epigastric perforator) flap’. This is a method in which excess skin and fat from the lower tummy is taken and used to replace the missing or damaged breast tissue.  It is one of the more technically challenging and longer surgical operations that we do but it is also the one I find most rewarding.

There is a saying in plastic surgery that you can rob Peter to pay Paul – but only if Peter can afford it! In other words, you can only take one part of the body to reconstruct another if it is not needed at the site it is taken from.  The great thing about the DIEP flap is that you are able to actually improve the site the tissue it is taken from whilst also restoring the breast shape. In other words, it is like having a ‘tummy tuck’ as well as a breast reconstruction! The film producers must have sensed my passion for this as they said that if I was agreeable and there was a suitable patient they would like to film the operation. I felt it would be a great opportunity to show what could be done and hopefully inform women considering this operation of what it involved. We were fortunate that we had a patient brave enough and confident enough to tell her story and allow this personal and challenging journey to be shared with a wide audience. 

The production team was at all times professional, but I am so grateful to them for also being kind, thoughtful and genuinely caring and interested. As I write this blog, I have seen the previews of the program that will be shown, and I am confident of the positive effect it will have. I am so proud of the team I work with day in and day out and their dedication to achieving the best we can for our patients. I hope that at a time when the NHS is struggling to cope with ever increasing need, this series showing diverse and innovative surgical procedures will give confidence to anyone who may be facing surgery or cares for someone who is.        

Surgeons: At the edge of life starts on BBC Two on Monday 8th January at 9pm