Oncological Breast Cancer Surgeon Western Sydney

Dr Nesh is an experienced Windsor breast cancer surgeon and general surgeon .

He is committed to using the least invasive surgical and laparoscopic techniques to help patients achieve optimal oncological and cosmetic results. He understands that every patient is different, and offers a customised surgical strategy based on each patient’s unique circumstances.

Dr Nesh is a no No Gap surgeon for any pensioner who has private health insurance for surgical hospital procedures.

He is highly experienced in abdominal surgery and breast surgery, having performed hundreds of surgeries for benign and malignant breast conditions as well as colonoscopy, hernia and gallbladder procedures.

Not all patients are suited to oncoplastic surgery but Dr Nesh is committed to providing every woman as much choice as possible during their breast cancer surgery.

What is oncoplastic breast surgery?

  • This is a modern breast cancer surgery technique that involves removing breast cancer lesions using minimally-invasive plastic surgery techniques and then reconstructing the breast/breasts after the cancer has been surgically removed.
  • “Removal” of a breast cancer lesion means excising the tumour with some excess margin to ensure complete removal of the cancer as much as possible, and with as little disfigurement to the breast as possible.
  • It also means that the surgeon can remove a larger area of tissue while maintaining a normal breast shape and symmetry with the opposite breast by using additional cosmetic techniques.  This is important because the devastation of losing a breast or both breasts cannot be overlooked and studies show that women whose breasts look different to each other after surgery were less likely to believe they were healthier because of the surgery compared to women whose breasts looked similar – which in turn increased the risks of depression.
  • Oncoplastic surgery can be helpful in giving women more control over how they look and feel during the breast cancer journey.
What is a nipple sparing mastectomy?
  • This form of mastectomy removes all of the breast glandular tissue, but leaves the breast skin envelope, nipple and areola.
  • Reconstruction of the breast can be performed immediately afterwards using a silicone implant or the patient’s own tissue.
What is immediate breast reconstruction?
  • Some women are suitable for immediate breast reconstruction, where the breast is reconstructed at the same time as the cancer is removed, which means only one set of recovery and expenses.
  • Most patients are suitable for this however, Dr Nesh will advise you based on your circumstances.
What are the benefits of oncoplastic surgery?

Compared with standard breast-conserving surgery, oncoplastic surgery has certain advantages and disadvantages:


  • Ability to resect larger breast volumes (bigger margins may mean less chance of missed cancer cells)
  • Improved breast cosmetic results especially where a surgical breast reduction can be performed to balance breast volumes, or where there is a significant amount of breast drop (ptosis)


  • The scars may be bigger, although they can often be discretely placed
  • There may be higher complications as the surgery is longer and often the other breast is treated at the same time and surgery may be longer.
Lumpectomy v Mastectomy: what’s the difference?
  • Many studies now show that women will have the same survival outcome whether they choose to have a lumpectomy or mastectomy.
  • A lumpectomy involves removing the breast cancer lesion while preserving the breast as much as possible. This is also known as breast-conserving surgery, segmental mastectomy, quadrantectomy or excisional breast biopsy.
  • Oncoplastic lumpectomy combines plastic surgery techniques with lumpectomy surgery to give patients the best cosmetic outcome after the cancer is removed.
  • A lumpectomy is often an ideal alternative to a mastectomy for less advanced breast cancers.
  • There are some circumstances where a lumpectomy cannot be performed; for example, when the cancer is extensive, or there is a genetic risk of breast cancer.
  • Where lumpectomy is not suitable, mastectomy is a procedure that involves the removal of all the glandular tissue of the breast.

The pros and cons of lumpectomy include


  • Same overall survival rate as mastectomy patients with less damage to the breast and preservation of the breast
  • Less invasive procedure


  • Generally not suitable for larger or more aggressive cancers or for women with a high genetic risk of contracting breast cancer or where there is a high chance of breast cancer occurring in the other breast.


The pros and cons of mastectomy include


  • Peace of mind “I just want it all out!”
  • Many patients will not need radiation therapy to ensure all traces of cancer are gone, which can be time consuming and painful and involves five days of treatment per week for nearly two months.


  • Mastectomy takes longer with longer recuperation and permanent loss of breast and likelihood of more additional surgeries for reconstruction after the mastectomy.