We were delighted to speak with Professor Jian Farhadi, Consultant Plastic Surgeon and past Director Department of Plastic & Reconstructive Surgery at Guy’s and St. Thomas’ Hospital in London. He is a specialist in reconstructive and aesthetic breast surgery and as well surgery after weight loss. He is also the chair of the London Breast Meeting and the Co-director of the Masters in Breast Surgery Programme.
Could you start by telling us a little bit about what led you into the field of plastic surgery?
Well, I was always fascinated with medicine. Primarily, I was interested in the surgical and technical aspects of it and then once I was on the path, deciding in which field I should go, I was even more fascinated with reconstructive surgery. I was bringing together medical knowledge and technology in a way that I could shape things – you could use the technology behind it to do things differently to other surgical specialties, like orthopaedics, for example, where it's much more about bones. I felt more comfortable in working with soft tissues than with bones, and with smaller tissue sizes but at the same time focusing on the large sizes of the body.
What are some of the moments throughout your career that you feel were significant in that journey?
You know, as a junior doctor you get quickly fascinated when you shadow senior surgeons performing complex surgeries, and the more I was involved with it – and I started my career very early on in that field – the more I wanted to go in that route. I saw the potential of what else could be achieved which maybe at that time was not there. So yes, I saw by shadowing senior doctors at the very, very beginning of my career and that was a big motivator for me to go up the reconstructive path.
Your education was between the UK and Switzerland, right?
Switzerland, yes. That is correct.
Were there quite a lot of changes you felt when moving between the two?
I think there's always differences in the way things are approached – there are different philosophies behind it, different work patterns, and my aim was always to get the best out of the situation that I was in. I think every training system has its points and my focus was always to take the best out of it.
I think in the Swiss system, I learned early on that you had to approach the patient methodically, very precise. And before performing a surgery, you always needed to present your surgical plan and action to the senior doctors. Even though that was sometimes painful at times, because you had to prepare for every surgery – you had to prepare; you had to read; you had to present; and you had to explain why you were going to be doing something. That mindset, preparation was, and is, an essential part in my future role as a surgeon.
Moving then to the UK, I was exposed to a huge number of experiences. The great thing was, as a big difference, I was working with a number of different consultants. Therefore, I could really harness many different approaches and many ideas. I didn't have this beforehand, because in Switzerland you just stay in one place – there's a more controlled, much smaller team – whereas in the UK I was exposed to large teams with many different opportunities and many different inputs.
Except for taking every opportunity that a trainee can, to shadow the individuals they meet, what other advice would you offer a trainee based in the UK?
I think the shadowing was more useful in taking you to a path that you want to go to. So, the most important advice I can give to juniors is really this: expose yourselves to a lot of experiences, and take the best out of situations. See every single day as an opportunity to learn. And focus much more on improving the surgical skills. We live in a time where, because of lack of opportunities and exposure, the experiences are decreasing. Hence, we see a huge demand on support systems like AI and robotics, which are supporting the lack of experience in surgical actions. So, to reiterate, be open minded, and see every surgical procedure, every patient as an opportunity to learn, and maximise the input and output you can do.
Do you feel as though education takes up a large part of your working week?
It does. I mean, education has been present all the way through my entire career and has always been a centre part of what I do. Is it now part of my daily practice, training more juniors or having colleagues which are working with me, and always thinking about how I can pass on my experiences to the next generation. It is also now in publishing my experiences, in running workshops, courses, masterclasses, and as well the London Breast Meeting.
Well, that's a good bridge it, because it would be good to hear about the different themes and objectives that will be brought up at the meeting that you think are worth highlighting ahead of time.
Well, this year our aim is to focus on more of what we would call a ‘deep dive’, getting down to the nitty gritty bit, basically – things that we do on a daily basis, as surgeons, which actually helps the outcome and therefore the patient. These are things that cannot be published, cannot be always followed. We wish to tell delegates about the secrets of their own success in the surgical procedures that they do, the knowhow – how they perform and how they do aftercare, how they prepare the patient. Our programme is more of a detailed way of looking at things instead of the big philosophy behind it or the latest technological advances; it’s things that we do every day, but exploring them closely.
Right, so there's a strong focus on the practicality of a working day and as you say, homing in on all of those things that, perhaps in some way are seen as smaller, although equally as relevant factors.
Yes, yes. We’ve had years where we were focusing more on principles and standards, years that we were focusing more on innovations, new technologies, but this year is more about our surgical practice. It asks, “what is the best practice?” With a special focus on the nitty gritty bit of tips and tricks and how we can do things to get better outcomes.
Brilliant. I think it’s felt across a lot of the conferences of many specialties that delegates have said they would like to see something a little more tangible, something a delegate can go back to the practice the day after and actually start implementing and experimenting with. To finish up – more of personal question – in your spare time, how do you like to relax?
As I live now most of the time in Switzerland, I have here the opportunity that I can take the bicycle, cycle and go on the lake, especially in the summertime when the weather allows. That's what I like to do most, to relax and take my mind off things, or actually where I can think about different items which are burning my head – a space and time to organise my thoughts. So, cycling and going boating is my way to relax. Yeah, good choices. (19:44) Yeah, I think being out in nature only ever provides benefits, I think.
Good choice. There are some things that only nature can provide. Well, thank you for your time today, Jian.
Thank you.
The London Breast Meeting, celebrating its 10th anniversary, will be held
between 4–6 September 2024 at the Royal College of Physicians.
For more information and to register your attendance go to:
https://www.londonbreastmeeting.com
/londonbreastmeeting2024/en/page/home
