Why did you decide to become a Oral & Maxillofacial Surgery Specialist ?

I did dentistry to begin with. I passed dentistry with honours and had four different groups in which I had top marks at the university. And I sat there very deeply unhappy, thinking that this is it and this is what Im going to be doing. I did an elective at GKT, Guys Kings and St Thomas's. Somebody mentioned to me, I was getting bored just looking at the dentistry there. And then somebody said, why don't you go downstairs to theatre? Somebody's doing a cancer operation. So I'd never seen one. I just went downstairs to see a cancer operation. And I was just blown away by what they could do, which is remove cancer at the same time and reconstruct it. And then patch up the patient and it looked like nothing had happened. And then I went back home and said, this is what I want to do.

I got into private practice not because I wanted to, and it was actually because somebody wrote to me on my NHS email, asked if I treat a rare type of cancer called sarcoma surgically. Someone from Egypt wanting treatment. Of course, they're not entitled to treat on the NHS. So I had to then ask a colleague if they would be willing to take on the case. And that actually made me feel that medicine should be available to everybody, whether you have money or you don't. So that's the reason I got into private practice.

What are the common symptoms that your patients tend to present with?

Common things are ulcers in the mouth, ear pain, patches, white patches or red patches, lumps and bumps, odd symptoms that no one has a clue or answer to, or sometimes they've had treatment elsewhere. This is another thing about my practice, I get a lot of redo cases. They've been treated elsewhere and it's incomplete or the clinician didn't know, and they come back to then have formal treatment with me.

In terms of emergencies, I can see patients who have got swellings, fever, can't open their mouth, can't talk, dental abscesses. But majority of it is related to lumps, bumps, ulcers in the mouth, coloured lesions in the mouth.

What are the treatments that you're able to offer your patients?

Diagnostics include ultrasound, CT scans, cone beam scans, OPGs, MRI scans, PET CTs. Also fine needle aspirations, core biopsies, open biopsies, biopsies under general anaesthetic. They can have virtually any investigation they need, including things like whole genome sequencing and next generation sequencing because of cancer diagnosis.

Treatment options are mainly surgery and reconstruction. It really depends upon the type of surgery you need and what needs to be reconstructed. If you have a tumour in the top jaw, surgery is about removing the top jaw, but then reconstruction options are on the same day. There will be facilities for using your own tissue from another part of your body. I have a dentist that works in the group and then we can also do all the rehabilitation so that functionally the patient is able to go back to normal life.

For me, success is not how many years a patient has survived because that's sometimes not in our hands. What is important to me is how can somebody go back to their normal life? Because I treat a lot of young people, for me it's a big marker of can these people go back to their job, can they speak well, can they eat well, can they go out for a meal with their friends without being afraid or ashamed. A lot of surgery that I do involves swallowing and speaking. Can these people get married? The people that are 10 and 12 years old that I treat, can they go back and have the same opportunities?

When you have an operation in your belly, your clothes hide it. When you have an operation in your face, nothing hides it. Some of the techniques developed over the last couple of years, where I place my incisions or how I access them is all so that they are more lateral in the face, not in the centre, not visible.

There are no two operations that are the same. It's all tailored to the patient. I do work with a team of people: speech and language therapists, dietetics, physiotherapists, psychologist, a CNS, somebody from oral medicine, an oncologist, a proton beam specialist, and somebody that does trials.

What are your areas of sub-specialist interest?

My sub-specialist interests are essentially around cancer mainly, cancer reconstructive surgery. And also a lot of secondary reconstructions, because cancer is just an episode nowadays. People live longer than we expect them to, which is good, but then they have the side effects of the treatment they've had, most of it radiotherapy based.

I treat both adult and paediatric population. That's a big thing, being able to treat both.

Salivary gland and then also things like nerve reanimation.