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00:01Surgeons.
00:02They can change your life forever
00:05as they tread the line between life and death.
00:08We got a bed.
00:11But what's it really like to hold someone's life in your hands?
00:15It's miracles and disasters. Nothing in between.
00:18Let's get this bugger out!
00:20And how do you balance the needs of others
00:22with the needs of your family?
00:24Own sweet home.
00:25You take care and have a good sleep, alright?
00:29I will do. Love you, Mum. Bye.
00:31Now, we go behind the mask
00:33to find out just what it takes...
00:36I feel like you've been hit by a bus.
00:38...to live life as a surgeon.
00:41A bit of a rollercoaster.
00:43It looks bright, yeah.
00:44It all went really well.
00:46Professor Omar is number one.
01:04Sasha Dewar is a consultant breast surgeon working at Broomfield Hospital in Essex.
01:11My parents were doctors.
01:13So, medicine's in my DNA.
01:15And I chose to do surgery because it's the hardest thing as a woman
01:19that I possibly could have done at that time.
01:22Only 17% of NHS consultant surgeons in the UK are female.
01:29Breast surgery was the perfect combination of science and creativity.
01:34You had to cure people,
01:35whilst also making women feel good about themselves.
01:43The breast unit at Broomfield is one of the largest specialist centres in the country.
01:51Today, Sasha is giving biopsy results to 36-year-old Jess,
01:56who recently found a lump on her breast.
01:59She's here with her mum, Jo.
02:02The waiting in general was quite tricky.
02:04On the one hand, we had time to process it.
02:07On the other hand, it just felt like a long time, didn't it?
02:11Waiting.
02:11You've been very strong.
02:13But, yeah, you just want to know a definite answer
02:16and then a definite plan going forward, that's all.
02:19You have got a 14-month-old baby to keep you on the end.
02:22Yeah, exactly. I've been busy, so...
02:25Hello, Jessica. Hi, I'm Kira, one of the breast care nurses.
02:28And who have you brought with you today?
02:29OK. Mum, please take a seat here.
02:32Hiya, come on in. Hi.
02:33I've got matching glasses.
02:35I think yours are nicer.
02:38OK, right, so I met you last week and I told you that this wasn't a cyst.
02:42This was a solid lump and it looked a little irregular,
02:44so I was a little bit concerned about what we were going to find.
02:47Now we've got some more information
02:49and we have confirmed that this is a breast cancer.
02:52OK. OK?
02:56You were expecting it.
02:58You're young, so we will throw everything at you.
03:01OK.
03:02As Jess's tumour has been found early,
03:04Sasha can operate on it.
03:06Let me just say what the operation would be.
03:08It's a small lump, OK?
03:09So let's just say my aim is to take away the lump
03:13and a margin of tissue around it,
03:16a bit like a thick layer of chocolate around a Malteser,
03:18and we call that a lumpectomy.
03:21What you have here in your case is a cell where the cancer has gone through the cell wall.
03:28OK.
03:28And that's where the word invasive comes in, OK?
03:32Invasive cancer has the potential to spread elsewhere in the body,
03:36most commonly to the lymph nodes.
03:39At the time of surgery, we'll take a couple away just to make 100% sure.
03:43Yeah. OK.
03:44Lymph nodes, the lump, goes to the lab,
03:46and then we have another meeting, and I call that checkpoint too, OK?
03:49It goes fine, yeah.
03:50All right, so the main thing that you can do whilst you're waiting
03:53is get your fresh air, get your five-a-day, look after each other.
03:58Yes, definitely.
03:58OK?
03:59It's lovely to meet you both, and I can see you're well supported.
04:02Yes.
04:03And take care, guys.
04:04Bye.
04:14Jess is a mum to 14-month-old Matilda.
04:19Having a little girl has actually been kind of positive
04:23because I haven't been able to think so much
04:25because I've been just so busy with her,
04:28but then also you've got the flip side of that where you think,
04:31oh, God, what if, you know, the treatment doesn't work?
04:34Then, obviously, all you're thinking about is how it affects her,
04:37which makes her experience, you know, a little bit scarier.
04:42I have confidence in the team,
04:45but it's very hard to hear your daughter sit there
04:48and talk about potentially serious procedure
04:51that's going to happen to it.
04:53But, yeah, it's hard when it's your baby.
05:00Yeah, I think I had to come this way for my MRI, and it's really fun.
05:05Go on, have a hug.
05:06It's Operation Day, and Jess is with her husband, Dan.
05:10I know.
05:13See you later.
05:15See you.
05:16Big day's arrived.
05:17Yeah?
05:18How are you feeling, my darling?
05:19Yeah, good.
05:20Yeah, all fine.
05:21Trepidation mixed with excitement.
05:22Yeah.
05:23I just want to get rid of it now, obviously, so...
05:26So, let's pull the curtains round,
05:28and let's have a little look at you.
05:29Yeah, no problem.
05:31Perfect.
05:32OK, straighten up.
05:33There we go.
05:34Show me where your lump is.
05:37Yeah.
05:38My plan is to keep the scar somewhere neat and discreet.
05:41At the edge of a natural crease that you've already got,
05:44or somewhere that's nicely hidden.
05:47So, when you look at the mirror in the morning,
05:50don't see him.
05:53Sasha is an oncoplastic specialist,
05:56combining cancer treatment with reconstructive surgery.
06:00The whole recovery from breast cancer,
06:02we realise it's down to not just being tumour-free,
06:06but how a woman looks after surgery.
06:09There are so many women walking around
06:11that have had breast cancer,
06:13but they don't need to wear a mutilating scar.
06:22Nisa, get the pictures up for Jess, please.
06:26Sasha is operating with registrar Nisa.
06:30This is a great picture.
06:31So, that's interesting.
06:33It's useful.
06:34You can see here, can't you?
06:35Yeah, quite obviously.
06:36It's palpable, which means you can feel it,
06:38but it's on the muscle here at the back.
06:41So, that's the muscle coming down, isn't it?
06:42So, that's a good mammogram.
06:44And this shows that it's at the back of the breast there.
06:46Well, I think it's going to be
06:47what we call the level one glanduloplasty.
06:49Level one just means bringing the tissue together.
06:52Yeah.
06:52Or in my food vernacular,
06:55bring the sizes of the piece of pie together
06:58so that there's no dent.
07:00Sounds good.
07:01Okay, good.
07:02Let's go.
07:06Sasha will make an incision around the areola,
07:09the area of skin that surrounds the nipple.
07:14From here, she'll gain access to the breast
07:16and remove the tumour.
07:19She will then remove lymph nodes from the armpit,
07:22carefully avoiding the auxiliary vein.
07:24The main blood vessels supplying and draining the arm.
07:29Finally, she'll bring the breast tissue together
07:32without leaving a dent where the tumour has been removed.
07:36Hello, stranger.
07:39Just squeeze my hand.
07:41Now, I'm not giving you my right hand
07:43because it's the one I need to operate with.
07:46So, you're going to squeeze my left hand
07:48and if you squeeze it really hard,
07:50I'm okay because I've still got one good one.
07:54My patients, I hope,
07:56find me warm and approachable and kind.
08:01They might remember that I held their hand
08:03as they went off to sleep.
08:06So, good night, have a good sleep.
08:09You're in good hands.
08:10But, ultimately, the moment those theatre lights go on,
08:14I've got a job to do.
08:15Remember, we can't overrun.
08:18Let's do a background count.
08:20Six, five, five.
08:20Before surgery, Jess was injected
08:23with a low dose of radioactive material.
08:26All right, blue dye going in, guys.
08:28She is now also injected with blue dye.
08:31These will travel to Jess's armpit
08:33and allow Sasha to identify the lymph nodes
08:36that need removing.
08:38Good, good.
08:39Well done.
08:42Plenty of exposure.
08:45Starting.
08:46Next, Sasha makes a small incision
08:49to access the breast tissue.
08:51One of my own.
08:5240-40, I asked for.
08:54Skin hooks.
08:55Please.
08:57Skin hooks for this, not cows,
08:59because the hole's too small.
09:00Yeah.
09:02Agreed.
09:03Agreed?
09:04Agreed.
09:04So, the challenge here is a tiny hole.
09:08It's the closest you'll get to keyhole surgery.
09:10Here's a deep, dark hole,
09:11but it's going to give her
09:12the best oncapastic outcome, isn't it?
09:14Yeah, I agree.
09:15You can really feel it, can't you?
09:17Yeah, it's a proper hole.
09:18It's like a little tiny golf,
09:19but it's a Malteser.
09:23Oh, that's nice, Nita.
09:25It's bleeding for you to deal with.
09:27It's just a bleeder.
09:29Because what happens with tumours
09:31is that, as they grow,
09:33they take on a new blood supply.
09:35It hasn't taken long to locate the tumour,
09:37but now, before it can be safely removed,
09:41she'll have to stop the bleeding.
09:52At Broomfield Hospital,
09:54surgeon Sasha Dewar
09:55is operating on 36-year-old Jess.
10:01Here we go.
10:03So, that's the tumour.
10:05She is removing a cancerous tumour
10:06from Jess's breast.
10:09There we go.
10:10OK.
10:11So, that has come from here.
10:14That's her little triangle.
10:22Look.
10:23Look at that.
10:24That's where it's come from.
10:26That would be the cavity
10:27if I didn't try and close it.
10:28And as soon as she tried to put a bra on,
10:32she'd end up with a cavity like that.
10:35But what I'm going to do
10:36is bring the edges together.
10:38Let's do the axilla.
10:39Let's do the armpit.
10:41There is a chance
10:42the cancer could have spread
10:43to the lymph nodes in Jess's armpit.
10:45How we want it.
10:46Can I have some light over my shoulder,
10:47please, both sides?
10:48So, Sasha will carefully remove some
10:51and send them off for testing.
10:53So, you already had a listen.
10:56I'd love a bit of volume.
10:59The two injections Jess had earlier
11:01will mean any lymph nodes
11:03that need to be removed
11:04will hopefully be dyed blue
11:06and emit a radioactive signal.
11:10Oh, look.
11:11Right where the probe is.
11:13I can see.
11:15Bright blue nodes.
11:17Let's see if that's the node that was noisy.
11:20If the gamma probe makes a noise,
11:22the lymph node is radioactive
11:24and Sasha will remove it.
11:28So, that's what we call
11:29central lymph nodes.
11:31Hot and blue.
11:33Now the question is,
11:34how many are there?
11:38Jess means absolutely everything to me.
11:41We met and that was just
11:45kind of an instant thing, to be honest.
11:49And wow, it just went so fast from that point.
11:54Yeah, when you know, you know, right?
11:59You don't like to think the worst,
12:04but you naturally do.
12:06Don't even want to go down that thought pattern
12:11of Jess not being around for Matilda, really.
12:17Yeah, I guess I'm not trying to overthink at this moment
12:21until we know the outcome from today.
12:25And, fingers crossed, it's a positive outcome.
12:32Something up there.
12:34Sasha has removed two lymph nodes from Jess's armpit.
12:38And then there's something here as well.
12:40When you pulled that out, there was another big node behind it, I think.
12:43Oh my God, that's so deep.
12:45The vein, which is the main thing,
12:48that I'm trying to stay away from,
12:51is right here.
12:54The auxiliary vein carries blood from the arm and chest
12:57towards the heart.
13:01Sasha must work carefully to avoid damaging the vein.
13:05Do you think I've got it?
13:08Yeah, there's another node.
13:10It's deeper. I had it.
13:12There appears to be another lymph node that still needs removing.
13:17Okay, are you protecting me from that very big vein?
13:20Yeah.
13:20Okay, let's stay away from that.
13:23That might be it.
13:25Just above it, yeah.
13:28Oh, that's veins.
13:30That's veins again.
13:32If Sasha can't find the final lymph node,
13:35it could mean leaving cancerous cells in Jess's body.
13:40There.
13:41Don't move.
13:44Ew, it's so high up.
13:49Bingo.
13:50That's blue.
13:51That might be it, yeah.
13:55That's it.
13:56That's it.
13:57That's it.
13:57Okay, let's get this bugger out.
14:00They find it, deep inside Jess's armpit.
14:04It's only tiny, isn't it?
14:05It's teeny tiny.
14:07All that struggle.
14:13And it's delivered.
14:15Yes, we're getting the same ring here.
14:16But look, we're getting the same ring.
14:17So, three, four hundred.
14:19Pack it up, because that will bleed now.
14:22It's so tiny.
14:23It's literally a lentil.
14:26Right, pressure up.
14:28We're closing.
14:28Yeah.
14:29Okay, can you put a stitch in...
14:31The three lymph nodes will now be tested to see if they contain any cancer cells.
14:37The results should be back in two weeks.
14:41Sasha now has to finish filling the dent left by the tumour in the breast.
14:47The trick here is to try and magic up a bit of tissue to fill the dents.
14:55Sorry, I just got hit by blood.
14:59We've closed the dent, so that little circle is where the dent was.
15:03That will all settle down to be a nice, smooth, filled defect.
15:09Thank you to everybody for today.
15:13Challenging case, but I'm glad we took that extra time.
15:16We got the lymph nodes out.
15:18I was like a dog with a bone.
15:19I couldn't...
15:20You know, once you hear the trace, you can't unhear it.
15:23You know that there's more going on in there.
15:28Got a bit hairy.
15:29A couple of moments there.
15:30It's a bit bleedy.
15:31Didn't enjoy that very much.
15:33But the operation that tends to be in the upper inner quadrant,
15:37blood vessels are bigger and the pressures are higher.
15:40Big pressure vessels, full of blood, pumping.
15:45Well done, Jess.
15:48She's waking up nicely.
15:58Hello.
15:59Hello.
16:00Hello. Is that Dan?
16:02Speaking.
16:02Dan, hi. It's Sasha.
16:05Jess is surgeon.
16:06Jess is doing fine.
16:08OK?
16:08It's all gone really well.
16:11So, I've called you the minute I've downed tools
16:13to let you know that it's all gone fine.
16:16So, when is she out, Sasha?
16:17Do you know?
16:18No, we're going to let her go this evening.
16:21Her own home is the safest place for her, to be honest,
16:24because then I know...
16:25Oh, I guess you're on daddy duty.
16:28Are you coping OK?
16:30Yeah, that's enough for me now to stop.
16:32I was just obviously really nervous about how it all went.
16:37Yeah, no, that's great.
16:38Take care, love.
16:39Bye-bye.
16:40Bye.
16:43Relief.
16:44Always good to hear.
16:46I need to text my kid.
16:50Won't be leaving for a little while.
16:55That's overrun.
16:58Are you OK?
17:00For a bit longer.
17:04Oh, this is telling.
17:06Whatever sends you home relaxed.
17:10Huh.
17:11From the mouths of babes.
17:17Hey, listen.
17:19It's going to hit you now.
17:20Bit of a roller coaster.
17:22I haven't tried yet.
17:23I know, sweetheart.
17:24Get her some tissues, guys.
17:26Come on.
17:27Listen, you just go with it.
17:30You just go with it, because there's going to be...
17:33There's going to be high points and there's going to be low points.
17:36At least it's a relief.
17:38Yeah.
17:38It's the anticlimax.
17:40Yeah.
17:40All you need to do now is literally just eat well,
17:43snuggle that baby, hug that husband...
17:46Yeah.
17:46..and let everyone look over to you.
17:48The cancer is gone.
17:49Yeah.
17:50OK?
17:51It's out.
17:52OK?
17:53Onwards and upwards.
17:54All right, sweetheart.
17:56Have a good rest.
17:59Jess will now spend a couple of hours in recovery
18:01before Dan can take her home.
18:19It's absolutely joyous when you finish a list and it's gone well,
18:25and I can go home happy and relaxed,
18:28that everyone has been discharged safely to their homes,
18:31and now I can just concentrate on my baby.
18:36It's gone 6pm,
18:37and Sasha can now collect her 13-year-old daughter, Athene.
18:41I had Athene as soon as I became a new consultant.
18:46In addition to being a woman in surgery,
18:49I was a woman with a small child.
18:52Hey, baby.
18:53Hey.
18:54Hey.
18:55You OK?
18:56I'm good.
18:57So how was your day?
18:59It was good.
19:00Um...
19:00I want to hear all about it.
19:02OK.
19:02So four years into my surgical consultant post,
19:08I suppose Athene was three, nearly four.
19:11I went through a difficult divorce.
19:14How did it go? Tell me everything.
19:16We had a surprise test.
19:18Oh, we love those surprise tests.
19:21Oh, yes.
19:22Athene was in my care the vast majority of the time,
19:25so I was the sole breadwinner for both of us from that moment on.
19:31We've had to navigate every step of the way.
19:39Athene and I both finding our feet.
19:42It was hard.
19:44So rude.
19:46So she is quite independent.
19:48She's just...
19:49Yeah.
19:50Happy?
19:51Mm-hm.
19:52Have you washed your hands?
19:53About to.
19:54She's had to grow up adulting
19:56sooner than she probably would have been ready for.
20:00Can you read? I haven't got my glasses on.
20:02Is it 180?
20:03Yeah.
20:04She's the one that sometimes needs to look after me.
20:08Right, so after this, I'm going to sit down,
20:10I'm afraid, darling, and do my taxes.
20:13I mean, I've already got most of my work done,
20:14so I think I'm just going to shower,
20:18do my hair, and then...
20:19You must be exhausted after all that rowing.
20:21If I have time, I might do a bit more, but...
20:24No, rest properly.
20:25Yeah.
20:26I guess that would benefit.
20:26Yeah, exactly.
20:28I'm trying to give her as much for childhood still.
20:29I hold on to it with every fibre of my being.
20:32Is there anything else you need for the pool?
20:36Goggles.
20:52Morning.
20:54Morning, Dr Tomer.
20:56Sasha has worked at Broomfield Hospital for 17 years.
20:59Yes.
21:01Good morning.
21:02Good morning.
21:03Oh, that's cute.
21:05Yeah.
21:07Okay.
21:09And...
21:10Yeah, more chocolate.
21:11Okay, right.
21:12Dear Sasha, I found one of the worst things about cancer
21:15is being frightened and seeing my husband being frightened.
21:18I'd wake up at 3am and remember the cancer with a jolt.
21:22It felt like I was in capable hands from the start
21:24and that made me slightly less frightened
21:26because for the first time in the process,
21:28I began to understand that the cancer could be dealt with
21:31and those charts that chemo and radiotherapy and surgery
21:34could be successful.
21:38I remember you walking past my bed after the surgery
21:41and I yelled out,
21:42thank you, I'll remember you for the rest of my life.
21:47Yeah, that's special.
21:51Oh, really?
21:52Yes.
21:54Today, Sasha, a consultant radiologist,
21:57and a team of nurses are running a clinic for women
21:59concerned about their breast health.
22:05How old are you, sweetheart?
22:07Uh, 52.
22:09God, she looks good for 52.
22:11Oh, thank you.
22:12What's your secret?
22:13Just natural Brazilian genetics.
22:18Women are referred to the clinic from their GP
22:20for specialist assessment.
22:23So, show me your lump.
22:23Is it very sore?
22:25Painful?
22:26Yeah.
22:27I'll be gentle, okay.
22:30The majority go home with nothing to worry about.
22:33The thing is, is that you're in an age group now
22:36where cysts are really common.
22:38Get it checked.
22:39If you've got something that doesn't go away on its own,
22:41okay?
22:41Thank you very much for that.
22:42Well, you were very brave.
22:46What surprises people about my job as a surgeon
22:49is how little time I actually spend in an operating theatre.
22:53Fixing up worried well patients
22:55with the information to empower them
22:58to look after their own health,
23:00that's an important part of my role.
23:03So, again, so hands, let's do the upper outer quadrant together.
23:07So, soapy hands in the shower.
23:08It's that kind of pressure that I used on you, okay?
23:11Okay.
23:11Soapy hands, you don't need to go crazy.
23:13Then I want you to come out of the shower,
23:15ring your little bell and go your turn.
23:17Okay?
23:19Hi.
23:20Hello.
23:20Come on in. Hello.
23:22Take a seat.
23:22It is the most rewarding consultation.
23:25When I see an anxious woman
23:29and show her that she's in the hands of a team
23:33that can look after her
23:35and send her out with some positivity.
23:40This all feels very normal.
23:42I can feel what you can feel,
23:42but I think there's this normal breast issue.
23:44Dr. Tamer, what do you think about the mammogram?
23:47They look normal.
23:49Normal.
23:50We're happy.
23:51Okay?
23:52Breathe.
23:54Okay, right.
23:55I'm going to leave you in peace.
23:56Get changed.
23:57We're happy.
23:58Nothing more I need to do.
23:58We've got some tissues up there,
24:00if you're feeling a bit emotional.
24:12Tony was diagnosed with breast cancer five weeks ago.
24:16Today, Sasha is operating on Tony
24:18to remove the two tumours
24:20and give her a modified breast reduction.
24:24It's out of my hands now.
24:25You know, I've done the bit, I'm here.
24:29She is here with husband Neil.
24:31I'm nervous for Tony and very apprehensive,
24:35but I know that she's in good hands and breathe.
24:40Yeah.
24:49Tony and Neil are grandparents
24:50and live near Braintree in Essex.
24:53He's cut it down a bit further.
24:55I know, you say that every year.
24:57I know you don't.
25:00You know, you always think that it happens
25:03to somebody else.
25:05And there's...
25:06I mean, I am that somebody else.
25:08You know, there's no reason why
25:09I shouldn't be that somebody else.
25:11If you've got it,
25:13then you've got a fight on your hands.
25:15And you've just got to hope at the end of the day
25:18you'll win the fight.
25:20You have to be positive.
25:21We've got a grand order.
25:23We've got to keep entertained.
25:38This is so cool.
25:42I love this.
25:43It makes me feel like a proper tailor.
25:45In just a few hours,
25:47surgeon Sasha Dewar
25:48is operating on breast cancer patient Tony.
25:52What an honour to be allowed to do
25:55what I love all day long.
25:57I get to use my creative talents.
25:59I get to use my scientific mind.
26:01There's nothing more thrilling.
26:04Hey, hey.
26:06Good morning.
26:07Hello, darling.
26:08How are you?
26:08How are you?
26:10You know what I'm going to do on you now?
26:12I'm going to draw on you.
26:14Again?
26:15No.
26:16So we're going to draw
26:16and it's going to be weird
26:17and it's going to be a little awkward,
26:19but it's going to be ten minutes of
26:20one of us having our top off
26:22and it's not going to be me.
26:24I'm getting used to this.
26:28Sasha is going to remove two tumours,
26:30but she'll also give both of Tony's breasts
26:32a reduction at the same time.
26:38Which I'm going to mark.
26:40The correct position of your nipple.
26:42It's just funny being drawn on.
26:45She must draw on Tony's breasts
26:47to plan the cosmetic part of the operation.
26:52You know the Vitruvian man, Leonardo da Vinci,
26:54you know?
26:56What we know from all of those studies
26:59from those early anatomists
27:00is that the perfect position of the nipple
27:04is about a third of the way up from the elbow.
27:07And look at that.
27:08We are.
27:09Yes.
27:10So many women seeing a breast surgeon
27:12in years gone by
27:14weren't given much of a choice
27:16how their tumours removed.
27:19I look at a woman and see what she's got
27:22to start with
27:23and see if I can use her own body
27:25to help me.
27:27It's not about what we take.
27:28It's about what we leave behind.
27:33So what I'm trying to do
27:34is show myself
27:35how I'm going to create
27:36this kind of side profile.
27:38Look how lengthening it is for your waist.
27:41But basically I need to know
27:42how much give there is in the breast.
27:44A lot.
27:47Enough.
27:48It's a big part of holistic recovery, I think.
27:51To give something
27:52to somebody that's beautiful
27:54in the context of something awful.
28:00Sasha's former trainee, Emma,
28:02has come back to assist with the surgery.
28:05I know those who are.
28:06Hi, Sasha.
28:08Hey, darn it.
28:09How are you?
28:09I can't believe you came for me today.
28:11Thank you, Melbourne.
28:12No worries.
28:13It was an absolute pleasure.
28:14Yeah, let's go.
28:17There's no better assistant
28:18than somebody you've just trained up yourself
28:20that's a consultant now.
28:22So we've got a tumour machine.
28:23Ready?
28:23OK.
28:25Sasha will remove the two tumours,
28:27which are located high up on the chest wall,
28:31carefully avoiding damaging any blood vessels.
28:34To fill the cavity left behind,
28:37she will move tissue within the right breast,
28:40reducing it in size at the same time.
28:44The left breast will then be reduced in size
28:47and reshaped to match the right.
28:50Finally,
28:51she will ensure the nipples are repositioned
28:53in the correct place.
29:00Ready to start?
29:04Sasha carefully makes the first incision
29:07to access the breast tissue
29:09whilst preserving the nipple.
29:12So we get to save this whole quadrant of the breast.
29:16This piece of tissue can be saved
29:21and tucked up to fill this defect.
29:26Nearly there,
29:28and then I can start going for the tumours.
29:31Yes.
29:31And I'm taking away two tumours,
29:34you know, amongst the major vessels to the nipple.
29:36So I've got to think of another way
29:38of keeping this nipple alive
29:40whilst also taking those tumours out
29:42from this tiger territory.
29:46The tumours are close to major blood vessels in the chest.
29:50Cutting a few millimetres in the wrong direction...
29:53Swabs coming, please.
29:54..could have serious consequences.
29:56Got it.
29:57Small swabs.
29:58Tiny hole.
30:01Still bleeding, so stay where you are.
30:07There you go. Great.
30:09That's taught my lesson.
30:10Yeah.
30:11That is the tumour that she can feel.
30:13That's the highest one.
30:14That's the one near, you know, in her necklace line.
30:17Lovely.
30:18We're down to muscle already.
30:20Thanks, darlings.
30:22Sasha has reached the two tumours
30:24and can begin to remove them.
30:27Right.
30:27Clips ready?
30:29Don't move.
30:31Don't let it ping.
30:32Stay where you are.
30:33Let go.
30:35Clips off.
30:37Right.
30:39Let's unfold that.
30:41Let's unfold that.
30:41The tissue containing the tumours will be analysed in a lab
30:44to ensure all the cancer has been removed.
30:49Do you want to go and start on that side?
30:51Yeah, can do.
30:52Yeah.
30:53Sasha and Emma now move to the cosmetic part of the operation.
30:58Anu, are you okay to stretch for her?
31:01Yeah.
31:01Is that all right?
31:01Starting with reducing the size of the right breast.
31:05This is already small.
31:07Okay.
31:08Right lateral reduction.
31:13This here is going to form the central point of the new nipple.
31:18Yeah.
31:19I want to now think about the tissue that I'm, again, leaving behind.
31:23The skin that's going to be left behind.
31:25I want good vascularity.
31:27I want no thinning of the skin here.
31:30All the time keeping the nipple on its blood supply,
31:34which is from the muscle behind.
31:39Sasha moves the tissue around within the right breast
31:42to feel the dent that was left by the tumours.
31:46Just got to make it come over a bit more.
31:48How much more do you think I need to liberate to get it to come over?
31:52I don't think you need to liberate much more.
31:53Shall we have a quick look?
31:58Lovely.
31:59Shall we do a little sit-up, please?
32:01It's a beautiful shape.
32:02It's got that nice triangular kind of shape.
32:04Okay.
32:05So that's a nice nipple height and we agreed that.
32:07The defect is filled beautifully.
32:11She's got more of a cleavage now than she did before.
32:15And we've taken our two tumours.
32:17Yeah.
32:19With the right breast finished,
32:21Sasha must reduce the left to match.
32:24I know what I need to do.
32:25Okay.
32:26Which is basically take away the saggy part at the bottom of the breast,
32:29and then the top part of the breast will create a mound
32:32that is equivalent in volume to that.
32:38This is a bigger breast.
32:39I'm expecting more and I'm going to take more.
32:45Using staples, Sasha closes the left breast and checks its size.
32:52It feels too big.
32:53I know it's too big.
32:57You can feel that this is much bigger, isn't it?
32:59And it feels tight.
33:03Okay.
33:03Let's take some more off from the left.
33:06And then...
33:08So it's too high and it's too full.
33:12Despite being two and a half hours into the operation,
33:14with the breasts not looking symmetrical,
33:17Sasha decides she must reopen the breast.
33:33Sasha has removed two tumours from Tony's breasts,
33:37but she's not satisfied with their shape.
33:40I'm going to take out this fullness, this height.
33:43You can always take more out.
33:45You just can't put it back.
33:48To make them symmetrical,
33:50she's reopened the left side to take out more tissue.
33:56This is the perfect marriage of oncology
34:03and reconstruction,
34:07rebuilding something,
34:08and then pure aesthetics,
34:11where you're looking to really gild the lily
34:14when something is fixed.
34:18Nipple's still pink.
34:20So, taking off little bits of tissue
34:23to get it to sit nicely
34:24whilst not compromising the blood supply to the nipple.
34:32In terms of volume match,
34:35I'm pretty happy.
34:37Beautiful.
34:38Love it.
34:38Let's get the nipples done.
34:41Taking the top layer of skin off
34:42because now we've got to get in
34:44to free the nipple.
34:48The final stage is to ensure the nipples
34:51are in the right place
34:52and symmetrical.
34:55There we go.
34:57Delivering my nipple through.
35:01Good.
35:02That's all a bit looser.
35:06Perfect.
35:07I'm stepping away and de-scrubbing.
35:13Oh!
35:15This is a challenge from start to the end.
35:22She's waking up.
35:23Hi, Tony.
35:24Hello, sweetheart.
35:25It's me.
35:26Hello, darling.
35:28Oh, my God, it went so well.
35:30Very pleased.
35:31Are you nodding?
35:33She's nodding.
35:34She said...
35:35I said, I'm really happy.
35:36She's like, yeah, good.
35:38Sweeter.
35:39Sweeter.
35:44Hello.
35:52Look at you girls.
35:53Brilliant.
35:54We're amazed.
35:56Yeah, just made the surgeon session.
35:57OK.
35:58You're doing so well.
36:04I'm super pleased.
36:07There she is.
36:08There she is.
36:09Hello.
36:11How are you?
36:12You also look for sore eyes.
36:13I've been worried.
36:14I've been doing it.
36:15I'll be too.
36:16Good.
36:18I've got you a nice cup of tea ready.
36:21Oh, I bet that tastes good.
36:22It does.
36:23Sasha, thank you so much.
36:25Oh, yeah, anytime.
36:26It was very much appreciated.
36:27Anytime.
36:28Bye, guys.
36:29Bye, Sasha.
36:39My team at work.
36:41Hey.
36:42The nurses, my fellow doctors, and my trainees.
36:46They're my colleagues, but they're part of my life.
36:49You know, we're like a family.
36:51Guys.
36:52My little chicas growing up and going off to rule the world.
36:57Like girl bosses that you are.
37:00Emma and Isha were trained by Sasha and are now firm friends.
37:04To become a surgeon takes years of training and it's hard training.
37:11It's important that you've got people that you can count on emotionally and professionally.
37:18Who was my first training out of the two of you?
37:21Me.
37:21Me.
37:22I remember meeting you and then all of a sudden I hear this voice being like,
37:25Hi.
37:26Do you want some chocolate cake?
37:29You were like, oh, you're the new one.
37:32Oh, I hate that.
37:33Come to clinic.
37:34I'm so sorry.
37:34No, you're so nice.
37:35You're the new one in here.
37:37I just felt like I was automatically just enveloped, which was so warm.
37:42Engulfed.
37:43Engulfed.
37:43When I went into surgery right at the start, early 2000s, yeah, all of my consultants were white men.
37:52Being an Asian woman in surgery, I mean, I have known that this was going to be tricky.
38:00A tricky challenge.
38:02I think I chose general surgery because I was like, it was the hardest thing I could possibly do as
38:08a woman at that time.
38:09I was counselled against it.
38:12And I thought, you know, done this, I'm going to do it.
38:16I'm going to do this because you told me not to.
38:18And when I sat down with this guy who I held as my hero, and I said, well, this is
38:22what I want to do.
38:23And his words to me were, look, darling, who's going to do the shopping?
38:30No, seriously?
38:32I think when I started as a surgical trainee, there were no female consultants as role models for me.
38:38Really?
38:39So, and I'm a firm believer in the fact that you have to see it to be it.
38:44Yeah.
38:45It's my job to inspire the next generation of women that are coming up behind me,
38:50not pull up the ladder, to make their lives easier, not harder.
38:54That's my job for women of the future.
38:56Cheers!
38:56Cheers!
39:08Two and a half weeks after the operation, Tony is back to find out the results from her surgery.
39:18It's the unknown, isn't it?
39:20You know, sort of like being lucky so far, you just think, hmm, when's it going to run out?
39:26And hope it doesn't.
39:27And hope it doesn't, yeah, exactly.
39:31All day, you know, you're sort of like just waiting and waiting and waiting.
39:36So, I mean, I've been shaking from head to foot all day, and you've not done much better, have you?
39:41No.
39:42I think once we get this done, I think we'll feel a lot better, whichever way.
39:45At least we'll know what's going on.
39:53Tony Potter.
39:55Hello.
39:55Hello, Tony.
39:56How are you?
39:57I'm good, thank you.
39:57How are you?
39:58Yeah, all right, thank you.
40:00Hello.
40:01How are you, dear?
40:02Oh, good to see you.
40:04Hi, Sasha.
40:05How are you doing, Neil? You all right?
40:06Yeah, just about.
40:07What a long week, huh?
40:09You look good.
40:11Doing quite well, actually.
40:12Moving well.
40:14Very good, very good.
40:16Got some results for you.
40:19Success by my, in my interpretation of the word success, would be that my job as a surgeon is done.
40:26There's no more operating to be done.
40:29Now, managed to get the invasive cancer, and I'm delighted to say, it's all out.
40:38Great.
40:39Doing great.
40:39I am, I am.
40:41That is singularly, the most important bit of news.
40:46Right.
40:46Okay?
40:47Yeah.
40:49No more surgery, on to the next thing.
40:52I'm pleased to say, you're below the radar for chemo.
40:58It's good.
40:59I knew I shouldn't have looked at you.
41:04Sorry.
41:04That's news.
41:06That is the very news.
41:08So, surgery's a success.
41:12Oncologically, it's out.
41:20and
41:20sorry i can let it go now
41:31shall we have a look at you go on then so it's peeling off the cello tape
41:35okay it's immaculate oh look wow it's a bit dirty from the clay
41:44but it's well done well i don't want that do you want to have a little look before we do
41:47any of
41:47that is that all right for you not too low not too high oh wow look at that all right
41:54good i'm
41:55very happy with her it looks amazing i'm so happy with her i really am
42:04hello okay i feel a bit freer oh yeah liberated
42:08yeah it's kind of like yay i don't feel like a plastic person anymore i know
42:16i think the main reason i chose breast surgery is that we've got quick results
42:20the woman comes in with a with a tumor and she leaves cancer-free in many cases cured
42:29well that's a great feeling final final bye-bye they'll call me in if they want to show me
42:34something thank you all right thank you so much bye-bye young men take care bye
42:38go and celebrate we will thank you lovely
42:52combination of bravery ability to take risks but also being risk averse
43:00an attention to detail a good eye forward thinking circumnavigating problem solving
43:09these are all things that make a good surgeon
43:13when i look back on my life i want to know that i've been a good man that i've done
43:18my best
43:19that my impact on my daughter has not just been teaching her that women can do anything
43:24but that she can do anything i need to know that i've impacted on these women's lives not only
43:33sorting out the cancer for a woman but giving her the best breath she's ever had
43:37at this most awful time of her life
43:44so
44:04neurosurgeon omar gives patients a second chance at life
44:08so this is the part of the tumor that's been quite beautiful actually
44:12neurosurgery is miracles and disasters nothing in between doing really well okay
44:22catch that new next wednesday at nine and if you or someone you know has been affected by
44:28anything in tonight's program head to channel 5.com slash helplines for information and support
44:34alex polizzi dons kid gloves for her first challenge of the new series of the hotel inspector tomorrow
44:39at nine can she help 74 year old tony rejuvenate her bnb and save her home
44:46you
44:49you
44:49you
44:49you
44:49you
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