It's a surprise to discover that Stephen Sinclair comes from farming stock. As a child he loved working with his father on the family's Co Antrim farm and actually wanted to be a vet. Yet today, the 57-year-old is a leading consultant plastic surgeon at the Ulster Hospital where he specialises in breast reconstruction for cancer patients.
"Yes, at the time it was a bit of a step into the unknown having enjoyed a really happy childhood helping dad out," he says.
"There are no doctors or nurses in the family, so I didn't know what I was getting into when I started," he laughs.
"At one stage I was interested in doing veterinary surgery, but just towards the end of school (St Mary's in Belfast), I changed my mind and decided to opt for medicine."
After graduating from Queen's University in 1987, Stephen spent the early part of his career in hospitals in and around Belfast, working on different wards and in different roles.
"I realised that I wanted to specialise in surgery, and then when I went through the different specialties in surgery, I realised that plastics was the one I wanted to pursue," he says. "So I took a research job in the Queen Victoria Hospital in East Grinstead, London.
"It's where plastic surgery pretty much started in the UK. During World War II, pilots and aircrew who had been badly burned and injured were treated there under Archibald McIndoe and he and the hospital became world-renowned for pioneering reconstructive plastic surgery (those wartime patients famously formed a club called The Guinea Pigs).
"After finishing my research, I came back to Belfast for a few years before moving to the Frenchay Hospital in Bristol, where I was senior registrar in plastics, for three years."
Stephen then undertook fellowships in America (including the Emory Centre, Atlanta and Baptist Hospital, Nashville) and Institut Curie in Paris, to further his skills in breast reconstruction.
He has been a consultant plastic surgeon at the Ulster Hospital since 1999 and last year was appointed Clinical Director of Plastic Surgery.
"It's important for every woman diagnosed with breast cancer to have access to reconstruction, even if they don't go ahead with it, or it's not something for them," he says.
"Everyone benefits from going through the process of learning what it involves. And whether it is the right thing for them at that time.
"Once a patient has gone through such a devastating diagnosis and treatment that can involve removing all or part of the breast, we begin the process of discussing reconstruction.
"Plastic surgeons are very much part of a team that works closely together. Each patient gets individual treatment as a result of a multi-disciplinary meeting where everybody from all the different specialties involved make a plan for that patient, which may include reconstruction.
"For those patients for whom it is the right way forward, it is undoubtedly beneficial to them, physically, and equally important mentally. Probably more importantly mentally.
"Of course, treating the cancer takes priority, but discussions around reconstruction begin at a very early stage.
"If reconstruction happens at the same time as surgery, then that can be very beneficial because the patient doesn't feel the sense of loss with regards to their breasts, and they don't have to go through that physical and emotional process.
"However, some people decide that it's not for them and for some, it's better to undergo treatment and then come back to the option of reconstruction a little bit further down the line.
"For some people reconstruction is not suitable at all, either because of their age or their general health, or because of their family or job it doesn't suit them to undergo what can be sometimes a significant surgery."
Although specialising in breast reconstruction, Stephen also works in general plastic surgery and trauma.
"Every two months all of the plastic surgeons cover trauma for a week where we deal with more routine things such as hand injuries and tendon and nerve injuries that happen on farms and factories and different places like that.
"And also traffic accidents and major limb injuries such as open fractures of legs and arms.
"We're kind of one of the last specialties that operate in nearly every area of the body. We can use techniques that we have learned in all areas of the body.
"That's what drew me to plastic surgery - the ability to reconstruct significant defects using techniques that are constantly evolving and developing.
"You have to keep up-to-date with everything. As well as teaching my junior colleagues, I often learn from them as well," he laughs.
In his role as clinical director, Stephen is passionate about developing all areas of plastic surgery provision in Northern Ireland. "The plastic surgery unit is mainly based at the Ulster, where we have 11 surgeons. Part of it is also based at the Royal and the Children's Hospital where there are three full-time equivalents.
"I've been working with the health board here for the past few years on developing an overall plastic surgery service in Northern Ireland and we've made some really significant progress in that time. The outlook I feel is a positive one."
Like anyone who works in the medical profession, Stephen admits that there are times when the job gets to him.
"Sometimes it does," he says. "But good days and positive outcomes help balance the not so good days.
"And it's very important to keep a work/life balance and to make time to get away from the job and recover.
"Obviously there are individual patients that affect you and that provide you with individual challenges. Whether that be someone with cancer or who has suffered a major trauma.
"Reconstructing is what I specialise in and it's great to see patients coming back following successful surgery and seeing how surgery has changed their appearance and their wellbeing.
"It's great to see them looking happy and positive. But then, there are patients for whom the outcome isn't so good.
"I remember one young girl who had suffered severe injuries to both legs after a terrible accident on a ride-on lawn mower.
"Unfortunately reconstruction just wasn't possible and she ended up with a bilateral below knee amputation, which was a very, very difficult decision to make at the time.
"In cases such as that, we involve colleagues from lots of different areas to help us come to the right decision for that patient. However, it's still very difficult not to be able to do what you're trained to do and reconstruct and put someone back together again. Sometimes it's just not possible.
"It can be very hard not to get emotionally involved, especially if it's a young patient, or somebody who has a young family and has just been given a cancer diagnosis.
"You can't help but feel sympathy and empathy, but we've been professionally trained and our job is to give people the best advice for their situation and to help them through their surgery, if that's the right choice for them."
The Covid pandemic and a lack of resources have, says Stephen, provided the biggest challenges of his career.
"Given the limited resources in the NHS, treating people in a timely fashion has been a recurring issue - nearly every day," he says. "It's hard because we want to treat everybody as quickly as we can and that's not always possible. Over the past year, Covid has made that situation much worse.
"We've had to change everything that we do. But we do pull together as a team and the specialties all work well together. We have been able to continue to provide a trauma service and a service for patients with very urgent cancers that need treated.
"All departments meet weekly to try and balance the resources we have with the different types of patients that come into each of the different areas of the hospital."
Stephen insists that having downtime is vital in enabling him to do his job to the best of his ability. And he credits his wife of 20 years, Mary-Clare, and his three teenage children with achieving a good work/life balance.
"It's our 20th wedding anniversary this year. Mary-Clare and the children are a great support to me and are full of life and keep me on my toes," he admits.
"We get on really well as a family and enjoy going on holiday together skiing or travelling in France.
"I also love playing golf and am continually trying to learn to play the guitar," he laughs.
"It's definitely hard not to bring your work home with you at times. But it's lovely to have a family to go home to, and who really take your mind off it.
"Everybody talks about resilience these days but you can only be resilient if you give yourself time to recover and recharge.
"Keeping a balance in life is important and having that balance also helps when you are at work. It helps you focus on the job in hand."
1: Family life is really important. Spend time with your family and don't let your life be taken up totally with work.
2: Don't worry about things. It's good to have a back-up plan in case things go wrong, but don't over worry.
3: Try not to have regrets. Don't dwell on the past, or regret things that have happened. Try and learn from things and move on.
4: Don't take anything at all for granted.
5: Listen to Sunscreen by Baz Luhrmann every now and again. My kids get fed up when I put it on, but it's a little nugget of wisdom.