KEY POINTS:
An infection that turned a woman's breast reduction wounds septic has been blamed by the surgeon on a mosquito bite.
The doctor, who has interim name suppression, faces a charge of professional misconduct relating to the procedure he chose to perform on her in 2005.
He told the Health Practitioners Disciplinary Tribunal in Taradale yesterday the cause of the infection could not be known. Evidence from other surgeons has said the operation he performed was always going to lead to problems because of the woman's obesity and the size of her GG breasts.
A mosquito bite the woman received on her leg in the week after the operation became the focus of the hearing yesterday.
"It is my view that this exacerbated, or even caused, the infection in her breasts," the surgeon said.
He also denied choosing a technique that was not suitable for obese people.
"I did not and do not believe that it was not a suitable technique," he said.
"There were other procedures available such as a breast amputation and free nipple graft but I do not believe that such techniques are appropriate for a woman of child-bearing years."
Although the surgeon went ahead with his chosen technique, the 37-year-old woman lost her ability to breastfeed.
The surgeon said in his evidence the woman had not mentioned her wish to one day breastfeed.
"She had actually told our staff that she did not intend to have children and did not want to breastfeed," the surgeon said.
He said if a woman indicated she wanted to have children and breast reduction surgery he would usually recommend she bear children first.
On Wednesday the woman told the tribunal she had met another woman who had recently had the same surgery which had been organised by the surgeon.
She said the meeting hadn't meant much to her because she didn't know the woman before the surgery.
"If a conversation with a woman who had just undergone exactly the same surgery meant little to (her) then it is hardly likely that a detailed medical account would have been any more meaningful," the surgeon said.
In response to allegations the woman was not told of the potential risks the breast reduction posed the surgeon said he had given her an article entitled 'Breast Reduction Patient Information' which outlined the risks.
The surgeon said the woman had also filled out a positive appraisal form before she left hospital.
"In that form she makes no comment at all about feeling misinformed or uninformed," the surgeon said.
When the infection had set in and the women's breasts were leaking discharge profusely the surgeon said he did not tell her about the likelihood of misshapen breasts because it was not in her interest as she was already anxious.
"It is not always in the patient's best interests that a complete catalogue of the worst possible scenarios are set out for them," he said.
He said he also didn't inform her the antibiotics might not work for the same reason.
"To have informed her during this emotional period, that the treatment may not be effective would in my view have been cruel and was certainly unnecessary," he said.
The hearing continues.
- HAWKE'S BAY TODAY
