What is Hypospadias

What is Hypospadias?

Hypospadias is a birth defect of the urethra in the male that involves an abnormally placed urethral meatus (opening). Instead of opening at the tip of the penis, a hypospadic urethra opens anywhere along a line running from the tip along the underside of the shaft to the junction of the penis and scrotum or perineum. A distal hypospadias may be suspected even in an uncircumcised boy from an abnormally formed foreskin and downward tilt of the glans.


The urethral meatus opens on the glans penis in about 50-75% of cases; these are categorized as glanular hypospadias. Hypospadias of the shaft (when the urethra opens on the shaft), and peroneum (when the urethra opens on the perineum) occur in up to 20 and 30% of cases respectively. The more severe degrees are more likely to be associated with chordee or curvature. Undescended testes and hernias can be associated with hypospadias.


Incidence of hypospadias

Hypospadias are among the most common birth defects of the male genitalia but widely varying incidences have been reported from different countries, from as low as 1 in 4000 to as high as 1 in 125 boys.There has been some evidence that the incidence of hypospadias around the world has been increasing in recent decades.


Causes of hypospadias

Most hypospadias are sporadic, without inheritance or family recurrence. For most cases, no cause can be identified.

Genetic factors are likely involved in at least some cases, as there is about a 7% familial recurrence risk.


Treatment of hypospadias

Glanular hypospadias are primarily a cosmetic defect and have little effect on function except for direction of the urinary stream. If uncorrected, hypospadias can make male urination messy, necessitate that it be performed sitting, impair delivery of semen into the vagina (possibly creating problems with fertility), or interfere with erections. Surgical repair of hypospadias is nearly always successful in one procedure and can usually be performed in the first year of life or at age 3. When the hypospadias is very proximal, or there are associated birth defects such as chordee, the best management can be a more complicated decision. It often requires a 2 stage repair. The foreskin is often used for grafting and circumcision should be avoided prior to repair.


Currently, I operate in the first year of life and the majority of children have 1 operation. The more severe cases have 2 procedures. The majority require a catheter or stent for 1 week but usually go home after approximately 3 days to return after 1 week for removal of the stent. They are then seen in the clinic 6 weeks later.


In a minority of patients surgery produces unsatisfactory results, such as scarring, curvature, or formation of urethral fistulas (leak) or strictures. A fistula is an unwanted opening through the skin along the course of the urethra, and can result in urinary leakage or an abnormal stream. A stricture is a narrowing of the urethra severe enough to obstruct flow. In my hands, fistula occurs in approximately 5% of cases and strictures very rarely. They usually require further surgery.


If you would like more information, please visit or to arrange a consultation at one of my clinics in Warwick, Coventry or Nuneaton, please call 07468 418 419

Interesting news for the world of Body Contouring

In 2014, more than 20 million aesthetic procedures were performed worldwide,

A recent research carried out highlights the predicted growth set to set hit the world of body contouring, this growth is estimated to rise by 8.61% CAGR between 2016-2020

What could be the reasons for this predicted growth?

  • An increase of qualified surgeons and practitioners carrying out these procedures
  • New procedures available
  • An increase in males having surgery

What is Body Contouring?

Body contouring refers to the procedures used to remove excess fat, skin, or both. Body contouring is mostly commonly carried out on areas such as the chest, thighs, and arms and occasionally to the face. There are many procedures available, the most common being Liposuction however Breast Uplifts (Mastopexy) and Tummy Tucks (Abdominoplasty) are also common Body Contouring procedures.

What is Liposuction?

Liposuction, also known as liposculpture or suction assisted lipectomy, is a technique to remove unwanted fat deposits. A narrow metal tube is inserted through a small incision in the nearby skin. It is attached to a strong vacuum pump which is drawn back and forth within the area of excess fat. The process removes tunnels of fat leaving the small blood vessels and nerves intact.

What is a Mastopexy?

Mastopexy commonly referred to as a Breast Uplift is a surgical procedure to address the sagging or drooping of the breast which usually becomes a concern following childbirth, breast feeding or weight gain. Pleats of surplus skin are removed from underneath the breast, the breast itself is remodelled into a tighter cone and the nipples are repositioned at a higher level so that they lie at the points of the tightened breasts. Mastopexy can also reduce the size of the areola (the darker skin surrounding the nipple). If the breasts are too small as well as droopy, their size can be increased during the operation by placing breast implants underneath the tightened breasts.

What is an Abdominoplasty?

Abdominoplasty (often referred to as Tummy Tuck) is a procedure carried out to remove excess skin and fat and to improve abdominal contours. The muscles are tightened during the procedure however there are different techniques available depending on the severity of the patients concerns.

If you are considering a Body Contouring procedure or any other cosmetic treatment and would like more information, please visit or to arrange a consultation at one of my clinics in Warwick, Coventry or Nuneaton, please call 07468 418 419


AMWC 2016 – The importance of congress to Plastic Surgeons

It’s been great reading all the updates from AMWC today, however due to commitments in the UK with my wonderful patients I’ve not been able to attend this years’ meeting in Monaco.

Why these meetings are an important part of the service my team and I bring to you in clinic

Many patients may not realise that in addition to carrying out consultations, operating and maintaining our own professional development there are many events that take place throughout the year of a Cosmetic Surgeon. These congress meetings are important opportunities for surgeons and industry specialists to come together to discover all the latest innovations in the world of Aesthetics and Cosmetic Surgery. We get to hear about new products and techniques, have the opportunity to attend lectures that are relevant to our own practices and also meet fellow surgeons from around the world.

These meetings are important to the team here at as they give me the opportunity to bring this innovation home to my clinic and patients, ensuring I can provide the service my patients expect and deserve.
For more information about my clinic and the procedures I specialise in, please visit my website above or you can contact a member of my team on 07468 418 419

The part that Social Media has played in the increase in the Cosmetic Surgery industry.

The part that Social Media has played in the increase in the Cosmetic Surgery industry.

The rise in Social Media over recent years has certainly played a huge factor in the rise in the cosmetic surgery industry. Platforms such as Facebook, Twitter and Instagram not only allow us access to celebrities, some of whom have undergone procedures themselves but non celebrities whose network like and share users images too. The ‘selfie’ unfortunately encourages people to be more critical of their own self image, a selfie taken at a certain angle or in bad lighting can make a user judge themselves inaccurately sometimes to the point where they seek further advice to change that feature. Prospective patients will often bring along an image of a nose they have seen on the internet or a breast shape that they’d like to achieve. I believe we should be thankful to the launch of the internet for that engine for finding useful information, allowing us to network and the opportunity to market our businesses, social media plays a huge part of this and like with any model comes with its own pros and cons that should be viewed in a balanced way.

If you are reading this article on a social media platform and would like to arrange a consultation, I hold clinics in Warwick, Coventry and Nuneaton. To make an appointment call 07468 418 419 or visit my website for more information.

Important things to think about before having a Breast Reduction


Stemming from the recent Breast Reduction surgery that American actress Ariel Winter underwent, this article highlights from a surgeons perspective the four most important things a patient should think about before considering a Breast Reduction. Miss Winter, a popular American TV star has been very open about having surgery to reduce her breast size from a 32F to a 34D and the reasons why she chose surgery. This article outlines the following considerations:


  1. The physical pain of having larger breasts

Unless a patient has larger breasts it is difficult to understand the discomfort and in some cases the pain that they can cause. Back and shoulder pain are the most common complaints, the weight of the breasts can put additional pressure on the spine which over time can be painful, bra straps will then add to the discomfort across the shoulder area

  1. The effect the size has on self esteem

Larger more pendulous breasts can affect body image, women can be deterred from wearing tighter fitting clothes, avoid certain sporting activities for example swimming etc and can sometimes be very conscious of their chest area.

  1. The result may not be exactly as you envisaged

We are always very clear in consultation that it is so important to be realistic about the result envisaged. Not only will the breast be smaller but it will be a different shape and in a different position to that remembered before surgery. The objective is to create a result that suits the patients’ body shape and one that the patient is happy with.

  1. The cost and the recovery

Breast Reduction is major surgery and will usually require a two night stay in hospital, it is of paramount importance that the discharge advice is followed, any medication is taken as directed and that the patient rests, to avoid infection or complications.


What is a Breast Reduction


Reduction Mammaplasty (Breast Reduction) is an operation which removes the excess fat and skin from the breasts, which are reshaped and the nipples repositioned to form newer smaller breasts. This should result in more attractive breasts and reduce many of the problems outlined above. There are several different surgical designs to reshape the breasts and are illustrated opposite. All of them will involve a scar around the areola of the breast. Each method will use different scars and will have advantages and disadvantages, the most suitable technique in each case will be discussed at consultation. Breast Reduction may be used to correct asymmetry of the breast, where one breast is very much larger than the other and where it is considered to be the least normal of the two.

If you are considering a Breast Reduction, I hold clinics in Warwick, Coventry and Nuneaton. To make an appointment please call 07468 418 419 or visit my website for more information.

Why patients choose Cosmetic Surgery?


This article is somewhat different from other items I have written, I tend to write about specific procedures, the benefits of the procedure and how they are performed. However today I came across an interesting article about the reasons why patients choose to have surgery.


Cosmetic Surgery is often connected to vanity however there are many reasons why patients choose surgery and the results can often be life changing. We live in a nation where looking good is important, we pay to visit the gym and stay healthy but there are sometimes alternative reasons why surgery is an option and there are many examples of this.


  • Blepharoplasty is a procedure to remove sagging skin from the eyelid area, Sir Alan Sugar is an example of someone who chose this procedure for more medical reasons. Back in 2007, the 59-year-old electronics tycoon had the operation because of vision problems, A qualified pilot, he explained that droopy skin overhanging his eyelids was threatening to block his sight and stop him pursuing his hobby of flying Learjets. Affected vision is a common symptom that patients describe when attending consultation, corrective surgery is usually minor and can often be carried out under local anaesthetic as a daycase patient.
  • Breast Enlargement is the most popular procedure sought by patients either for reconstructive (following mastectomy) or cosmetic reasons. Enhancement surgery is common amongst women who have naturally small breasts or who have lost volume and size due to weight loss or breastfeeding. Breast size can affect body image and confidence and in some cases deter individuals from going about day to day life for example swimming and wearing closer fitting clothes. Breast Enlargement is performed by placing an implant either on top of the muscle or behind depending on the look the patient wishes to achieve and can give the patient their confidence back.


  • Breast Reduction is one of the most life changing procedures I carry out, patients with larger and sometimes pendulous breasts can often suffer with back pain which can lead to posture issues, inability to find comfortable underwear and can cause some ladies embarrassment. Breast Reduction surgery is major surgery as in some cases it can involve taking away large amounts of fat, glandular tissue and skin. Following surgery women report to feel increased confidence and most importantly a new feeling of comfort that was unknown before surgery.


  • Male Breast Reduction / Gynaecomastia sometimes referred to as ‘man boobs’ can be an embarrassing condition for men to live with. It is provoked by an imbalance of the hormones Oestrogen and Testosterone and can vary from small, firm enlargement of breast tissue just behind the nipple to a larger, more female-looking breast. Males suffering with Gynaecomastia can sometimes be deterred from going to the gym or being seen shirtless as the condition often affects body confidence. Depending on severity Gynaecomastia can be treated in two ways, either with liposuction alone or if required with a combination of excision and liposuction to result in a smooth chest contour.


  • Tummy Tuck / Abdominoplasty is a very common procedure particularly for women who have had children and men or women who have lost weight. Pregnancy and weight loss can leave excess skin and fat around the abdomen which cannot be shifted by exercise or diet alone, it can make certain clothes uncomfortable to wear and affect body image. An Abdominoplasty is major surgery and involves the removal of fat and skin from the area, giving the abdomen a smoother effect and should only be considered once weight loss has stabilised and a females family is complete.


This article outlines only a small number of the conditions that affect patients that make the decision to have surgery, however there are many more. If you are considering a cosmetic procedure please visit one of my clinics in Warwick, Coventry or Nuneaton. To make an appointment you can call 07468 418 419 or visit my website for more information

Crowdfunding for Cosmetic Surgery? The Royal College of Surgeons to enforce regulation in the UK

Crowdfunding is the practice of funding a project or venture by raising many small amounts of money from a large number of people, typically via the Internet. It has become synonymous with the cosmetic surgery industry over recent years with the introduction of websites used to raise money for surgical procedures like breast implants.

I have written about responsible marketing in articles previously, and I do not believe Crowdfunding for Cosmetic Surgery is appropriate, it most certainly has a place but not within the cosmetic surgery industry. I have read many articles about successful crowdfunding projects; money raised for The Nepal Earthquake and the recent floods in the UK, for these kind of projects, Crowdfunding is a fantastic way of raising much needed funds.

Cosmetic Surgery on the other hand is serious and should not be taken lightly, I have to agree with Mary O’Brien of the British Association of Aesthetic Plastic Surgeons (BAAPS) who called the practice “degrading”, and stated that’s BAAPS were “deeply concerned”.

According to a report in the Sunday Times, doctors who perform surgery on patients who have crowdfunded breast implants “could find themselves in front of the General Medical Council (GMC) and potentially banned from practising”.
I support any recommendations and legislation that safeguard our patients and improve the quality of care that patients receive across our industry. Reportedly the Royal College of Surgeons (RCS) will be releasing new rules in mid 2016 that deter utilising web sites that help women to crowdfund for cosmetic surgery, great news RCS !!

If you are considering a cosmetic surgery procedure, I hold clinics in Warwick, Coventry and Nuneaton. To make an appointment please call 07468 418 419 or for more information please visit my

BAAPS say the number of men opting for cosmetic surgery doubles in the past decade

BAAPS say the number of men opting for cosmetic surgery doubles in the past decade

Figures in 2015 suggest that cosmetic surgery in men has doubled over the last 10 years. Surgery for men only accounts for 9% of the total cosmetic surgery industry however one of the most commonly carried out procedures in my practice is Male Breast Reduction (Gynaecomastia).  A Male Breast Reduction procedure is carried out to remove enlarged breast tissue (often referred to as ‘moobs’) and in extreme cases excess skin also.


The symptoms of Gynaecomastia can vary from a small, firm enlargement of breast tissue just behind the nipple to a larger, more female-looking breast, it can affect one or both breasts and the area can be painful or tender to touch.


What is involved in a Male Breast Reduction?

The breast is made up of two main components, glandular tissue (firm and dense) and fatty tissue (soft). The ratio of glandular to fatty tissue in any breast varies from individual to individual and in Gynaecomastia there may be an excess of both. If there is predominantly a diffuse fatty enlargement of the breast, liposuction is the usual treatment. If excess glandular tissue is the primary cause of breast enlargement, it may need to be excised (cut out). This will leave a scar, usually around the nipple edge. This excision can be performed alone or in conjunction with liposuction. Major reductions that involve the removal of a significant amount of tissue and skin may require larger incisions that result in more obvious scars. The procedure is usually carried out under general anaesthetic although in minor cases local anaesthesia and sedation can be used.


If you are considering surgery and wish to book a consultation with a GMC Specialist Surgeon, I hold clinics in Warwick, Coventry and Nuneaton. You can make an appointment by calling 07468 418 419 or for more information please visit my website

What cosmetic treatments would you pay for? – Poll conducted by…/what-cosmetic-surgerytre…

What cosmetic treatments would you pay for?

UK Based Website Money Saving Expert conducted a recent poll surveying 10,500 members of the public to discover what treatments are the most desired.

94% of women under 40 said they would consider an Abdominoplasty (Tummy Tuck)

What is an Abdominoplasty (Tummy Tuck)

Abdominoplasty or “tummy tuck” is a cosmetic surgery procedure used to make the abdomen thinner and more firm. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. This type of surgery is usually sought by patients with loose or sagging tissues after pregnancy or major weight loss

How is the procedure carried out

1. An incision is made from hip to hip just above the pubic area.
2. Another incision is made to free the navel from the surrounding skin.
3. The skin is detached from the abdominal wall to reveal the muscles and fascia to be tightened. The muscle fascia wall is tightened with sutures.
4. Liposuction is often used to refine the transition zones of the abdominal sculpture.
5. A dressing and sometimes a compression garment are applied and any excess fluid from the site is drained.

Patients are usually required to return for a post operative wound check appointment with a nurse to review recovery and to remove any sutures. An Abdominoplasty is major surgery and will usually require a two night stay in hospital and lots of rest to reduce the risk of post operative complications.

If you are considering an Abdominoplasty (Tummy Tuck) I hold clinics in Warwick, Coventry and Nuneaton. If you would like to make an appointment please call 07468 418 419 or for more information you can visit my website

A Point of View: Does cosmetic surgery really make people feel better about their bodies?


A very interesting read here and some may think that as a #Cosmetic #Surgeon I would be in favour of cosmetic surgery or treatments for every patient irrespective of their reasons for making the decision to have surgery, they would be wrong.


As an independent plastic surgeon,  I see many patients in my clinics and with varying stories behind their decision to have treatment. The most common reasons being to boost self confidence and self-esteem, however on occasion I see patients that I do not feel are right for surgery at that time. It could be that the result they are looking for maybe unachievable, that they have had surgeries before and not been satisfied which can sometimes point towards psychological issues, or even made the decision due to peer pressure, these patients in my opinion are  not suitable candidates and I will always advise them to go away and think very carefully about their reasons or to seek further support before they proceed.


#Cosmetic or #Plastic #surgery is a life changing decision and requires a great deal of thought not only about the procedure itself or the surgeon you choose but also about the reasons behind your decision. A good surgeon will decline treatment to unsuitable patients, quite often these patients go home and consider the reasons, sometimes they will change their minds entirely and sometimes even years later they will come back often with a completely different mindset. As a surgeon it is a great feeling to have provided this support and probably why many of my patients refer their friends and relatives into my care.


Are you considering cosmetic surgery, what is the next step?


I hold clinics in Warwick, Coventry and Nuneaton. To make an appointment please call or 07468 418 419 or for more information please see my website