Plastic Surgical Experience
I was inspired to enter plastic surgery after seeing craniofacial procedures at Oxford and assisting with breast reconstructions and microvascular operations at the Royal Sussex County Hospital in Brighton with the plastic surgeons from East Grinstead in attendance.
I was a senior house officer for eleven months at Mount Vernon and at East Grinstead, which were excellent introductions to clinical management and basic reconstructive techniques. This was followed by a further five months as a locum registrar at Mount Vernon and then entry into plastic surgical research. This entailed a lot of microvascular surgery involving over three hundred free flap experiments and also anatomical studies. Specialist registrar training in plastic surgery followed this.
Eighteen months at Roehampton and St Georges’s Hospital allowed me to gain further experience in general plastic surgery, cleft surgery and the treatment of burns injury. During this period I also spent one month at the Chung Gung Hospital Taiwan. I saw a tremendous range of microsurgery carried out at a very large tertiary referral center. Entry into the Bradford-Leeds senior registrar rotation exposed me to general plastic and oncological head and neck surgery at St Luke’s hospital and advanced microsurgery at St James’s hospital Leeds, especially in the fields of trauma, congenital hand, head and neck and craniofacial surgery. This was followed by fourteen months in Adelaide and Taiwan. I was trained to deal with maxillofacial trauma and exposed to craniofacial and aesthetic surgery as well as to further microsurgery.
As a consultant plastic surgeon in Leeds my duties included microsurgical reconstruction for head and neck, breast, lower limb trauma and gynaecological defects. This post also involved much general plastic surgery which included surgery for breast reduction, breast enlargement, vascular anomalies and the management of skin tumours and head and neck cancer. I personally carried out over 150 free tissue transfers during this period, and was a founding member of the Leeds craniofacial team.
I have had aesthetic training during my fellowships in Adelaide and Taiwan and as a trainee in Leeds. I have had seventeen years of private aesthetic practice as a consultant plastic surgeon including extensive experience in the rejuvenation of the face and reshaping of the breast, trunk and limbs with the use of techniques such as facelifts, blepharoplasty, endoscopic brow lifts, rhinoplasty, chemical peels, liposuction, breast augmentation, mastopexy and breast reduction. I am a director of The Westbourne Centre Birmingham, which specialises in aesthetic patients. I am a member of The British Association of Aesthetic Plastic Surgeons (BAAPS) and The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS).
I was a general surgical registrar for thirteen months and was trained to deal with most general surgical emergencies, which gave me experience with many arterial, gastro-intestinal and urological surgeries. I became competent at repairing hernias, performing laparotomies, bowel resections, cholecystectomies, gastrectomies, endoscopies, and embolectomies, and became acquainted with the use of anastomotic stapling guns.
General Paediatric Surgery
I trained under Mr Howat, paediatric surgeon at the Royal Alexander Hospital, Brighton, where I learned to perform routine operations such as herniotomies, orchidopexy, and hypospadias repair. I assisted with major cases such as correction for oesophageal atresia and was exposed to emergency paediatric surgery.
At the John Radcliffe Hospital in Oxford I undertook duties as a general casualty officer and I saw much acute orthopaedic surgery. I became familiar with A/O bone fixation methods, hip replacement, skin grafting and tendon repair.
At the Radcliffe Infirmary Oxford I spent six months managing head injuries and other neurosurgical emergencies. I assisted with specialized neurosurgical procedures and learnt to carry out laminectomies, burr holes and to turn cranial flaps. This is where I was first exposed to craniofacial surgery.
In 1980, I experienced four months in the Southern Highlands province of Papua New Guinea during a student elective. I ran a forty-bed medical ward and occasionally had to perform surgery on victims of numerous tribal wars, which took place while I was there. I treated penetrating injuries as a result of spears, arrows and hatchets. I was also sent out on a medical survey into the jungles of central Papua for the investigation of a whooping cough epidemic. In February 1992 I spent four weeks in Taipei, Republic of China, at the Chung Gung Memorial Hospital to observe and carry out microsurgical and free flap procedures under the supervision of Fu Chan Wei, head of the department of microsurgery. In 1995 I spent twelve months in South Australia as the craniofacial and plastic surgical fellow at the Women’s and Children’s Hospital and at the Royal Adelaide Hospital. I had a further two months at the Chung Gung Hospital observing craniofacial surgery under the supervision of Dr Yu Ray Chen., then spent one month observing cleft surgery at the Showa Hospital Tokyo Japan under the supervision of Professor Onizuka.
I have been on 6 charity missions to operate at The Plastic Reconstructive Centre in Accra Ghana on general plastic as well as craniofacial cases, and patients with vascular anomalies. In the last three years I have been operating annually in Ethiopia for the NOMA Charity, Facing Africa.
My introduction to craniofacial surgery started in Oxford as a senior house officer in neurosurgery. Further exposure occurred at St James’s University Hospital Leeds during senior registrar training in 1995. I spent twelve months in South Australia as a craniofacial and plastic surgical fellow at the Women’s and Children’s Hospital and at the Royal Adelaide Hospital. I was trained by Professor David David AC during my stay in Australia.
I had a further two months at the Chung Gung Hospital observing craniofacial surgery under the supervision of Dr Yu Ray Chen. I was trained in the management of a large range of craniofacial conditions and for craniofacial, maxillofacial trauma and aesthetic surgery. I spent one month observing cleft surgery at the Showa Hospital Tokyo Japan under the supervision of Professor Onizuka.
Since becoming a consultant I have established a multidisciplinary department of Craniofacial Surgery in Leeds with my paediatric neurosurgical and maxillofacial colleagues. I have also developed an interest in craniofacial vascular malformations and neurofibromatosis, post traumatic and congenital facial deformity, nasal reconstruction and facial palsy.
Since appointment to the Birmingham craniofacial unit in August 2001 I have been part of the multidisciplinary team and just recently gave up my post as clinical lead. The unit is only one of the four designated craniofacial units in the country and deals primarily with skull and facial deformity caused by rare syndromic and non-syndromic conditions.