THERE can't be many people who carve body parts as they chat animatedly about their passion for their work. But then again Ken Stewart is something of an exceptional person – and so is his work.
In a side room at the Royal Hospital for Sick Children, as colleagues dash in and out to ask his advice, the plastic surgeon chats eloquently, passionately and self-deprecatingly about his job.
While he talks, he casually but carefully carves a p
erfect, life-size ear from a block of silicone, to use in patient clinics.
As lead clinician for the National Centre for Ear Reconstruction, Ken spends much of his working life thinking about ears, examining them, repairing them, and creating them. This morning he has already conjured one up out of an apple for our photographer, and more normally carves them using cartilage from a patient's own ribs.
Ears are not the only item on his varied theatre schedule. There's a procedure that involves transferring fat from the stomachs of HIV-positive patients to their faces.
It helps to hide the ravaging effects of drug therapy – a tell-tale sign of their diagnosis.
There are also breast reconstructions on women undergoing mastectomies, and these days he and his colleagues also find themselves dealing with increasing numbers of skin cancer patients.
In new research from the British Association of Plastic, Reconstructive and Aesthetic Surgeons, 28 per cent of 18-24 year olds said the risk of skin cancer wouldn't make them spend less time sunbathing this summer, and figures from the British Association of Dermatologists show that potentially-fatal melanoma is the second most common cancer in those aged 20 to 40.
There may be a greater awareness of the dangers of the sun, but Ken says it clearly is not translating into a reduction in cases: "There's no doubt there's a real increase in the incidence. It may partly be related to global warming and holes in the ozone layer, but it also relates to the increase in cheap travel and the affordability of getting to somewhere hot quickly. In terms of my department's workload it's going up year-on-year."
Thanks to his expertise, he often removes skin cancers from ears, but there is also another group of patients which is set to grow, he says: "We get a lot of old soldiers that have fought in the desert and are reaping their rewards. They're becoming less common as time passes, but it won't be long before some of the Iraq and Afghanistan soldiers are coming our way."
The 42-year-old, who lives in the Grange, has been fascinated by plastic surgery since the age of 16, when, as a high school student in Glasgow, he went to a lecture at Strathclyde University on the use of tissue expanders – balloons which are inserted into the scalp and gradually inflated to create extra skin which can be used in grafts.
What he learned that day helped to convince him to read medicine at university.
After studying in Aberdeen and Edinburgh, he worked around the world, including spells in Sydney and Toronto, before settling as a consultant plastic surgeon based at the Sick Kids and St John's in Livingston, and also working at the ERI.
He is proud of the 11-strong team with which he works: "I don't like to brag, but I think in Edinburgh we're a world-class department. Any aspect of plastic surgery, we're at the cutting edge of it and offering the best possible treatment that's available anywhere in the world," he says.
He also spends a day-and-a-half a week on his private practice, carrying out non-essential cosmetic surgery at Spire Murrayfield Hospital.
But, as is clear from the attention he lavishes on his silicone sculpture, his passion is ears. Cancerous ears, cauliflower ears, children born with missing ears or sticky-out ears.
"I love making ears," Ken says. "I love doing the surgery, but particularly doing the post-op clinics, when they come back with their new ears and girls come back in wanting their ears pierced.
"As one of my colleagues said, you never get tired of seeing the smiles on their faces when they see their ear for the first time.
"My personal opinion is that there's something particularly special about looking after children. If it's done well it's life-changing surgery. You see them come out of their shell and their parents tell you all sorts of stories about how things have changed for them.
"It's very complicated surgery because the ears have so many different curvatures, it's quite complex to make the perfect ear.
"I'm not sure I've done one that's perfect yet, but I'm getting there. It's basically sculpture. A lot of my colleagues that make ears internationally are also sculptors. I don't have the time myself – I've got four kids, which is a full-time job in itself."
The privilege of changing people's lives is what he loves, he says – the days of the domineering surgeon wielding the power of God to conjure flesh anew are gone: "I think that idea of paternal medicine is outdated. Patients don't accept it and doctors don't expect it."
Not surprisingly, his proud mum loves to tell everyone how her son makes ears for children, but when he tries to talk to her about his cosmetic surgery practice, she doesn't want to hear.
Ken doesn't share his mother's qualms about the "nip and tuck" end of his profession, however, as long as a responsible attitude is taken towards patients.
Ninety per cent of his cosmetic patients are women, most commonly seeking breast augmentation or tummy tucks. Sometimes he is asked to sort out the mess caused by less experienced surgeons in the UK or, increasingly, abroad, as people indulge in what's often referred to as "cosmetic surgery tourism".
There is another growing clientele, as Ken explains: "More and more common now are massive weight-loss patients, people who turn their lifestyle around or have had surgery to help them lose weight, and because their skin's been stretched beyond its elastic limits there are lots of loose pieces of skin that they want to be rectified."
It is not, he insists, a matter of preying on the insecure: "We have a psychologist that we work very closely with and she and I will regularly ask patients to see her, but most patients that come for cosmetic surgery are normal people who have got a straightforward problem that they want fixed. It's a service industry.
"The motivations are the same for the patients (as they are for reconstructive patients]. They've got an issue that they want to be fixed but for whatever reason the NHS isn't able to do it.
"Plastic surgery is a huge amount of psychology. You're operating on people's bodies, but you're trying to make them happy. I quite often get people coming to see me and I don't think they're going to achieve what they want to achieve.
"I've had patients coming to see me wanting 20 litres of fat sucked off them and I say 'what you need to do is change your lifestyle'.
"I couldn't imagine a better job really, I have a nice balance between the reconstructive stuff which rewards the heart, and the cosmetic stuff, which rewards the wallet."
Ken says that cosmetic surgery can even offer some of the same, rewarding long-term relationships that build up with reconstructive patients.
He says: "I have some adults who come back and see me for multiple procedures. One lady who's a country and western singer has had about eight procedures and she turned round her lifestyle. She had some cosmetic surgery and started feeling really good about herself so she started exercising.
"Whenever she comes in for surgery she brings me one of her CDs and we play it while I'm operating on her."
As well as his demanding workload, Ken and his "very understanding" wife, Jill, a nurse, have four sons, aged between four and ten. He also sails, is training for the New York Marathon, and supports the Sick Kids New Pyjamas fundraising campaign.
Raising a family as well as taking on such a heavy workload is difficult, but being a dad adds to the meaning he derives from his work, he says: "I think if you're looking after children it does help if you're a parent. I remember once we had a little girl from Fife with meningococcal septicaemia and we had to amputate all four limbs.
"When you're a professional you just get on with what you've got to do. It didn't affect me at the time, but then I went home and put one of my kids in the bath. I got them out and they stood on their feet and I thought 'God that little girl's not going to be able to do that'."
SURGICAL TEAMWORK GIVES LAURA NEW LEASE OF LIFEEIGHT-year-old Laura Clarke had her first operation at the age of just three, when she had a tumour removed from her spine.
She also underwent radiotherapy, which cleared the cancer, but left her spine weakened and bending forward, making it difficult for her to hold her head upright. In March she travelled from her home in Gourock to the Sick Kids for an operation by the National Spinal Deformity Team to straighten her spine, but it was not successful.
On 19 June, Mr Stewart and his colleagues joined forces with the spinal team for a more complex operation.
He explained: "Me and the spinal surgeons and two colleagues set about taking bone from her fibula and moving it to her back.
"We started operating on Friday morning at 9am, but even with four consultant surgeons we got to midnight and it wasn't finished. We kept her in intensive care overnight and then finished the job the next day. It's really rewarding to do that kind of thing. That teamwork is one of the fantastic things about the NHS."
Laura has been recovering well and was not fazed when doctors said they were going to take bone from her leg to fix her neck: "I was excited because I wanted a cast. When I first sat up after the operation I felt dizzy, but I feel fine now."
