Controlling breast surgery incisions

Improving surgeon accuracy in breast surgery procedures

Shweta Aggarwal, a consultant plastic surgeon specialising in breast cancer, reconstructive and aesthetic surgery, came to Team Consulting with a clinical challenge – how to ensure a perfect circular cut around the nipple areolar complex in breast surgery. In current practice, surgeons often use a guide to draw an incision line around the nipple. While this helps with accuracy, the actual cutting is still done by hand and depends on the ability of the surgeon to cut in a smooth line.

Shweta wanted to improve this process by developing a medical device that would allow for more consistent, controlled incisions – removing the reliance on human accuracy and helping to improve patient outcomes. Working closely with her, we helped translate her clinical knowledge into a prototype device and industrial design vision.

Surgical | FemTech | Front End Innovation | Industrial design | Mechanical engineering

Working with Team Consulting has been an incredibly rewarding journey. They were able to develop an in depth understanding of the issues and went out of their way to research the subject.
Shweta Aggarwal, Consultant Plastic Surgeon

Understanding the clinical challenge

Understanding the context of use is essential for creating solutions that meet real users’ needs. To gain a deeper understanding of the current surgical workflow for the procedure, our human factors and FemTech experts observed Shweta perform a live oncoplastic surgery. This allowed our team to study the current process for cutting around a nipple, including the use of traditional marker devices and surgical pens to identify the incision area. It also helped the team understand the nuanced constraints of this specific procedure, including how the surgeon and other practitioners are situated relative to the patient, and how they ensure the breast tissue is positioned securely for the incisions.

Drawing on these insights, we then created a detailed user journey map outlining each step of the process — from setup and preparation to marking and cutting. This helped to identify the key users involved, the tools they rely on and the pain points they encounter throughout the procedure, in order to produce a set of clear design challenges for concept generation with our designers and engineers.

Procedural observations are one of the most effective ways to understand user needs and gain a more accurate understanding of the user journey. This allowed us to focus our ideation on solutions that seamlessly integrate into the existing workflow, enhancing users’ capabilities without requiring them to change their practice.
Andrea Pisa, Head of Human Factors - Product Development, Team Consulting

Rapid ideation and concept development

Working from the identified design challenges, we rapidly developed a range of potential concepts, collaborating closely with our client throughout the process to ensure the solutions were clinically feasible and would meet the needs of surgeons and patients. The concepts ranged from the “mild” to “wild”, allowing our team to explore novel approaches and ideas, while staying grounded in practical, clinical needs and requirements.

Technical, commercial and clinical feasibility evaluation

To narrow down the initial concepts, we evaluated each one carefully to determine their technical, clinical and commercial feasibility. This helped us to focus on the ideas with the strongest potential for real-world impact and successful implementation.

As part of this process, we developed a high-level business case for each concept. This included key assumptions around pricing, revenue models, the number of kits per healthcare unit, annual procedure volumes and estimated development costs. These inputs allowed us to forecast potential returns and assess commercial viability.

Sustainable design considerations

Sustainability was also a key concern for our client, recognising the ongoing drive for less waste in surgery as part of the NHS Net Zero plan. To support these aims, we focused on exploring options that would offer more reusability, rather than relying on single-use components. This approach would also align with current clinical practices, where reusable marker devices are already the standard.

When refining the final concept, we carefully considered the reprocessing requirements and looked for opportunities to make as many components reusable as possible. These decisions were made with both environmental impact and practical implementation in mind, ensuring the final solution would be sustainable, cost-effective and compatible with existing surgical workflows.

Prototyping and product vision

We selected the final concept based on simplicity and precision, opting for the solution that would ensure a clean, circular cut, without impacting the surgeons’ existing workflow. The concept we selected features a reusable instrument with guides of varying sizes, to account for different nipple sizes, along with a simple fitting for standard disposable scalpel blades to be attached.

We deliberately designed a simple solution that addressed the core challenge without adding unnecessary complexity. Our client was focused on keeping the tool intuitive and familiar, so it would integrate seamlessly into the surgeon’s existing workflow while also creating better, more consistent outcomes for women undergoing surgery. It also needed to be feasible and affordable for use in the NHS.
Lara Zaki, Senior FEI Strategy and Innovation Specialist, Team Consulting

User-centred design

A fundamental element of our design approach was the careful consideration of patient safety and outcomes, as well as surgeons’ workflows and needs. Having observed a live procedure and by collaborating closely with our client throughout, we were able to develop a concept designed for and compatible with women’s bodies, as well as ergonomic for both female and male surgeons.

A key design challenge was ensuring the device remained stable on the breast tissue during use — particularly within a busy operating theatre where space is limited. To address this, we designed a cutting guide that allows the surgeon to hold the device against the skin from the outside, while cutting along an inner circumference — keeping their fingers safely out of the way.

Outcome

The result was a reusable, easy-to-use device concept that enables surgeons to make consistent, precise circular incisions during breast reduction and therapeutic mammoplasty procedures. By reducing reliance on manual precision, the device helps minimise surgical error to support better outcomes for women.

This project focused on a clearly defined, practical challenge — one that could be addressed quickly and effectively. Through a targeted, collaborative approach, we identified a specific clinical need and developed a viable, user-friendly solution that integrates seamlessly into existing surgical workflows.

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