E P L Turton FRCSEd FRCS(genSURG) MD(Hons)
Consultant Breast Oncoplastic and Aesthetic Breast Surgeon
Background: Mr Turton's training career in Medicine and Surgery commenced in 1987. He studied at the Leeds University School of Medicine and qualified with 3 distinctions and 3 honours. After completing house officer training at St James's University Teaching Hospital he immediately went on to a full surgical training programme. He was awarded the Fellowship to the Royal College of Surgeons in 1996. He spent a two year period performing research and wrote a thesis which led to the award of a higher degree, MD(Hons), as Doctor of Medicine with commendation. He spent a period in the United States in 1999 on a Traveling Fellowship and visited leading centers: Stanford University Medical Center, California ; University of Colorado, Denver, Colorado; Cleveland Clinic Foundation,Cleveland,Ohio.
Mr Turton completed the Specialist Higher Surgical Training throughout the major centers in Yorkshire and went on to super-specialise in Breast Surgery. He spent the final 2-years of training learning and developing advanced skills in Breast Reconstruction Surgery, Cosmetic Breast Surgery and Oncoplastic Breast Surgery. He underwent and passed the formal exit exam for Specialist General Surgery and for his Sub-specialty of Breast Surgery. He was appointed to a substantive Consultant Breast and Reconstructive Breast Surgeon post at the Leeds Teaching Hospitals Trust in 2004.
What is a Specialist?
Specialists must be judgment-safe and competent in their field of specialist practice. The specialist will offer choices to patients, share decisions with them sensitively and provide education and support for care. They must be able to demonstrate the qualities and abilities to manage a clinical unit or team, ensuring high standards of professional care and effective working relationships with colleagues across professional disciplines. The specialist will be able to monitor plans and initiatives, to evaluate them and ensure that modifications are made where appropriate. Specialists take on a leadership role within teams and organisations and will have the vision and foresight to develop new ways of working and the commitment to see projects and teams through to the end. Specialists will demonstrate the personal capacity and qualities to respond positively to feedback from colleagues and patients, to take and accept responsibility for clinical decisions, and to manage and respond to complaints from families of patients and fellow professionals in a professional manner. They must support teaching and training programmes for trainees, departments and staff under their supervision. Specialists must demonstrate a commitment to the highest standards of care and ethical and professional behavior within their specialty and within the medical profession as a whole.
Training in Surgery underwent major changes since 1995 following the recommendations of the Calman-Hine Report. Patients with breast disease have since been seen and treated in highly specialised Breast Units by a Breast Surgery Specialist. These surgeons will have received the highest level of training in breast disease, breast cancer treatment and surgery of the breast. They are members of Association of Breast Surgeons (ABS) of the British Association of Surgical Oncology (BASO). Membership can be checked on the ABS web site. A Specialist Consultant Breast Surgeon should also therefore hold a substantive post in a UK hospital as a Specialist Breast Surgeon. Details can be checked on most UK surgeons to see the area they operate on most frequently as an NHS consultant by looking up their details at their local hospital, and also by looking at the Specialist Info web site.
Cosmetic surgery covers a range of specialties, including not only plastic, otorhinolaryngological, maxillofacial and general surgery but also ophthalmology, dermatology, dentistry, anaesthesia and
clinical psychology.
Operations performed by a surgeon should reflect their area of Specialisation.
All doctors setting up as cosmetic surgeons for the first time from April 2002 must be on the GMC's specialist register. See what the Healthcare Commision says about the regulation of Cosmetic Breast Surgery, and review the Department of Health advice on finding a specialist for Cosmetic Surgery. The MHRA also provides useful information about silicone implants.
Don't be afraid to ask a surgeon about his/her qualifications, experience and specialities.
The GMC (www.gmc-uk.org) holds general and specialist registers of doctors practising in the UK. Contact them to check if the doctor or surgeon you have chosen is on their register.
What is an Oncoplastic Breast Surgeon?
The only route to becoming a Breast Specialist is through training as a Specialist in General Surgery with further super-specialisation in Breast Surgery. Breast reconstruction is a major part of the specialist breast surgeon's workload, and often involves major operations on the breast, and neighboring structures to create skin and muscle flaps. In addition the opposite breast is often also operated on the reduce it's size (breast reduction), to lift it (mastopexy), or to enlarge it (breast augmentation) to produce better symmetry with the new breast.
A Breast Surgeon receives training in all aspects of General Surgery (Endocrine surgery, Vascular Surgery, Visceral Surgery, Breast Surgery) and then Specialised training that focuses on the Breast: Breast reconstruction, Breast tissue flaps, Breast implants and expanders, Breast Reduction and Augmentation, Male breast Surgery, Nipple-areola surgery and reconstruction. In recent years there has been further development of this field of Oncoplastic Surgery. Accredited Breast Surgeons become members of ABS.
It is vitally important if you are having breast cancer surgery that your specialist is regularly performing Breast Operations of the type you are seeking as there are numerous examples in the literature that Specialists who concentrate on one body area (eg Breast) or disease (eg Breast cancer) have superior outcomes to those that practice more generally.
A Specialist Breast Surgeon should have extensive Breast Surgery experience and should perform breast surgery regularly as part of their NHS duties. A Reconstructive Breast Surgeon and an Oncoplastic Breast Surgeon are specifically sub-specialised to perform more complex Breast Operations. You should therefore ask specifically about their volume of Breast reconstructive operations. If you are having a breast augmentation or reduction you should of course ask about their Cosmetic Breast Surgery experience.
Specialist Breast Surgeons and their group, the Association of Breast Surgery are driving and developing the Breast Curriculum for Specialist Breast Surgeons. This comprises training specifically in Aesthetic Breast Surgery, Oncoplastic Surgery as well as Breast Reconstruction. A new professional group, the British Association of Aesthetic Breast Surgeons (BAABS), has been independently formed by a group of Specialist Breast Surgeons with Aesthetic and Breast Reconstruction skills of the highest demonstrable standards to give the public a point of reference to this extremely specialised area. Experienced senior surgeons who are positioned to offer the highest standards of Cosmetic Breast Surgery and who are trained in Breast Reconstructive and Oncoplastic techniques who are performing Aesthetic Breast Surgery to the highest standards and who are members of ABS are invited to apply for membership to this Association. This group has been formed independently of the Association of Breast Surgery. Membership is likely to remain quite limited in the UK to reflect the experience that must be achieved. Please check membership from the BAABS web site.
More about Mr Turton:
He continues to work as a full-time Specialist Oncoplastic Breast and General Surgeon. His principal interest is in breast surgery whether it be cosmetic or for the treatment of disease. He performs a very large number of cosmetic breast operations per year in the private sector, the majority of which are breast augmentations and reductions simply because this comprises the greatest volume of requests. Last year there was an approximate 30% increase in cosmetic breast surgery in the UK. He covers the full spectrum of breast surgery in the private sector.
Within the NHS he also performs a very large number of breast cancer operations per year including full breast reconstruction. Unfortunately the incidence of breast cancer continues to rise year on year, although it has become one of the most treatable female cancers. More patients than ever survive their disease and he is glad to report that the majority do so without losing their breast or with a breast reconstruction that greatly reduces the cosmetic sequelae of a mastectomy.
A large component of Mr Turton's NHS work comprises Oncoplastic Breast Surgery. He is regularly performing operations to augment or reduce breasts to improve symmetry or performing cosmetic breast surgery in patients who have been accepted through the cosmetic exceptions panel.
Mr Turton completed further focused advanced technique improvement for cosmetic breast surgery under the auspices of the Inamed Academy.
He has visited the Akademikliniken in Stockholm Sweden and operated in person with Per Heden, recognized as one of Europe 's leading Cosmetic Breast Surgeons. He has acquired extensive surgical experience of style 410 (shaped) implants and it is this training that has been so important and so instrumental to the development of the techniques that he now uses on his cosmetic breast augmentation patients.
He continues to seek the very best and safest ways of performing aesthetic breast surgery and maintains an active programme of continuous professional development and audit.
This has included the following events in which Mr Turton has personally attended in the last 3-years:
Advanced Plastic Surgery of the Breast. Birmingham. November 2004.
Aesthetic Surgery of the Breast. European Symposium. Milan. December 2004.
Inamed Academy Programme Master-class on Cosmetic Breast Augmentation. Buckinghamshire. October 2005.
The British Association of Plastic Surgeons Educational Programme in Plastic Surgery: Breasts (March/April 2006).
Inamed Academy Phase 2: Akademikliniken, Stockholm , Sweden. April 2006.
Masterclass in Oncoplastic and Breast Reconstruction Surgery. November 2006.
Cancer research UK Clinical Trials Unit, 6th National Breast Trials
Meeting, ICC. Birmingham. November 2006.
San Antonio 29th Annual Breast Symposium. San Antonio, Texas. December 2006.
24th Miami Breast Conference.
Latest Advances in Oncoplastic Techniques. Miami Beach Florida. February 2007.
Allergan Academy Aesthetic Breast Congress 2007. Comprehensive scientific programme covering breast aesthetics. Hilton Metropole Hotel, London. April 2007.
Liposuction, Lipomodelling, Water-jet liposuction. Training day with Hartmut Myer, Hamburg. May 2007.
Allergan Breast Augmentation with 410 implant. Preceptorship, Personal advanced training techniques, Live operative demonstrations, & Fast-track recovery from breast augmentation. William Adams, Dallas Cosmetic Surgeon. September 2007.
Breast Augmentation Advanced Course. Presented in association with the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), The British Association of Aesthetic Plastic Surgeons (BAAPS) and the Royal College of Surgeons. September 2007.
The 4th Jersey Masteclass in Oncoplastic Breast Surgery. June 2008. International lecturers and live operative surgery.
Presentations in 2007:
Advances in Oncoplastic Breast Surgery. Weetwood Hall, Leeds. 1st February 2007.
Bilateral Breast Augmentation and Cosmetic Breast Surgery. Mammary Fold Educational Event. Birmingham. May 2007.
Advanced Breast, Oncoplastic and Aesthetic Breast Surgery. Educational Event. York. October 2007.
Television Show: ITV1 October 2007. Filming by ITV Yorkshire on Breast Reduction.
Presentations in 2008:
Television Show: Diet Doctors Insider and Out, Series 3. Channel 5. On Male Breast Surgery for Gynaecomastia
Local Meeting: Oncoplastic and Aesthetic Breast Surgery. Grand Round presentation, Leeds General Infirmay. January 2008.
Yorkshire Evening Post Article February 2008: Question and Answer Column on Breast Reduction Surgery for large breasts.
Cosmetic Breast Surgery, Aesthetic Breast Recosntruction and Oncoplastic techniques. The Body Beautiful Meeting April 2008.
Yorkshire Evening Post Article June 2008: Question and Answer Column on Breast Enlargement Surgery for cosmetic breast augmentation.
Literature and Specialist Aesthetic Surgery Books:
He reads widely around the subject of cosmetic breast surgery and enjoys teaching the techniques and lecturing to Specialist Breast Surgery trainees. He also instructs Oncoplastic Breast Surgery trainees and has the privilege to assist their final phase of training before they take up their own substantive consultant posts.
Relevant and interesting books which he owns, has read and would recommend to other aesthetic breast surgeons include:
Plastic and Reconstructive Breast Surgery by John Bostwick
Reoperative Plastic Surgery. Kenneth C. Shestak.
Breast Reconstruction with Autologous Tissue : Art and Artistry. Stephen S. Kroll.
Silicone Survivors: Women's Experience With Breast Implants. Susan Zimmermann.
The Silicone Breast Implant Story: Communication and Uncertainty. Marsha L. Vanderford & David H. Smith.
The Augmented Breast: Radiologic and Clinical Perspectives. David P. Gorczyca & R. James Brenner.
Color Atlas of Mammaplasty (Operative Techniques in Plastic Surgery). Paul K. McKissock.
Plastic and Reconstructive Surgery of the Breast: A Surgical Atlas. Heinz Bohmert.
Cosmetic Breast Surgery: A Complete Guide to Making the Right Decision--from A to Double D. Robert M. Freund & Alexander Van Dyne.
Atlas of Procedures in Breast cancer Surgery. Tari A King.
A Surgical DVD of Oncolastic and Reconstructive procedures of the Breast. G Querci Della Rovere
Liposuction. C William Hanke & Gerhar Sattler.
Oncoplastic and Reconstructive Surgery of the Breast.
GQ della Rovere, JR Benson, N Breach and M Nava.
And finally:
This site remains under development and information is being added on a weekly basis. Mr Turton hopes to provide a site that will ultimately be the preferred site for information on cosmetic breast surgery in the UK.
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