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Richard Harman - Thyroid, Melanoma, Breast and General Surgeon

Private Service, General Surgery, Breast, Oncology, ENT/ Head & Neck Surgery

Description

Richard Harman is a Thyroid, Melanoma, Breast and General Surgeon on the North Shore with subspecialty interests in:

  • Endocrine surgery (thyroid, parathyroid and adrenal surgery)
  • Melanoma surgery (also non-melanomatous skin cancer; SCC and BCC minor and major excisions).
  • Breast surgery (comprehensive expertise in all aspects of breast surgery, handling both benign & malignant conditions)

Richard is also available for consultation for common general surgical procedures such as hernia and laparoscopic gallbladder procedures.
Richard is a very experienced surgeon and has audited and published results with excellent patient outcomes. He has held positions in senior leadership roles for the College of Surgeons, and more recently Head of Division for Surgery at Waitemata Health.

Consultants

How do I access this service?

Make an appointment, Contact us, Referral

Referral Expectations

When you come to your appointment, your surgeon will ask questions about your illness and examine you to try to determine or confirm the diagnosis. This process may also require a number of tests (e.g. blood tests, x-rays, scans etc). Sometimes this can all be done during one visit, but for some conditions this will take several follow-up appointments. Occasionally some tests are arranged even before your appointment to try to speed up the process.

Once a diagnosis has been made, your surgeon will discuss treatment with you. In some instances this will mean surgery, while other cases can be managed with medication and advice. If surgery is advised, the steps involved in the surgical process and the likely outcome are usually discussed with you at this time.

Fees and Charges Categorisation

Fees apply

Fees and Charges Description

Richard is a Southern Cross Health Insurance Affiliated Provider and a nib First Choice Health Partner.

Hours

Office hours at all locations are Monday to Friday 8:30am - 5:30pm

Languages Spoken

English

Procedures / Treatments

Endocrine Disorders

Abnormalities of the endocrine system treated by general surgery include disorders of the pancreas and adrenal glands in the abdomen and the thyroid and parathyroid glands in the neck. These are often very complex conditions requiring extensive investigations. If surgery is required it is often quite complicated and will usually mean a stay in hospital for several days or even longer.

Abnormalities of the endocrine system treated by general surgery include disorders of the pancreas and adrenal glands in the abdomen and the thyroid and parathyroid glands in the neck. These are often very complex conditions requiring extensive investigations. If surgery is required it is often quite complicated and will usually mean a stay in hospital for several days or even longer.

Parathyroidectomy

An incision (cut) is made in the front of and at the base of the neck and one or more of the parathyroid glands are removed.

An incision (cut) is made in the front of and at the base of the neck and one or more of the parathyroid glands are removed.

Thyroidectomy

An incision (cut) is made in the front of and at the base of the neck and part or all of the thyroid gland is removed.

An incision (cut) is made in the front of and at the base of the neck and part or all of the thyroid gland is removed.

Skin Cancer

New Zealand has a very high rate of skin cancer, when compared to other countries. The most common forms of skin cancer usually appear on areas of skin that have been over-exposed to the sun. Risk factors for developing skin cancer are: prolonged exposure to the sun; people with fair skin; and possibly over-exposure to UV light from sun beds. There are three main types of skin cancers: basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Basal Cell Carcinoma (BCC) This is the most common type and is found on skin surfaces that are exposed to sun. A BCC remains localised and does not usually spread to other areas of the body. Sometimes BCC’s can ulcerate and scab so it is important not to mistake it for a sore. BCCs occur more commonly on the face, back of hands and back. They appear usually as small, red lumps that don’t heal and sometimes bleed or become itchy. They have the tendency to change in size and sometimes in colour. Treatment Often a BCC can be diagnosed just by its appearance. In other cases it will be removed totally and sent for examination and diagnosis, or a biopsy may be taken and just a sample sent for diagnosis. Removal of a BCC will require an appointment with a doctor or surgeon. It will be termed minor surgery and will require a local anaesthetic (numbing of the area) and possibly some stitches. A very small number of BCCs will require a general anaesthetic (you will sleep through the operation) for removal. Squamous Cell Carcinoma (SCC) This type of skin cancer also affects areas of the skin that have exposure to the sun. The most common area is the face, but an SCC can also affect other parts of the body and can spread to other parts of the body. The spreading (metastasising) can potentially be fatal if not successfully treated. A SCC usually begins as a keratosis that looks like an area of thickened scaly skin, it may then develop into a raised, hard lump which enlarges. SCCs can sometimes be painful. Often the edges are irregular and it can appear wart like, the colour can be reddish brown. Sometimes it can appear like a recurring ulcer that does not heal. All SCCs will need to be removed, because of their potential for spread. The removal and diagnosis is the same as for a BCC. Malignant Melanoma This is the most serious form of skin cancer. It can spread to other parts of the body and people can die from this disease. A melanoma usually starts as a pigmented growth on normal skin. They often, but not always, occur on areas that have high sun exposure. In some cases, a melanoma may develop from existing pigmented moles. What to look for: an existing mole that changes colour (it may be black, dark blue or even red and white) the colour pigment may be uneven the edges of the mole/freckle may be irregular and have a spreading edge the surface of the mole/freckle may be flaky/crusted and raised sudden growth of an existing or new mole/freckle inflammation and or itchiness surrounding an existing or new mole/freckle. Treatment It is important that any suspect moles or freckles are checked by a GP or a dermatologist. The sooner a melanoma is treated, there is less chance of it spreading. A biopsy or removal will be carried out depending on the size of the cancer. Tissue samples will be sent for examination, as this will aid in diagnosis and help determine the type of treatment required. If the melanoma has spread more surgery may be required to take more of the affected skin. Samples from lymph nodes that are near to the cancer may be tested for spread, then chemotherapy or radiotherapy may be required to treat this spread. Once a melanoma has been diagnosed, a patient may be referred to an oncologist (a doctor who specialises in cancer). A melanoma that is in the early stages can be treated more successfully and cure rates are much higher than one that has spread.

New Zealand has a very high rate of skin cancer, when compared to other countries. The most common forms of skin cancer usually appear on areas of skin that have been over-exposed to the sun.
Risk factors for developing skin cancer are:  prolonged exposure to the sun; people with fair skin; and possibly over-exposure to UV light from sun beds.
There are three main types of skin cancers: basal cell carcinoma, squamous cell carcinoma and malignant melanoma.

Basal Cell Carcinoma (BCC)
This is the most common type and is found on skin surfaces that are exposed to sun. A BCC remains localised and does not usually spread to other areas of the body.  Sometimes BCC’s can ulcerate and scab so it is important not to mistake it for a sore.
BCCs occur more commonly on the face, back of hands and back.  They appear usually as small, red lumps that don’t heal and sometimes bleed or become itchy. They have the tendency to change in size and sometimes in colour.

Treatment
Often a BCC can be diagnosed just by its appearance.  In other cases it will be removed totally and sent for examination and diagnosis, or a biopsy may be taken and just a sample sent for diagnosis.
Removal of a BCC will require an appointment with a doctor or surgeon.  It will be termed minor surgery and will require a local anaesthetic (numbing of the area) and possibly some stitches. A very small number of BCCs will require a general anaesthetic (you will sleep through the operation) for removal.

Squamous Cell Carcinoma (SCC)
This type of skin cancer also affects areas of the skin that have exposure to the sun.  The most common area is the face, but an SCC can also affect other parts of the body and can spread to other parts of the body.  The spreading (metastasising) can potentially be fatal if not successfully treated.
A SCC usually begins as a keratosis that looks like an area of thickened scaly skin, it may then develop into a raised, hard lump which enlarges.  SCCs can sometimes be painful. Often the edges are irregular and it can appear wart like, the colour can be reddish brown.  Sometimes it can appear like a recurring ulcer that does not heal.
All SCCs will need to be removed, because of their potential for spread.  The removal and diagnosis is the same as for a BCC.

Malignant Melanoma
This is the most serious form of skin cancer. It can spread to other parts of the body and people can die from this disease.
A melanoma usually starts as a pigmented growth on normal skin.  They often, but not always, occur on areas that have high sun exposure.  In some cases, a melanoma may develop from existing pigmented moles.

What to look for:

  • an existing mole that changes colour  (it may be black, dark blue or even red and white)
  • the colour pigment may be uneven
  • the edges of the mole/freckle may be irregular and have a spreading edge
  • the surface of the mole/freckle may be flaky/crusted and raised
  • sudden growth of an existing or new mole/freckle
  • inflammation and or itchiness surrounding an existing or new mole/freckle.

Treatment
It is important that any suspect moles or freckles are checked by a GP or a dermatologist. The sooner a melanoma is treated, there is less chance of it spreading.
A biopsy or removal will be carried out depending on the size of the cancer.  Tissue samples will be sent for examination, as this will aid in diagnosis and help determine the type of treatment required.  If the melanoma has spread more surgery may be required to take more of the affected skin.  Samples from lymph nodes that are near to the cancer may be tested for spread, then chemotherapy or radiotherapy may be required to treat this spread.
Once a melanoma has been diagnosed, a patient may be referred to an oncologist (a doctor who specialises in cancer).
A melanoma that is in the early stages can be treated more successfully and cure rates are much higher than one that has spread.

Breast Biopsy

Open Excisional: a small incision (cut) is made as close as possible to the lump and the lump, together with a surrounding margin of tissue, is removed for examination. If the lump is large, only a portion of it may be removed. Fine Needle Aspiration and Core Needle Biopsy: both these procedures involve inserting a needle through your skin into the breast lump and removing a sample of tissue for examination.

Open Excisional: a small incision (cut) is made as close as possible to the lump and the lump, together with a surrounding margin of tissue, is removed for examination. If the lump is large, only a portion of it may be removed.

Fine Needle Aspiration and Core Needle Biopsy: both these procedures involve inserting a needle through your skin into the breast lump and removing a sample of tissue for examination.

Breast Cancer Surgery

This may be: Simple or Total: all breast tissue, skin and the nipple are surgically removed but the muscles lying under the breast and the lymph nodes are left in place. Modified Radical: all breast tissue, skin and the nipple as well as some lymph tissue are surgically removed. Partial: the breast lump and a portion of other breast tissue (up to one quarter of the breast) as well as lymph tissue are surgically removed. Lumpectomy: the breast lump and surrounding tissue, as well as some lymph tissue, are surgically removed. When combined with radiation treatment, this is known as breast-conserving surgery.

This may be:

  • Simple or Total: all breast tissue, skin and the nipple are surgically removed but the muscles lying under the breast and the lymph nodes are left in place.
  • Modified Radical: all breast tissue, skin and the nipple as well as some lymph tissue are surgically removed.
  • Partial: the breast lump and a portion of other breast tissue (up to one quarter of the breast) as well as lymph tissue are surgically removed.
  • Lumpectomy: the breast lump and surrounding tissue, as well as some lymph tissue, are surgically removed. When combined with radiation treatment, this is known as breast-conserving surgery.
Hernias

A hernia exists where part of the abdominal wall is weakened, and the contents of the abdomen push through to the outside. This is most commonly seen in the groin area but can occur in other places. Surgical treatment is usually quite straightforward and involves returning the abdominal contents to the inside and then reinforcing the abdominal wall in some way. Hiatus Hernia Laparoscopic: several small incisions (cuts) are made in the abdomen (stomach) and a narrow tube with a tiny camera attached (laparoscope) is inserted. Small instruments are inserted through the other cuts, allowing the surgeon to push the hernia (part of the stomach and lower oesophagus that is bulging into the chest) back into position in the abdominal cavity. The hiatus (opening) in the diaphragm (a sheet of muscle between the chest and stomach) is tightened and the stomach is stitched into place. Open: an abdominal incision is made over the hernia and the hernia is pushed back into position in the abdominal cavity. The hiatus (opening in the diaphragm) is tightened and the stomach is stitched into place. Fundoplication: during the above procedures, the top part of the stomach (fundus) may be secured in position by wrapping it around the oesophagus. Inguinal Hernia Laparoscopic: several small incisions are made in the abdomen and a narrow tube with a tiny camera attached (laparoscope) is inserted. Small instruments are inserted through the other cuts, allowing the surgeon to push the hernia (part of the intestine that is bulging through the abdominal wall) back into its original position. The weakness in the abdominal wall is repaired. Open: an abdominal incision is made and the hernia is pushed back into position. The weakness in the abdominal wall is repaired. Umbilical Hernia An incision is made underneath the navel (tummy button) and the hernia (part of the intestine that is bulging through the abdominal wall) is pushed back into the abdominal cavity. The weakness in the abdominal wall is repaired. Incisional Hernia Laparoscopic: several small incisions are made in the abdomen and a narrow tube with a tiny camera attached (laparoscope) is inserted. Small instruments are inserted through the other cuts, allowing the surgeon to push the hernia (part of the intestine that is bulging through the abdominal wall) back into its original position. Open: an abdominal incision is made and the hernia is pushed back into position.

A hernia exists where part of the abdominal wall is weakened, and the contents of the abdomen push through to the outside. This is most commonly seen in the groin area but can occur in other places. Surgical treatment is usually quite straightforward and involves returning the abdominal contents to the inside and then reinforcing the abdominal wall in some way.

Hiatus Hernia
Laparoscopic: several small incisions (cuts) are made in the abdomen (stomach) and a narrow tube with a tiny camera attached (laparoscope) is inserted. Small instruments are inserted through the other cuts, allowing the surgeon to push the hernia (part of the stomach and lower oesophagus that is bulging into the chest) back into position in the abdominal cavity. The hiatus (opening) in the diaphragm (a sheet of muscle between the chest and stomach) is tightened and the stomach is stitched into place.
Open: an abdominal incision is made over the hernia and the hernia is pushed back into position in the abdominal cavity. The hiatus (opening in the diaphragm) is tightened and the stomach is stitched into place.

Fundoplication: during the above procedures, the top part of the stomach (fundus) may be secured in position by wrapping it around the oesophagus. 

Inguinal Hernia
Laparoscopic: several small incisions are made in the abdomen and a narrow tube with a tiny camera attached (laparoscope) is inserted. Small instruments are inserted through the other cuts, allowing the surgeon to push the hernia (part of the intestine that is bulging through the abdominal wall) back into its original position. The weakness in the abdominal wall is repaired.
Open: an abdominal incision is made and the hernia is pushed back into position. The weakness in the abdominal wall is repaired.

Umbilical Hernia
An incision is made underneath the navel (tummy button) and the hernia (part of the intestine that is bulging through the abdominal wall) is pushed back into the abdominal cavity. The weakness in the abdominal wall is repaired.

Incisional Hernia
Laparoscopic: several small incisions are made in the abdomen and a narrow tube with a tiny camera attached (laparoscope) is inserted. Small instruments are inserted through the other cuts, allowing the surgeon to push the hernia (part of the intestine that is bulging through the abdominal wall) back into its original position.
Open: an abdominal incision is made and the hernia is pushed back into position.

Gallstones

General surgery covers some disorders of the liver and biliary system. The most common of these is pain caused by gallstones. These are formed if the gallbladder is not working properly, and the standard treatment is to remove the gallbladder (cholecystectomy). This procedure is usually performed using a laparoscopic (keyhole) approach.

General surgery covers some disorders of the liver and biliary system. The most common of these is pain caused by gallstones. These are formed if the gallbladder is not working properly, and the standard treatment is to remove the gallbladder (cholecystectomy). This procedure is usually performed using a laparoscopic (keyhole) approach.

Salivary Gland Disorders

Disorders of the salivary glands may be dealt with by the general surgical department or the ENT (ORL) department depending on the local policy.

Disorders of the salivary glands may be dealt with by the general surgical department or the ENT (ORL) department depending on the local policy.

Disability Assistance

Wheelchair access, Wheelchair accessible toilet, Mobility parking space

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Parking

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Contact Details

Auckland Breast Centre, 209 Shakespeare Road
Milford
Auckland
Auckland 0620

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Street Address

Auckland Breast Centre, 209 Shakespeare Road
Milford
Auckland
Auckland 0620

This page was last updated at 2:00PM on September 3, 2024. This information is reviewed and edited by Richard Harman - Thyroid, Melanoma, Breast and General Surgeon.