A breast surgeon who intentionally wounded his patients has had his 15-year jail term increased to 20 years.
Ian Paterson, 59, who appeared at the Court of Appeal via video link, was told his current sentence was "not sufficient" to reflect the seriousness and the totality of his offending.
Paterson was found guilty in May at Nottingham Crown Court of 17 counts of wounding with intent.
Jurors also convicted him of three further wounding charges.
'Brutal and sustained'
Explaining the decision to increase his jail term, one of the three Appeal Court judges - Lady Justice Hallett - told Paterson his victims had been, "left feeling violated and vulnerable".
She described his treatment of patients as "brutal and sustained".
"They have lost their trust in others, particularly some in the medical profession," she said.Image copyright Thompsons Image caption
"Some have experienced long-term psychological effects."
Representing Paterson, Nicholas Johnson QC said "his crimes are truly notorious".
He said in prison the surgeon was regarded as a "marked man" so had to be kept apart from other inmates.
Reaction from court:BBC Midlands correspondent Phil Mackie
That decision has been met with some satisfaction by Ian Paterson's victims who have come to the Court of Appeal today.
They were hoping for at least 20 years when he was sentenced to 15 years in Nottingham at the end of May.They felt that day, that whilst they were glad he had gone to prison, that he should have been sent to prison for longer.
Paterson has appeared via video link from Nottingham Prison.He was taking notes and shaking his head occasionally.
Lady Justice Hallett said the Appeal Court judges had to impose a "just and proportionate sentence".
The judges found the exercise difficult but they did think the original sentence had been unduly lenient.
They said there had been a breach of trust and an abuse of power and took into account the vulnerability of the patients - some of whom were under his care for a decade or more.
She said ultimately the 15-year sentence just was not long enough, given the totality of all of those factors.
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The court heard from nine women and one man who were treated in the private sector at Little Aston and Parkway Hospitals, run by Spire Healthcare, in the West Midlands between 1997 and 2011.
However the case was referred to the Court of Appeal by Solicitor General Robert Buckland.
Mr Buckland argued that Paterson's offending was "so serious and so exceptional" that a jail term "significantly higher" than 15 years was required.
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'I lost everything'
The trial heard Paterson, who treated thousands of patients during his career, exaggerated or invented cancer risks and claimed payments for more expensive procedures in some cases.
Jurors were not told Paterson also carried out hundreds of unnecessary operations on NHS patients, with a hospital trust paying out £17.8m in damages and legal costs.
In October, more than 500 of Paterson's private patients who had unnecessary operations will seek compensation at the High Court.Image copyright Richard T Harris Image caption
Linda Millband from Thompsons Solicitors, which is representing them, said:"Many of our clients were subjected to significant harm at the hands of Mr Paterson and some have been left with life-long conditions.
"While no length of sentence can undo this harm, it seems right and fair that this otherwise lenient sentence was revised, and extended by the courts."
Diane Green, who was given two unnecessary double mastectomies by Ian Paterson, said:"I lost everything - my home, my job, my marriage - as a result of what that man did.
"While no amount of jail time can repay or make up for what he did, a sentence 15 years...was never going to be enough for maiming and butchering hundreds of women like me."
"It is encouraging to see the Court of Appeal listening to victims like me and extending the sentence to 20 years."...
The NHS in England has announced it will finally give people a drug to dramatically reduce the risk of being infected with HIV, from next month.
The health service had previously fought against paying for Prep and even took the issue to court, unsuccessfully, last year.
The drug will be given to 10,000 people in a £10m trial lasting three years.
The Terrence Higgins Trust said it was "crucial" the NHS delivered plans to offer the protection routinely.
Prep (pre-exposure prophylaxis) is a daily pill that disables HIV before it gets a stranglehold in the body.
Scotland has already announced it will make Prep available on the NHS to people at risk of HIV.And in Wales, the government is also trialling the drug.
Sexual health clinics in London, Brighton, Manchester, Liverpool and Sheffield are expected to be the first to offer Prep to high-risk people, starting September.
The rest of the country will take part by April 2018.
Simon Stevens, the chief executive of NHS England, said:"This major new intervention should complement and supercharge the wide-ranging and increasingly successful effort to prevent HIV.
"It's another milestone in more than three decades' worth of progress in tackling one of humanity's major health challenges."
The trial will aim to answer questions about how Prep should be offered on a wide scale across England.
'This is about saving lives'Image caption
Harry Dodd, 25, is one of about 500 gay men in England who are taking Prep as part of a trial called Proud.
He says:"I've seen the panic on the face of previous boyfriends when they are awaiting their [HIV test] results - it's a huge fear, and it affects everything you do.
"To be able to have sex without having that fear hanging over you all the time is huge."
Harry says taking Prep has still not become socially acceptable.
"Too many people seem to think it will encourage a hedonistic lifestyle, but for me this is about saving lives," he says.
"People reacted with cynicism when the contraceptive pill for women was first introduced.
"For me, taking Prep has helped me to trust again, have relationships and build bridges, and that shouldn't be taken away."
Ian Green, chief executive of the Terrence Higgins Trust, said:"The priority must now be to make sure that the trial reaches everyone at risk of HIV, and that it is rolled out speedily across the whole country, by the end of this year at the very latest - spring 2018 is not soon enough.
"To make sure no-one at risk of HIV is left behind, it is crucial that at the end of this trial, a clear process for routinely commissioning Prep on the NHS is agreed."
Deborah Gold, the chief executive at the National Aids Trust, said:"This is a pivotal moment in the fight against HIV.
"Prep, if targeted properly at those in need and at high risk of HIV, offers the possibility of transforming the English HIV epidemic.
"We warmly welcome this announcement."
Actress Helen Mirren has been quoted - in colourful language - saying that moisturiser probably does nothing at all for the skin.Is she right?
Not really.If you have dry skin, moisturiser does help by supplying water to the skin and trapping it there.
Most moisturisers contain a greasy substance that holds the water in.
Many years ago, moisturisers were very greasy on the skin - but now there are huge numbers of moisturisers and creams for sale, each one with a slightly different mix of ingredients.
The key, according to Dr Sweta Rai, from the British Association of Dermatologists, is finding one that suits your skin type and feels comfortable.
"A moisturiser's job is to maintain an outer armour on the skin, which prevents against infection and helps skin conditioning," she says.
"If you're using a good moisturiser for you, then it will be doing a good job for your skin."
Oil v water
For oily skins, she recommends lotions that contain more water.
For dry skins, the advice is to choose ointments or creams that contain a little more oil.
Dr Rai says "many people are probably using the wrong moisturiser".
She suggests using a sun cream with a sun protection factor (SPF) of 30 as a moisturiser - that way it can protect against the Sun's rays, be reapplied regularly and keep the skin hydrated.
And she says it is possible to get a good moisturiser for under £10.
But moisturisers don't stop wrinkles or ageing, she says.
However, scientists who tested a cream with anti-ageing ingredients in 2012 did find that it appeared to smooth out wrinkles in some people.
As babies, we all start out with wonderfully smooth skin.
During puberty, glands in the skin start producing oil, and as we age, exposure to sun, cold weather and central heating systems all dry out the skin.
In winter the skin naturally dries out more, and in summer the skin naturally produces oils - but dry skin affects most people all year round.
- occlusives hold water in
- humectants draw water up from the skin
- emollients make the skin feel smooth
- water, vitamins and lactic acid
It says:"You really can't go very wrong.
"Almost all the moisturisers on the market will help with dry skin, and in most cases, the choice comes down to subjective experience."...
Tips for dry skin
- Turn down the heating - hot air is usually drier than cooler air
- Take warm baths and showers - not hot ones, because hot water takes away fatty substances in the skin that help retain water
- Use bath oils diluted in some warm water, which are a good post-bath moisturiser
- Use a mild soap - cleansers are an alternative
- Wear loose clothing because tight clothes that rub can dry out skin
- Stay protected in the cold - chilly air can be very drying
- ^ scientists who tested a cream with anti-ageing ingredients (news.bbc.co.uk)
- ^ An article from Harvard Medical School (www.health.harvard.edu)