anitahazari
Tel: 01342 330 396
[email protected]


GMC Specialist Register Plastic Surgery 4277037
  • Home
  • Profile
    • Memberships
    • Publications
    • 360 evaluation
    • Appraisal
    • E Logbook
  • COVID-19
  • Procedures
    • Breast Reconstruction
    • Breast Implants
    • Fat transfer Breast Enlargement
    • Breast Reduction/ Uplift
    • Inverted nipples
    • Male Breast Reduction
    • Abdominoplasty/ Tummy-tuck
    • Brachioplasty (Arm lift)
    • Thigh Lift
    • Liposuction
    • Labiaplasty
    • Expanded & Prominent Ears
    • Upper Blepharoplasty
    • Botox, Fillers & Dermaroller
  • Scar care
  • Hospitals
    • Queen Victoria Hospital
    • Kent & Canterbury Hospital
    • Chaucer Hospital
    • One Ashford Hospital
    • The McIndoe Centre
  • Photos
    • Breast Implants
    • Implants Uplift
    • Breast Uplift (Mastopexy)
    • Removal Implants Uplift
    • Breast Reduction
    • Male breast reduction
    • Tummy-tuck/Liposuction
    • Arm-Lift
    • Thigh Lift
    • Upper Eyelids
  • Patient Diaries
    • Michelle: My breast reduction
    • Louise's DIEP reconstruction diary
    • Melissa's Tummy-tuck
    • Charles' Gynaecomastia Story
    • Morag's tummy tuck story
    • Kate's Weight Loss surgery diary
    • Hannah's Labiaplasty story
  • Links
    • Sitemap
  • Anaesthesia
  • Media
    • Magazines
    • TV & Radio
  • Testimonials
  • Contact
    • Private Secretary
    • NHS secretary
  • Blog
  • Events
  • Privacy Notice

The UK National Flap Registry: First Report 2019

10/2/2020

0 Comments

 
It has taken six years from inception of the registry to delivery of this first report, with over 5750 cases from 97 hospitals across the UK. This registry, and certainly the first report, would not have been possible without data entry by flap reconstruction colleagues from various surgical specialties. Often these cases are long and physically demanding. 

UKNFR is the first national registry of its type in the world to collect data on all major pedicled and free flap operations. Data entry is voluntary, and it is acknowledged that unit data in this first report may not be a true representation of the case load of each participating unit.
 
An overview
• This is the first report of the UK National Flap Registry.
• The first patient record was added to UKNFR on 1 August 2015.
• Up to 8 August 2019, 5,751 operation records had been added to UKNFR, with over 180 registered consultant users actively adding data to the registry.
• Cases have been included from 97 private and NHS hospitals in England, Wales, Northern Ireland and Republic of Ireland. Surgeons in Scotland are awaiting permission from the Public Benefit and Privacy Panel (PBPP) for Health and Social Care.
• Participating speciality associations include the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS), British Association of Oral and Maxillofacial Surgeons (BAOMS), British Association of Head and Neck Oncologists (BAHNO), Association of Breast Surgery (ABS) and British Society for Surgery of the Hand (BSSH).
 
Outcomes
Interpretation of the data has taken into account that some records may be incomplete and that not every case from each unit will have been included. The key outcomes were as follows:
• Overall total flap survival: breast 97.6%, head & neck 94.2%, limbs 94.5%, trunk and perineum 94.2%.
• Unplanned re-operation rate: breast 8.6%, head & neck 12.1%, limb 15.5%, trunk and perineum 12.0%.
• Average length of stay in days: breast 4.7days, head & neck 18.6, limb 12.9, trunk and perineum 11.5.
• Patency rates: Anastomotic patency of blood vessels is an objective measure of surgical outcome in free tissue transfer. More couplers were used in breast microsurgical reconstruction, constituting 81% of end-to-end vein anastomoses with over 98% patency rates.
• Outcomes were also analysed according to other groupings, such as specific risk factors or comorbidities: smoking, diabetes and an ASA score >3 were all associated with a significantly increased flap failure rate.
• The majority of flaps were from a single donor site to single recipient site (85.0% of operations)
• The most common donor flap in breast reconstruction was the deep inferior epigastric perforator flap (77.5%)
• The majority of breast reconstructions were delayed (49.0%) i.e., after completion of cancer treatment, compared to immediate (45.2%) i.e., mastectomy and reconstruction performed at the same time.

Breast-Q PROMs
After breast reconstruction, Patient Reported Outcome Measures (PROMS) were measured using the Breast-Q questionnaire at 6 months. Using a benchmark of a Breast-Q score of ≥70 (range 0-100) to define satisfaction, 72.5% of patients were satisfied with the breast reconstruction, 83.5% were satisfied with the outcome and 87.8% were satisfied with the information they were given. Though a further questionnaire was sent out at 18 months after reconstruction, the numbers of returned questionnaires were inadequate for this report and will be presented in future reports.
 
Surgeon dashboard
One of the big successes of the registry has been the surgeon dashboard. The registry displays the surgeon’s own data on a dashboard which allows easy visualisation of it in real time. This includes the number of procedures performed, case-mix, flap survival, unplanned return to theatre and length of hospital stay. The dashboard is very useful during appraisal and revalidation as it produces evidence of the surgeon’s performance in the form of a real time audit. 

0 Comments

The card that reminded me why I care so much for the NHS.....

2/5/2016

0 Comments

 
Picture
Picture
28 years ago, I decided to do medicine to make a difference.
And then along the years, got caught up in surgical training, Royal College exams, getting a consultant post, establishing a breast reconstruction service, having a family and getting that balance right......and it slipped from the conscious mind. The tremendous changes to the NHS in the last few years started to take their toll. This year's constant oppressing bureaucracy made me question whether I wished to continue.......
And then I got THE CARD. With so many happy faces. I cried. For it has reminded me again why I chose to be a doctor and a surgeon. And I would do all those years all over again and put up with almost anything, just to get such a card and make a difference to so many of 'my ladies'.  
Will I feel the same in years to come if the spirit continues to be crushed? I do really hope so and that I continue to be strong and resilient. Because collectively, as a profession we care and we always will, especially if we all stand together.
0 Comments

The UK National Flap Registry (UKNFR): a National database for all pedicled and free flaps in the UK (JPRAS Editorial)

23/1/2016

0 Comments

 
uk_national_flap_registry_jpras_editorial.pdf
File Size: 162 kb
File Type: pdf
Download File

0 Comments

GMC guidance for doctors who offer cosmetic surgery- my views for safeguarding patients

10/6/2015

0 Comments

 
The GMC have launched a consultation on new draft guidance which sets out the standards for doctors offering cosmetic interventions. One of the key points is "making sure patients are given enough time and information before they decide whether to have an intervention". This will differ for surgical and non-surgical procedures, of course, and in case of surgery, will also depend on the complexity of the operation. The GMC have not specified a particular time period.

The majority of plastic surgeons have been using a '2 weeks cooling-off ' period for some years. I believe that the following should be made mandatory for all cosmetic surgery:
  • a minimum 2 weeks 'cooling-off' period
  • 2 consultations: the first consultation lasting 30min when  the patient's suitability for the operation, risks, benefits, and long-term results  are discussed; followed by a further consultation at a later date.
  • the surgeon performing the operation should see the patient at the 2 consultations.
  • Defer cosmetic surgery on those under 18 years unless, unless under exceptional circumstances. 

The GMC public consultation  runs until 1 September. To participate and submit your views, visit http://www.gmc-uk.org/guidance/news_consultation/27171.asp. 


Listen to my interview on the BBC Radio 4 Today, 0715hrs on 8 June 2015 with Justin Webb and James Naughtie:
0 Comments

BAPRAS: Think Over before you Make Over

22/2/2015

0 Comments

 
Picture
Every year thousands of people in the UK put themselves at serious risk by undergoing bad or inappropriate surgery that could be easily avoided by asking some simple questions about their treatment.  Poor surgery can have both physical and psychological consequences, so it is vital to make an informed choice and choose the right surgeon for the job. 

Following 5 Cs for cosmetic surgery will help you decide if cosmetic surgery is the right choice for you. 


THINK OVER BEFORE YOU MAKE OVER 

1 Think about the CHANGE you want to see

Do your research. Find out all you can about the treatment/s you want. Be precise as to the change you hope to see and the reasons why.


2 CHECK OUT potential surgeons

If you are thinking about cosmetic surgery, speak to your GP. Find a surgeon who
has the right credentials and is on the appropriate specialist register with the GMC. Fully qualified Plastic Surgeons will be on the GMC Specialist Register for Plastic Surgery. Find out about their experience of the procedure you are considering and make sure you meet them and discuss the outcome you can expect before you commit to having something done.


3 Have a thorough CONSULTATION & ask the right questions

Your Plastic Surgeon will discuss and clarify the treatment options with you and then plan your treatment. Find out as much as possible by bringing along questions so you know the risks involved and feel comfortable with the surgeon who will be carrying out your surgery.

4 COOL OFF before you commit

Give yourself some time to ensure that you want the surgery and to make sure you feel at ease with the surgeon who will be treating you.

 5 CARE about your aftercare 


Aftercare can be just as important as the surgery itself, so make sure you know who to contact and how you will be looked after, especially if there are any complications or problems following your surgery or treatment.


Key questions to ask your surgeon before choosing cosmetic surgery
  1. Who will operate on me? 
  2. What are your qualifications?
  3. What are the potential risks and complications?
  4. What is your complication & re-operation rate?
  5. What results can I expect and how long will they last for? 
  6. What aftercare do you provide? 

THINK OVER BEFORE YOU MAKE OVER 


0 Comments

Live scheduling of Operations: Moving forwards in the NHS

17/1/2015

 
Picture
Some of the most frustrating moments I have faced in my NHS practice have been the total loss of input I have in the way patients are scheduled for my operating lists. My last act in the process is filling out the waiting list form- the form then disappears into the abyss of middle management in the NHS. I have often despaired, then in late December, I heard the magic words 'live scheduling'.... it has restored my faith in my ability to deliver appropriate and timely care to my patients. And I started using it straightaway!

Now when I am in my NHS clinic, at base in QVH or a peripheral clinic such as Canterbury, via secure remote access to the server in East Grinstead, I can see my operating lists over several months (with my holidays, including study and professional days keyed in). I can offer the patient sitting in front of me, an elective surgery operating slot that is mutually acceptable. I give them a date for their surgery! Easy Happiness all round.

Am I a good teacher? Lessons learnt from trainee feedback

14/4/2014

 
Picture
At my NHS hospital, it is one of my duties as a Consultant to teach and mentor trainee plastic surgeons. A recent trainee feedback survey on the Consultants as trainers, showed that though I scored better than average in my 'trainer' skills, there were improvements that I could undertake in my teaching style, as demonstrated by the comments below: 

  • Excellent surgeon, but does not always teach.
  • Although some find her scary, she is approachable and does like to teach
  • Can be difficult to approach
  • Very keen on teaching and extremely supportive to trainees.  Uses clinics as mock exam cases providing excellent teaching.  In theatre, explains decision-making very well and takes trainees through case with supervision
  • Teaching at trauma meeting is excellent
  • Amazing, perfect
  • Very good at giving opportunities to “have a go” in theatre, for which I’m very grateful, but a slightly more forgiving teaching style would be better!


Though I am not Shrek or an Ogre at work, I obviously do need to improve! Sometimes I must appear to be unapproachable, even though I feel I am not. And I have often wondered if, perhaps, the direct manner in which I speak gives rise to this perception. My second sin is that, I will form an opinion about a trainee in the first 2 weeks or so.  If I find the trainee surgeon unreceptive, arrogant, lazy or rude to staff /patients,  I do not give him/her the same support I would have otherwise. As a teacher, irrespective of trainee attitudes , I should be encouraging to all. And 
that is the difficult part.

A  calmer & focused life - my secret habit

12/3/2014

 
Picture
Approaching 40, juggling home and work, was making me feel that I needed more than 24 hrs in a day. I was flat out, managing a busy breast reconstruction & aesthetic practise, and needed to keep running just to stay still.  I was often taking my troubles home and my husband felt the brunt of my stress. Something had to give, but I didn't want my commitments to lessen.

So I invested in one-one sessions in transcendental meditation (TM). I didn't buy into the whole TM  lifestyle, I only took what in needed from it. My life started to feel more balanced. I became  calmer, more relaxed but at the same time my clarity of thought improved. My husband noticed the difference within 2 months, my son commented 'Mummy, you are nicer and fun when you have done quiet time'. 

Over the years, as with any new technique we learn, keeping the momentum started to falter. Then I read about Andy Puddicombe and his App for mindfulness meditation. I thought, why not give it a try? It is one the best decisions I made last year. 

My sense of calm and focus has increased. I perform well in pressurised situations. My anaesthetist attached me to monitoring devices, and my heart rate & blood pressure is lower. TM was a calming type of meditation technique, whereas this app has taught me a combination of both insight and calm.

Go get it! Give it a try! Watch this little animation by clicking on the link below:

http://www.getsomeheadspace.com/News/headspace-extra/the-headspace-animations--expectation.aspx
(I have no conflicts of interest to declare).

The Confidence- Competence Gap: Nurturing future leaders

1/2/2014

 
Picture
I was invited by the BAPRAS President to an interesting event last week at RBS Bishopsgate, London- 'Inspiring Women Leaders' a book launch by Lee Travers, an executive coach who has distilled the qualities that successful leaders possess.


When it comes to surgical training, as a plastic surgery trainer, I am seeing more women choosing this career path, especially as the intake in medical schools is 60% female. For  my generation, the gender of the trainee surgeon  is irrelevant. What is crucial is surgical ability, insight and empathy for patients. There is also this nebulous elephant in the room: the confidence - competence gap. The dissociation between these two elements is most noticeable at the ends of the spectrum. On one hand, there are trainees who over-estimate their ability to perform a surgical task. Their profiles and attitudes to risk are perhaps similar to those encountered in other industries such as investment / banking sectors. At the other end of the spectrum, there are those who need mentoring and nurturing to encourage self-belief. Many, however, are in the middle of the spectrum: have insight, and know their limits. As a trainer, I have to identify where the trainee is on this spectrum, and help him/her  to explore their potential to its maximum. They are the future of our profession. 

Female, Brown and Short- my life as a Surgeon in the UK

20/1/2014

 
I remember the day, 25 years ago, a naive 19 year old telling my father, a general surgeon & fellow of The Royal College of Surgeons of England (RCSE), that I wanted to pursue a career in surgery. He advised me against it as it would be too difficult, not suited for women and suggested a non-surgical speciality. His words were not dissimilar to those of Prof Meirion Thomas in his article in the Daily Mail. The difference is that my father, now 78, has changed his views and moved with the times. Especially as I have made him proud on three occasions: the first, when I passed each of my FRCS exams at the first attempt; the second, when I received the Hunterian Professorship by the RCSE in 1999-2000; the third, when I was appointed as the first female consultant plastic surgeon at the world-famous Queen Victoria Hospital, East Grinstead- the home of Archibald Mcindoe & the guinea-pigs, and where the first Microvascular Toe-Thumb transfer by John Cobbett was carried out in 1969.

In my career so far, I have not been subject to any overt sexism or racism. If there has been anything covert, my in-built mechanism of being blind & deaf to it has certainly made me immune, as such issues are not of my making but is the burden that the perpetuator carries.  As a woman, I have had to work harder, be supremely organised in both my work and home life, be diplomatic but hold my ground, just so I could be on par with my male peers in my early career. Now, with more women choosing a career in surgical specialities; colleagues of my generation feel that the gender of the surgeon is irrelevant, more important is surgical ability and insight. The response from the RCSE President has been heartening. 

Striving for a work-life balance is not just something women want, as I do too; but so does each of my male colleagues of my generation where I work: we all want time to have a life outside of work, see our children grow up, rather than Daddy (or Mummy) be a sticker on the fridge. Life-work balance makes us well-rounded contributors to society, helps us to empathise with our patients and involve them in their care, rather than have the paternalistic & patronising personas of surgeons of my father's generation. Ours is a different generation, with different needs in an NHS that has undergone a radical culture change. Attitudes such as those Prof Meirion Thomas that breed intolerance of women in surgical specialities, should stay where they belong, in the last century.

I wholly concur with the view held by the Chief Executive of NHS Employers "Some people are women, get over it."

    RSS Feed

    Archives

    February 2020
    May 2019
    December 2018
    February 2018
    August 2017
    May 2017
    January 2017
    May 2016
    March 2016
    January 2016
    November 2015
    August 2015
    June 2015
    May 2015
    March 2015
    February 2015
    January 2015
    December 2014
    November 2014
    October 2014
    August 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013
    October 2013
    September 2013
    August 2013
    May 2013
    April 2013

    Categories

    All
    Breast Surg Info
    Breast-surg-info
    Charity Runs
    Lectures
    Media
    My Beliefs
    Surgical Aides
    Surgical-aides
    Tummy Tuck Info
    Tummy-tuck-info

Picture
Picture
Picture
Picture
Picture
Picture
Profile
Procedures
Hospitals
Photos
Contact
Links
Testimonials
Blog
​

​Privacy Notice
Private  01342 330 396
[email protected]

-------------------------------------------
NHS    01342 410210 / 01342 414465
[email protected]
GMC Specialist Register Plastic Surgery 4277037
Terms and Conditions | Sitemap | Registered in England