E P L Turton
FRCSEd FRCS(genSURG) MD(Hons)
Consultant Breast Oncoplastic and Aesthetic Breast Surgeon
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.
Mr Turton completed the Specialist Higher Surgical Training in General Surgery (comprises the sub-specialties of Breast Surgery, Vascular surgery, Endocrine Surgery, Hepatobiliary surgery, Upper GI surgery, Colorectal Surgery, Emergency Surgery) 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. He has worked full time at the Leeds Teaching Hospital as a substantive consultant ever since, and also in private practice at the Leeds Nuffield and Leeds Spire Hospitals providing a full breast aesthetic and oncological service that is second to none. He receives referrals from all over the UK.
Mr Turton is also an Honorary Senior Lecturer in Surgery for the Leeds Teaching Hospitals Trust. He is also a surgical trainer for Specialist Registrars learning the intricacies of Cosmetic Breast Surgery, Reconstructive Breast Surgery and Oncoplastic Breast Surgery. He was a member of the Education and Training Committee of the Association of Breast Surgery at BASO for 5 years and is now the regional ABS Committee representative serving on Council. He is also the regional representative for Oncoplastic Breast Surgery Training and is the General Surgery representative (for Breast Surgery) on the Training Interface Group for Reconstructive Cosmetic Surgery working with Plastic Surgery colleagues for the mutual benefit of patients. Mr Turton is also a member of the Aesthetic subcommittee for the Association of Breast Surgery.
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 behaviour within their speciality 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, through the parent speciality of general surgery, in breast diseases, breast cancer treatment and all aspects of surgery of the breast. They are full members of Association of Breast Surgery (ABS), a subspecialty association with more than 1200 members, who represent the many different professional groups who are treating breast cancer, share an interest in breast research, better models of training, data collection and patient care. Membership can be checked on the ABS website. 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 specialities, including not only plastic, otorhinolaryngological, maxillofacial and general surgery, the sub-specialty of breast surgery, but also ophthalmology, dermatology, dentistry, anaesthesia and clinical psychology. Mr Turton will only provide cosmetic breast surgery services- ie keeping in line with his specialist area.
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 Care Quality Commission 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 a lot of useful information about silicone implants and the curbs recommended to rid the industry of unscruplous sales techniques and the reformation of the whole industry.
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 neighbouring structures to create skin and muscle flaps. In addition, the opposite breast is often also operated on to reduce it’s size (breast reduction), to lift it (mastopexy), or to enlarge it (breast augmentation) to produce better symmetry with the new breast. Using breast plastic surgery techniques for oncological work enhances aesthetic results without compromising the oncological principles.
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: Therapeutic mammoplasty, 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. How many of this type of operation have they done since qualifying as a consultant?
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. Throughout the UK there are 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. They are involved in providing excellent NHS service, private practice, teaching, overseeing fellowship posts, and working in partnership with their plastic surgery colleagues.
He continues to work as a full-time Specialist Oncoplastic Breast and Reconstructive Breast Surgeon both within the NHS and in the private sector. His principal interest and workload are in breast surgery whether it be cosmetic or for the treatment of diseases of the breast. 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 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. Overall he performs around 200-300 breast operations per year.
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, recognised 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 in 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. He is now a trainer for cosmetic and reconstructive breast surgery registrars, who are awarded a post through the national Training Interface Group scheme. He also continues to lecture and provide training courses on cosmetic breast surgery where time permits.
This has included the following events in which Mr Turton has personally attended in the last 10-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 implants. 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 Masterclass in Oncoplastic Breast Surgery. June 2008. International lecturers and live operative surgery.
Lipomodelling of the breast. Canniesburn Plastic Surgery Unit, Glasgow. September 2008
International Meeting of Oncoplastic and Reconstructive Breast Surgeons. Nottingham. 22-24 September 2008.
The 1st St George’s Oncoplastic Seminar. 14-15th October 2008. London.
Yorkshire Breast Cancer Network Study Day. 11-12th November 2008. Harrogate.
San Antonio Breast Cancer Conference. December 2008. San Antonio, USA.
St Gallen Breast Symposium. 13th March 2009. Switzerland.
Association of Breast Surgery Conference. 17th April 2009. Harrogate.
1st North of England Breast Cancer Symposium. 25th April 2009.
Speciality skills in Oncoplastic Surgery. 8th September 2009, London.
Oncoplastic and Reconstructive Breast Surgery Conference. 28th September 2009.
San Antonio Breast Cancer Conference. 10-15 December 2009. San Antonio, USA.
2nd North of England Breast Oncology Symposium. 24th April 2010.
Breast Masterclass. 8th July 2010. Birmingham.
Breast reconstruction utilising Strattice Reconstructive Tissue Matrix. 8th July 2010.
Modern concepts: breast aesthetics and reconstruction. 9-10th July 2010. Birmingham
Association of Breast Surgery Education and Training Committee Meeting. 18th Jan 2011. London
QUEST Breast Reconstruction Trial Meeting. 28th February 2011. London.
3rd North of England Breast Oncology Meeting. 7th May 2011. Hull
Association of Breast Surgery Conference. 16-17th May 2011. Manchester
Association of Breast Surgery Education and Training Committee Meeting. 6th July 2011. London
Breast Update Course. 11th November 2011. Leeds. Invited lecture was given by Mr Turton on Modern Oncoplastic Breast Surgery and Advanced Techniques in Breast Reconstruction
4th North of England Breast Oncology Meeting. 28th April 2012. Hull
5th North of England Breast Oncology Meeting. 27th April 2013. Hull
Oncoplastic and Breast Reconstruction Conference. Nottingham. 23rd to 25th September 2013
Current Concepts in Aesthetic Breast Surgery. Royal Society of Medicine. 1st October 2013.
6th North of England Breast Oncology Meeting. April 2014. Hull
7th North of England Breast Oncology Meeting. April 2015. Hull
Beauty Through Science. Cosmetic Breast Surgery, Botox and Fillers. Stockholm. Sweden. 2015
Preceptorship in Cosmetic Beast Augmentation. Charles Randquist. Stockholm. Sweden. 2016
Allergan Medical Institute. Unlocking the Code to Facial Rejuvenation. Manchester. 2016
Presentations:
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.
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 Infirmary. January 2008.
Yorkshire Evening Post Article February 2008: Question and Answer Column on Breast Reduction Surgery for large breasts.
Cosmetic Breast Surgery, Aesthetic Breast Reconstruction 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.
1st St George’s Oncoplastic Seminar. London. 14-15th 2008. Lecture on Nipple Reconstruction.
Yorkshire Oncoplastic Breast Surgeons. Annual presentation and discussion of complex cases. 2012-2015
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 Oncoplastic and Reconstructive procedures of the Breast. G Querci Della Rovere
Liposuction. C William Hanke & Gerhard Sattler.
Oncoplastic and Reconstructive Surgery of the Breast. GQ Della Rovere, JR Benson, N Breach and M Nava.
Injectable Fillers in Aesthetic Medicine. Mauricio de Maio and Berthold Rzany.
Cosmetic Injection Techniques. A Text and Video Guide to Neurotoxins and Fillers.
Facial Aesthetics. Concepts and Clinical Diagnosis. Farhad B. Naini.
The Male Patient in Aesthetic Medicine. Mauricio de Maio and Berthold Rzany.
About the Allergan (formaly called McGhan) Natrelle Breast Implants and the Latest information.
ALLERGAN REASSURES PATIENTS AND SURGEONS OF THE QUALITY AND SAFETY OF ITS BREAST IMPLANT DEVICES SOLD AND DISTRIBUTED WORLDWIDE
Marlow International
The Parkway, Marlow
Buckinghamshire SL7 1YL
www.allergan.co.uk
Marlow, UK, 23rd December 2011 – Allergan, Inc. seeks to reassure patients and surgeons around the world utilizing Allergan’s breast implant devices (NATRELLE™, McGhan™ and CUI™) that its products are not part of the recent investigation into breast implant devices manufactured by French manufacturer, Poly Implant Prosthese (PIP) by regulatory authorities in Europe. It’s important to recognise that there are a number of different breast implant manufacturers around the world. The health authorities are specifically concerned about breast implants made by the company called Poly Implant Prosthese (PIP). Allergan maintains rigorous clinical development processes, extensive manufacturing and quality assurance testing, as well as an industry-leading post-marketing surveillance program, to ensure the highest quality and safety of its breast implants that patients and surgeons can rely on.
All Allergan implants are manufactured at our state-of-the-art facility using silicone and saline that is approved for use in medical devices and are designed to meet all relevant national and international Quality Control Standards and Current Good Manufacturing Practice (CGMP). Allergan is audited many times a year by various regulatory authorities including the European Notified Bodies and the U.S. Food and Drug Administration (FDA), to ensure its ongoing compliance with all applicable regulations and legislation such as the European Medical Devices Directive, US FDA regulations and guidance and relevant International Organization for Standardization (ISO) Standards, as well as the Company’s own exacting requirements. Such procedures ensure that all of Allergan’s medical devices are manufactured under a strictly controlled environment and that there is an established and validated process to ensure the consistency and quality of each device. From start to finish, it can take up to 12 days to manufacture and Allergan breast implant which undergoes almost 100 quality control tests, including materials inspection, product inspection and testing. These standards mean that every implant and tissue expander we manufacture is thoroughly evaluated for quality and durability.
In addition to the exacting standards to which we manufacture our implants, we also strive to exceed quality standards for labelling, packaging, shipping and traceability of all our products. These security measures include the use of tamper-evident seals, putting precautions and safeguards in place to prevent damage or interference with the implants and maintaining delivery tracking systems, which allows Allergan to facilitate notification to patients of new safety information regarding their breast implant products.
Allergan’s breast implants have been used with success for nearly 50 years, in more than 60 countries, with gel-filled implants being the most commonly selected implants worldwide. Allergan’s gel-filled breast implants have also undergone extensive assessment and evaluation by the relevant health authorities worldwide and have been CE marked and available in Europe since 1997. The U.S. FDA approval of gel-filled breast implants in 2006 followed the submission of extensive data gathered from the Company’s extensive pre-clinical device testing, use of PRESS RELEASE UK1126/2011 Date of Preparation: Dec 2011.
Allergan’s gel-filled breast implants in more than 1 million women worldwide, and nearly a decade of clinical studies involving more than 150,000 women with either gel- or saline-filled breast implants who had been followed for a total of over 214,000 person-years.
While breast implants have been safely used since the early 1960s, silicone technology has improved to where today’s implants are made with more consistent manufacturing parameters. Allergan’s implants have an advanced technology and enhanced safety profile due to several refinements in product design and manufacturing, including a more cohesive silicone gel, the addition of a barrier layer that is distinct from earlier breast implant devices, and a thicker shell that is designed to withstand more than 25 times the force of a normal mammogram without failure. In addition to the advanced cohesive silicone gel, Allergan’s breast implants offer further reassurance by using the unique INTRASHIEL™ Barrier Technology. The INTRASHIEL™ shell design is composed of several high-performance layers of silicone that act as a safety barrier designed to prevent any movement of the silicone gel.
Silicone gel-filled breast implants are among the most studied medical devices in existence, with more than 3,000 peer-reviewed and published reports on studies, including robust epidemiological studies, supporting their safe use. In June 2011, the U.S. FDA issued a report updating the clinical and scientific community on the safety of silicone gel-filled breast implants. This report confirmed that gel-filled breast implants are safe and effective when used as intended.
Health Authorities around the world, the medical profession and Allergan recognise that breast implants, saline or silicone, are not lifetime devices and it is possible, at some point in a patient’s lifetime, that the implant(s) may need to be removed or replaced. Allergan supports the recommendations issued by worldwide Health Authorities that physicians remain diligent in their monitoring of breast implant patients. We encourage patients with breast implants to keep up with their routine medical care and speak with their physician if they suspect any abnormality. We also encourage women who are concerned about their breast implants to contact their plastic surgeon.
As a world leader in special pharmaceutical and medical devices, Allergan is committed to the Science of Medical Aesthetics, which includes providing the highest-quality products and education to patients and surgeons. For nearly 30 years, Allergan’s medical devices have led the innovation in breast aesthetics and have consistently demonstrated a commitment to furthering the science, safety and quality of breast implant devices and surgery.
Further reading
• FDA Update on the Safety of Silicone Gel-Filled Breast Implants report issued by the Center for Devices and Radiological Health Division of the U.S. Food and Drug Administration in June 2011.
• Safety of Silicone Breast Implants report issued by the U.S. National Institute of Health’s Institute of Medicine (IOM) in 1999.
PRESS RELEASE UK1126/2011 Date of Preparation: Dec 2011
Allergan, Inc. is a multi-specialty health care company established more than 60 years ago with a commitment to uncover the best of science and develop and deliver innovative and meaningful treatments to help people reach their life’s potential. Today, we have approximately 10,000 highly dedicated and talented employees, global marketing and sales capabilities with a presence in more than 100 countries, a rich and ever-evolving portfolio of pharmaceuticals, biologics, medical devices and over-the-counter consumer products, and state-of-the-art resources in R&D, manufacturing and safety surveillance that help millions of patients see more clearly, move more freely and express themselves more fully. From our beginnings as an eye care company to our focus today on several medical specialties, including eye care, neurosciences, medical aesthetics, medical dermatology, breast aesthetics, obesity intervention and urologic, Allergan is proud to celebrate 60 years of medical advances and proud to support the patients and physicians who rely on our products and the employees and communities in which we live and work.
Forward-Looking Statement
This press release contains “forward-looking statements”, including but not limited to statements regarding product quality and safety, product manufacturing, adverse reactions, market and product potential, product availability and other statements associated with Allergan’s breast implant devices. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or unknown risks or uncertainties materialise, actual results could vary materially from Allergan’s expectations and projections. Risks and uncertainties include, among other things; technological advances in the breast implant device industry; challenges inherent in the regulatory processes; challenges related to market acceptance for our medical device products; inconsistency of treatment results among patients; potential difficulties in manufacturing a our medical device products; general industry and medical device market conditions; general economic conditions; and governmental laws and regulations affecting domestic and foreign operations. Additional information concerning these and other risk factors can be found in press releases issued by Allergan, as well as Allergan’s public periodic filings with the U.S. Securities and Exchange Commission, including the discussion under the heading “Risk Factors” in Allergan’s 2010 Annual Report on Form 10-K and subsequent Quarterly Reports on Form 10-Q.
© 2011 Allergan, Inc. Irvine, CA 92612. ® and ™ marks owned by Allergan, Inc. All rights reserved.
For further information please contact:
Janet Kettels, Allergan kettels_janet@allergan.com or +44 7738 506 476
Caroline Van Hove, Allergan vanhove_caroline@allergan.com or +1-714-227-5911
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.