Body Contouring with Dr Bernard Beldholm

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Dr Bernard Beldholm M.B.B.S B.Sc(Med) FRACS is a Specialist surgeon (board certified) focused on Body contouring surgery after weight loss and pregnancy.

Episodes

Monday Jan 01, 2024

The Extended Abdominoplasty explained

Monday Jan 01, 2024

In this podcast I’m going to talk about the extended abdominoplasty. This is in fact not just one operation but multiple different variations. We can include diastasis recti repair, VASER liposuction in this operation as well. We can also trim the mons pubis area. Find out all you need to know about the Extended Abdominoplasty.

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Welcome to the surgery podcast, this is Dr Bernard Beldholm. I’m a Registered medical practitioner, FRACS, Specialist surgeon and my medical registration number is MED0001186274. The content on this podcast is considered adult content.

This podcast focuses mainly on Post weight loss surgery and surgery post pregnancy. Ranging from

Abdominoplasty (tummy tuck)
Belt lipectomy (body lift)
Fleur de lis abdominoplasty
Brachioplasty (arm lift)
Thighplasty (inner thigh lift)

I will also discuss breast surgery in the context of post weight loss and post pregnancy changes.

I’m going to initially go though the basics of the extended abdominoplasty and the benefits and negatives as well.

What is the Extended abdominoplasty?

Mainly focuses on the Central abdomen & the flank-side areas. i.e., the lower and upper abdomen and the flank areas.
Excision of loose skin with re-positioning the umbilicus.
May repair abdominal muscle separation (diastasis recti)
The incision for the Extended abdominoplasty can vary widely depending on where the loose skin is and the extent of the extended abdominoplasty. Generally, it goes well past the hip areas

What different variation of the extended abdominoplasty are there?

There are significant amount of possible options with this operation.

These are some options available:

Skin only extended abdominoplasty
Extended abdominoplasty with VASER liposuction.
Extended abdominoplasty with diastasis recti repair
Extended abdominoplasty with hernia repair
Extended abdominoplasty with mons pubis resection

Who is the extended abdominoplasty for?

The full abdominoplasty is a very versatile operation. It can treat loose skin on the upper as well as lower abdomen. It can be used to repair muscle separation. Vaser liposuction can be included to remove fat in the abdominal area.

This operation is therefore suitable for both post-weight loss patients as well as post-pregnancy patients.

What is the recovery like?

The recovery varies from patient to patient, as well as the procedure that you are having.

Summary of the recovery:

A hospital stay of 1-3 days
Usually walking normally 10 days.
Back to work 2-4 weeks.
Feeling back to normal 3 months

Make sure that you subscribe to this podcast on your favourite podcast app. Leave a comment and give me a rating.

For the comments - QUESTIONS ONLY - NO TESTIMONIALS IN COMMENTS DUE TO AHPRA GUIDELINES.

From 1st July 2023 a GP Referral will be required for all procedures.

Call us on: (02) 4934-5700 or book online: https://beldholm.com.au/book-online/

I’m based in Newcastle & the Hunter Valley in Australia

Hunter Valley Office

30 Belmore Rd
Lorn NSW 2320

Newcastle Office

H+ Consulting Suites
Cooks Hill Healthcare Hub
Suite 3, 235 Darby Street
Cooks Hill, New South Wales, 2300

Disclaimer

Surgery is a serious decision.

You can find more information about risks & recovery on my website:

https://beldholm.com.au/about/disclaimer/

All Surgery is performed by me Dr Bernard Beldholm my medical registration number is MED0001186274 and my qualifications area

M.B.B.S B.Sc (Med) FRACS,

I’m a Registered medical practitioner and specialist surgeon (specialist registration in Surgery – general surgery).

The content on this podcast is considered Adult content. Individual results may vary. All surgery carries risks. You should seek a second opinion before proceeding. The opinions that are expressed on this podcast are those of Dr Bernard Beldholm & these opinions may differ from other doctors’ opinions.

The information provided on and through this podcast is not medical advice and should not be relied on. It is “best efforts” and for general information only. Do not use this podcast as a substitute for medical advice or self or other diagnosis.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from a qualified health practitioner. Results, recovery & potential complications will vary for each individual patient. Photos & videos featured are not a guarantee that your results will be the same & do not guarantee a particular surgical outcome. Content on our Instagram page & other social media pages is published with the consent of our patients. The content featured is general in nature and does not constitute medical advice. Immediate post-op results may differ from the final result.

Monday Jan 01, 2024

The full abdominoplasty explained

Monday Jan 01, 2024

In this podcast I’m going to talk about the full abdominoplasty. This is in fact not just one operation but multiple different variations. We can include diastasis recti repair, VASER liposuction in this operation as well. We can also trim the mons pubis area. Find out all you need to know about the Full Abdominoplasty.

---

This podcast focuses mainly on Post weight loss surgery and surgery post pregnancy. Ranging from

Abdominoplasty (tummy tuck)
Belt lipectomy (body lift)
Fleur de lis abdominoplasty
Brachioplasty (arm lift)
Thighplasty (inner thigh lift)

I will also discuss breast surgery in the context of post weight loss and post pregnancy changes.

---

I’m going to initially go though the basics of this operation and the benefits and negatives as well.

What is the Full abdominoplasty?

Mainly focuses on the Central abdomen. i.e., the lower and upper abdomen but not the flank areas.
Excision of loose skin with re-positioning the umbilicus.
May repair abdominal muscle separation (diastasis recti)
The incision for the full abdominoplasty can vary widely depending on where the loose skin is and the extent of the full abdominoplasty. Generally it goes slightly past the hip.

What different variations of the full abdominoplasty are there?

There are significant amount of possible options with this operation.

These are some options available.

Skin full abdominoplasty
Full abdominoplasty with VASER liposuction.
Full abdominoplasty with diastasis recti repair
Full abdominoplasty with hernia repair
Full abdominoplasty with mons pubis resection

Who is the full abdominoplasty for?

This operation is therefore suitable for both post-weight loss and post-pregnancy patients.

What is the recovery like?

The recovery varies from patient to patient, as well as the procedure that you are having.

In summary the recovery is:

A hospital stay of 1-3 days
Usually walking normally by 10 days.
Back to work 2-4 weeks.
Feeling back to normal 3 months

---

Make sure that you subscribe to this podcast on your favorite podcast app. Leave a comment and give me a rating.

for the comments - QUESTIONS ONLY - NO TESTIMONIALS IN COMMENTS DUE TO AHPRA GUIDELINES.

From 1st July 2023 a GP Referral will be required for all procedures.

Call us on: (02) 4934-5700 or book online: https://beldholm.com.au/book-online/

I’m based in Newcastle & the Hunter Valley in Australia

Hunter Valley Office

30 Belmore Rd
Lorn NSW 2320

Newcastle Office

H+ Consulting Suites
Cooks Hill Healthcare Hub
Suite 3, 235 Darby Street
Cooks Hill, New South Wales, 2300

Disclaimer

Surgery is a serious decision.

You can find more information about risks & recovery on my website:

https://beldholm.com.au/about/disclaimer/

All Surgery is performed by me Dr Bernard Beldholm my medical registration number is MED0001186274 and my qualifications area

M.B.B.S B.Sc (Med) FRACS,

I’m a Registered medical practitioner and specialist surgeon (specialist registration in Surgery – general surgery).

Monday Jan 01, 2024

The mini abdominoplasty explained

Monday Jan 01, 2024

In this podcast, I’m going to talk about the mini abdominoplasty. This is not just one operation but multiple different variations. We can include diastasis recti repair VASER liposuction in this operation as well. We can also trim the mons pubis area. Find out all you need to know about the Mini Abdominoplasty.

This podcast focuses mainly on Post weight loss surgery and surgery post pregnancy. Ranging from

Abdominoplasty (tummy tuck)
Belt lipectomy (body lift)
Fleur de lis abdominoplasty
Brachioplasty (arm lift)
Thighplasty (inner thigh lift)

I will also discuss breast surgery in the context of post weight loss and post pregnancy changes.

I’m going to initially go through the basics of this operation and the benefits and negatives as well.

What is the mini abdominoplasty?

Mainly focuses on the lower abdomen.
Excision of loose skin without re-positioning the umbilicus.
May repair lower abdominal muscle separation (diastasis recti)
The incision for the mini abdominoplasty can vary widely depending on where the loose skin is and the extent of the mini-abdominoplasty. Generally it goes from hip to hip.

What different variations of the mini abdominoplasty are there?

There are a significant amount of possible options with this operation.

These are some options available.

Skin only mini abdominoplasty
Mini abdominoplasty with VASER liposuction.
Mini abdominoplasty with diastasis recti repair
Mini abdominoplasty with hernia repair
Mini abdominoplasty with mons pubis repair

Who is the mini abdominoplasty for?

As we have discussed, there is a significant amount of variation in the options for mini-abdominoplasties.

I usually find that my post weight loss patients have a significant amount of loose skin and are usually not suitable for this operation as it does not remove enough loose skin to make a significant amount of difference.

The most common patient group is therefore the post-pregnancy patients. I commonly see patients with C-section cuts that have overhanging skin and discomfort in this area.

Some moms also mainly have loose skin in the lower abdomen, including isolated diastasis recti in this area. These can get a good result with the mini abdominoplasty.

Many women have excess external fat on the outside of their abdomen. This can be dealt with by performing VASER liposuction on the abdomen and sides in addition to the mini abdominoplasty.

What is the recovery like?

The recovery varies from patient to patient, as well as the procedure that you are having, A small skin-only mini abdominoplasty can be done as a day procedure and you should recover within 1-2 weeks.

For a more extensive mini abdominoplasty with VASER liposuction and muscle repair, you may need to have 3-4 weeks of recovery.

Mini abdominoplasty vs the full abdominoplasty?

The main benefit of the mini abdominoplasty is quicker recovery and significantly less cost as the procedure is shorter and can be done as a day-stay operation. The other benefit of a mini-abdominoplasty vs a full is a smaller incision. There is also no need to re-position the umbilicus so there is no scar in this location.

However, if there is muscle separation in the upper abdomen or loose skin in the upper and lower the full abdominoplasty is a better option.

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Make sure that you subscribe to this podcast on your favourite podcast app. Leave a comment and give me a rating.

For the comments - QUESTIONS ONLY - NO TESTIMONIALS IN COMMENTS DUE TO AHPRA GUIDELINES.

From 1st July 2023, a GP Referral will be required for all procedures.

Call us at: (02) 4934-5700 or book online: https://beldholm.com.au/book-online/

I’m based in Newcastle & the Hunter Valley in Australia

Hunter Valley Office

30 Belmore Rd
Lorn NSW 2320

Newcastle Office

H+ Consulting Suites
Cooks Hill Healthcare Hub
Suite 3, 235 Darby Street
Cooks Hill, New South Wales, 2300

Disclaimer

Surgery is a serious decision.

You can find more information about risks & recovery on my website:

https://beldholm.com.au/about/disclaimer/

All Surgery is performed by me Dr Bernard Beldholm my medical registration number is MED0001186274 and my qualifications area

M.B.B.S B.Sc (Med) FRACS,

I’m a Registered medical practitioner and specialist surgeon (specialist registration in Surgery – general surgery).

Monday Jan 01, 2024

Guide to the potential risks & Complications of an abdominoplasty

Monday Jan 01, 2024

In this podcast episode, I will go through the potential complications of abdominoplasty surgery. All surgery has complications, and it is important that you are aware of the risks before you have surgery. Some of these risks are minor and some are major. Some are more common than others. So stay with me, and I will go through these in detail.

This podcast focuses mainly on Post weight loss surgery and surgery post pregnancy. Ranging from

Abdominoplasty (tummy tuck)
Belt lipectomy (body lift)
Fleur de lis abdominoplasty
Brachioplasty (arm lift)
Thighplasty (inner thigh lift)

I will also discuss breast surgery in the context of post weight loss and post pregnancy changes.

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Complications.

The procedure will result in scar formation, as with all surgery. With an Abdominoplasty the scar is inside the bikini line and, depending on the amount of loose skin, may extend around to the back area. There will also be a scar around the umbilicus. Scarring is generally pink but fades to become white, soft and supple in the weeks or months after the operation. Most patients find that the wound heals quickly and that the appearance is ultimately acceptable to them. However, abnormal scarring occasionally occurs within the skin and deeper tissues, which may be unattractive and of different colour to the surrounding skin. Scars may also exhibit contour variations and "bunching" due to excess skin, or may be asymmetrical (with a different appearance between the right and left side of the body). In some cases, scars may require surgical revision or treatment. In rare cases keloid scars form, which are thickened by an inflammatory process in the scar tissue. This occurs due to an irregularity of the patient’s healing process.
Antibiotics are administered during the operation and,if required, will be prescribed afterwards. This minimises the risk of infection. Nevertheless infections can occur and, should this be the case, they are treated either by oral antibiotics or, in severe cases, by admission to hospital for intravenous antibiotics and further drainage procedures.
Postoperative pain will occur in varying degrees, from quite severe to moderate and mild on the first day. The pain gradually improves over the next few days and is assisted by using the prescribed pain medication. Increasing, unresponsive pain, should be brought to the attention of the surgeon as this may be an indication that complications are developing. Patients may not be able to stand fully erect for up to two weeks after the operation due to the tightness of the abdominal skin with resultant excessive pull on the surgical scar. Intermittent mild discomfort or intermittent sharp pains after the first few weeks after surgery is also common, as the swelling resolves and the nerves recover. Chronic pain, ranging from mild aching pain to sharp nerve pain can persist for more than one year.
Bruising and swelling is normal after the operation, but this varies from mild to severe with each patient.
Specific complications relating to an Abdominoplasty may include:
- Bleeding and excessive bruising. A haematoma could potentially form, which requires removal through further surgery.
- Infections - either superficial or deep.
- The resultant long scar, occasionally wide and thick, may be visible outside the underwear and the bikini line.
- Vaser Liposuction is used as part of the surgical technique for this procedure. Rare complications related to liposuction include injury to deeper structures such as the abdominal wall, bowel, nerves and blood vessels.
- Some numbness in the lower abdomen will result. Sensation usually returns fully, though in rare cases some permanent numbness remains.
- Drains (tubing) are rarely required for this operation but on occasion, they may be required and these may protrude from or near my horizontal incision for up to one week.
- Asymmetry may be noted

General complications applicable to all types of operations include, but are not limited to:

Heart problems (although very uncommon with modern anaesthetic techniques).
Lung problems; small areas of the lungs may collapse, increasing the risk of chest infection. Such problems may require antibiotics and physiotherapy to correct them. Other potential lung complications are quite rare.
Clots in the legs with pain and swelling. Rarely, part of such a clot may break off and travel to the lungs, causing fatal complications.
Allergic reactions to medications.
Potential for injury to deeper structures including nerves, blood vessels, and muscles.
Itching, tenderness, or exaggerated responses to hot or cold temperatures. Usually, this resolves during healing but, in rare cases, may be chronic.
Deep sutures may spontaneously poke through the skin, become visible or produce irritation that requires removal.
Wound disruption or delayed wound healing - especially in patients who do not stop smoking before their operation. Necrosis (skin death) can also occur.

----

Make sure that you subscribe to this podcast on your favourite podcast app. Leave a comment and give me a rating.

For the comments - QUESTIONS ONLY - NO TESTIMONIALS IN COMMENTS DUE TO AHPRA GUIDELINES.

From 1st July 2023, a GP Referral will be required for all procedures.

Call us on: (02) 4934-5700 or book online: https://beldholm.com.au/book-online/

I’m based in Newcastle & the Hunter Valley in Australia

Hunter Valley Office

30 Belmore Rd
Lorn NSW 2320

Newcastle Office

H+ Consulting Suites
Cooks Hill Healthcare Hub
Suite 3, 235 Darby Street
Cooks Hill, New South Wales, 2300

Disclaimer

Surgery is a serious decision.

You can find more information about risks & recovery on my website:

https://beldholm.com.au/about/disclaimer/

All Surgery is performed by me Dr Bernard Beldholm my medical registration number is MED0001186274 and my qualifications area

M.B.B.S B.Sc (Med) FRACS,

I’m a Registered medical practitioner and specialist surgeon (specialist registration in Surgery – general surgery).

Saturday Dec 30, 2023

What type of abdominoplasty do I need?

Saturday Dec 30, 2023

In this podcast I’m going to go though the different types of abdominoplasties and who they are suitable for. The two main groups of patients that require an abdominoplasty are

Post weight loss
Post pregnancy

Each of these groups tend to have different requirements and different types of surgeries.

This podcast focuses mainly on Post weight loss surgery and surgery post pregnancy. Ranging from

Abdominoplasty (tummy tuck)

Belt lipectomy (body lift)

Fleur de lis abdominoplasty

Brachioplasty (arm lift)

Thighplasty (inner thigh lift)

I will also discuss breast surgery in the context of post weight loss and post pregnancy changes.

In my experience there is significant differences between:

Post weight loss patients
Post pregnancy patients

I will go though these separately.

Post-weight loss patients

These are both men and women.

I find that there are two groups within this. The patients that have lost a significant amount of weight and are now either within normal BMI or underweight.

The other group is the patients who have lost significant weight but are still at a significantly high BMI range.

Most of my post weight loss patients will have a significant amount of loose skin. Most will require either:

extended abdominoplasty
fleur de lis abdominoplasty
belt lipectomy.

Apronectomy is not a common operation as most of the patients will do well with the above operations. However, if there is a significant amount of loose skin hanging in the lower abdomen, this operation can be done initially as a first stage.

Each operation is discussed in detail in the podcast:

extended abdominoplasty
fleur de lis abdominoplasty
belt lipectomy.
Apronectomy

Post pregnancy patients

Post-pregnancy has a more varied presentation. Most will have some muscle separation. Some will have a C-section cut. Many will have excess fat that they want to be removed.

The operations that are suitable range from

Mini abdominoiplasty
Full abdominoiplasty
Extended abdominoiplasty

Make sure that you subscribe to this podcast on your favorite podcast app. Leave a comment and give me a rating.

For the comments - QUESTIONS ONLY - NO TESTIMONIALS IN COMMENTS DUE TO AHPRA GUIDELINES.

From 1st July 2023 a GP Referral will be required for all procedures.

Call us on: (02) 4934-5700 or book online: https://beldholm.com.au/book-online/

I’m based in Newcastle & the Hunter Valley in Australia

Hunter Valley Office

30 Belmore Rd
Lorn NSW 2320

Newcastle Office

H+ Consulting Suites
Cooks Hill Healthcare Hub
Suite 3, 235 Darby Street
Cooks Hill, New South Wales, 2300

Disclaimer

Surgery is a serious decision.

You can find more information about risks & recovery on my website:

https://beldholm.com.au/about/disclaimer/

All Surgery is performed by me Dr Bernard Beldholm my medical registration number is MED0001186274 and my qualifications area

M.B.B.S B.Sc (Med) FRACS,

I’m a Registered medical practitioner and specialist surgeon (specialist registration in Surgery – general surgery).

Saturday Dec 30, 2023

Understanding Abdominoplasty surgery

Saturday Dec 30, 2023

In todays podcast I’m going to talk about abdominoplasty also referred to as a Tummy tuck.

What is an abdominoplasty?

Is an abdominoplasty right for me?

What types of abdominoplasties are there?

How do we decide which abdominoplasty is appropriate for you?

At the end I will go though a couple of examples

This podcast focuses mainly on Post weight loss surgery and surgery post pregnancy. Ranging from

Abdominoplasty (tummy tuck)

Belt lipectomy (body lift)

Fleur de lis abdominoplasty

Brachioplasty (arm lift)

Thighplasty (inner thigh lift)

I will also discuss breast surgery in the context of post weight loss and post pregnancy changes.

What is an abdominoplasty?

This is an operation on the abdomen that:

Removes loose skin

Tightens separated muscles also referred to as diastasis recti

if liposuction is added then we can also remove excess fat on the abdomen.

Is an abdominoplasty right for me?

There are 2 types of patients that I see comming in to have an abdominoplasty. These are;

Patients that have lost a significant amount of weight and have loose abdominal skin

Patients that are post pregnancy and have loose skin and also commonly muscle separation (Diastasis recti)

If you fall into any of these categories then you would be suitable to have an abdominoplasty.

What types of abdominoplasties are there?

There are many, many different kinds of abdominoplasties. Some treat small changes to the abdomen and others treat significant changes. once you add into all the different techniques that surgeons use for their abdominoplasties there may more at least 30 different kinds of abdominoplasties available.

The key is to choose the correct technique and correct abdominoplasty for your changes. We will discuss this further below.

There are several basic operation types

we have:

mini abdominoplasty
full abdominoplasty
extended abdominoplasty
Fleur de lis abdominoplasty
belt lipectomy
reverse abdominoplasty
apronectomy

Then we can add liposuction or repair of muscle separation to these as well.

How do we decide which abdominoplasty is appropriate for you?

Every patient is different and there is no such thing as a standard or fit all sizes abdominoplasty. Each patients abdominoplasty will be different.

This is the way that I assess your abdomen and decide on which abdominoplasty is right for you. There are 4 main areas that will determine which abdominoplasty is right for you.

1. Skin

2. Muscle separation (diastasis recti)

3. Abdominal scars and previous operations

4. Fat distribution

Make sure that you subscribe to this podcast on your favorite podcast app. Leave a comment and give me a rating.

for the comments - QUESTIONS ONLY - NO TESTIMONIALS IN COMMENTS DUE TO AHPRA GUIDELINES.

From 1st July 2023 a GP Referral will be required for all procedures.

Call us on: (02) 4934-5700 or book online: https://beldholm.com.au/book-online/

I’m based in Newcastle & the Hunter Valley in Australia

Hunter Valley Office

30 Belmore Rd
Lorn NSW 2320

Newcastle Office

H+ Consulting Suites
Cooks Hill Healthcare Hub
Suite 3, 235 Darby Street
Cooks Hill, New South Wales, 2300

Disclaimer required by AHPRA

Surgery is a serious decision.

You can find more information about risks & recovery on my website:

https://beldholm.com.au/about/disclaimer/

All Surgery is performed by me Dr Bernard Beldholm my medical registration number is MED0001186274 and my qualifications area

M.B.B.S B.Sc (Med) FRACS,

I’m a Registered medical practitioner and specialist surgeon (specialist registration in Surgery – general surgery).

Saturday Dec 30, 2023

Body Contouring Surgery with Dr Bernard Beldholm | FRACS | Specialist Surgeon

Saturday Dec 30, 2023

This podcast focuses mainly on Post weight loss surgery and surgery post pregnancy. Ranging from

Abdominoplasty (tummy tuck)
Belt lipectomy (body lift)
Fleur de lis abdominoplasty
Brachioplasty (arm lift)
Thighplasty (inner thigh lift)

I will also discuss breast surgery in the context of post weight loss and post pregnancy changes.

The aim is to published the podcast every week throughout the year.

AHPRA (Australian Health Practitioner Regulation Agency) has implemented very strict rules from 1 July 2023 for cosmetic surgery.

Most of the surgery that I perform is not strictly cosmetic as many of the operation post weight loss and post pregnancy have MBS item number.

However considering the power that AHPRA has over practitioners registration, I’m complying with the more strict rules for cosmetic surgery.

I’m therefore restricted from talking about certain topics including:

I’m unable to do patient stories or case studies
No testimonials are allowed and if you leave a testimonial in the comments then I will need to remove these
I’m unable to comment on other surgeons work
No funny stuff
no entertaining stuff
no music
AHPRA has also forbidden certain words so I’m careful to use medical terminology, but I will explain what all this means.
Everything has to be factual and based on proven research or practice
Risks and complications of surgery has to be included
Certain disclaimers are mandatory as well. I will add these to the end of of each episode.

This podcast therefore will be factual, accurate and based on current knowledge that is proven. I will try to explain concepts in simple language but I have to use the medical terminology initially to comply with AHPRA.

Make sure that you subscribe to this podcast on your favorite podcast app. Leave a comment and give me a rating.

for the comments - QUESTIONS ONLY - NO TESTIMONIALS IN COMMENTS DUE TO AHPRA GUIDELINES.

From 1st July 2023 a GP Referral will be required for all procedures.

Call us on: (02) 4934-5700 or book online: https://beldholm.com.au/book-online/

I’m based in Newcastle & the Hunter Valley in Australia

Hunter Valley Office

30 Belmore Rd
Lorn NSW 2320

Newcastle Office

H+ Consulting Suites
Cooks Hill Healthcare Hub
Suite 3, 235 Darby Street
Cooks Hill, New South Wales, 2300

Disclaimer required by AHPRA

Surgery is a serious decision.

You can find more information about risks & recovery on my website:

https://beldholm.com.au/about/disclaimer/

All Surgery is performed by me Dr Bernard Beldholm my medical registration number is MED0001186274 and my qualifications area

M.B.B.S B.Sc (Med) FRACS,

I’m a Registered medical practitioner and specialist surgeon (specialist registration in Surgery – general surgery).