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Are you worried that your son's foreskin is ballooning when he tries to pass urine? Well you're in the right place! In this post I will teach you about what ballooning means and how nearly all boy's foreskins will become retractable over time. Almost every boy is born with a foreskin that is non-retractile (physiological phimosis). It is normal, in young boys, for the inner surface of the foreskin to adhere to the head of the penis (the glans). The foreskin gradually becomes retractable due to a combination of intermittent erections (common in boys of all ages), and toughening (or keratinization) of the inner surface. Only 1% of 16-year-old boys will have non-retractile foreskins, compared with 10% at 3 years of age. Ballooning is one of the most common causes of worry for the parents that bring their boy's to see me in the clinic. In fact ballooning is another way that the foreskin becomes retractable - as it helps to loosen the adherent bits between the inner surface of the foreskin and the glans. As the foreskin becomes more retractable ballooning will settle. Is there anything that I can do to help my son's foreskin become retractable? I would not recommend that you try to pull your son's foreskin back for him. It is important to know that forceful retractions cause micro-tears and scarring that can actually make your son's phimosis (tight foreskin) even worse. Once your son is old enough to understand the principles (my two son's were about 4 or 5 before they were ready) he should be instructed how to gently retract his own foreskin. It is also really important to try to keep the inner surface of the foreskin as clean and dry as possible. This is easier said than done for a boy with a very tight foreskin. I suggest to all the boys that come to see me that they run the bath just before bedtime, do a wee and then clean the foreskin with soap and water in the bath just before bed. This ensures that the inner surface of the foreskin is clean and dry every night and will reduce the risk of infection or inflammation (such as balanitis). Is there any cream or other treatment available for my son's phimosis? Applying steroid cream to the inner prepuce twice daily for 6 weeks can help soften the skin and give your son the best chance of being able to retract his own foreskin. Using steroid cream for longer periods is not recommended as it then weakens the skin causing cracking and bleeding. What about surgery to treat my son's phimosis? Thankfully this is not commonly required. If there is white scarring of the prepuce then your son most likely has BXO and this requires a circumcision. If there is no BXO but he is either having painful erections, recurring balanitis or urinary tract infections then either a preputioplasty (procedure to widen the foreskin) or a circumcision can be considered. For more information on the procedures click here. If you think your son might need my help why not get in touch: you can email me directly at info@mrbrianmaccormack.com or simply call 02890667878 to book an appointment Until next time, take care of yourself and of your family. Best wishes

Are you worried that your child might need endoscopy? Well….you’re in the right place! In this post I'm going to teach you what this means for your child, and how someone like me can sort it out for them. Upper gastrointestinal endoscopy (or OGD) is a way for me to assess the food-pipe, stomach, and first part of the small intestine in your child. It is useful for diagnosing conditions such as gastro-oesophageal reflux, inflammation (such as in allergic conditions like eosinophilic oesophagitis), Crohn’s disease, and Coeliac disease. If your child is having endoscopy to confirm Coeliac disease they should have at least 4-6 weeks of a gluten-rich diet (ideally to the point where their symptoms are becoming difficult to tolerate) prior to the procedure, as this will massively increase our chance of making the diagnosis on biopsy. I perform this procedure under general anaesthetic and it usually takes me around 10 minutes to complete. During the procedure I will pass a flexible telescope via your child’s mouth – let me know if they have any wobbly teeth! During the procedure I can take tiny samples (or biopsies) of the lining of the gastrointestinal tract and can also take pictures and video to help discuss your child’s condition with you afterwards. Like in any operation there are small risks such as bleeding – but thankfully this is extremely rare and tends to settle on its own. Sometimes your child may have a sore throat or feel slightly bloated after the procedure. What I worry about is making a hole or a perforation. If your child develops severe abdominal pain, chest pain, breathlessness or temperatures after the procedure this is NOT normal and you should bring them to A&E immediately. This is vanishingly rare (about 1:2000). Following the procedure, I would expect your child to eat and drink and go home the same day. I will write to you as soon as I receive the results of the biopsies and let you know what else needs to be done based on these results. So, if you think your child might need endoscopy – why not get in touch? You can email me directly at info@mrbrianmaccormack.com or call 028 9066 7878 to book an appointment Until next time, take care of yourself and your family. Procedure information leaflet

Are you worried that your child has a tongue-tie? Well….you’re in the right place! In this post I'll to teach you what this means for your child, and how someone like me can fix it for them. As your child developed in the womb their tongue separates from the floor of their mouth. A tongue-tie occurs when this process doesn’t occur properly. Tongue-ties can be quite variable – some are really flimsy, while others can be quite thick. As children get older some tongue-ties can tear on the lower teeth when the child chews on something. If the tongue-tie is causing feeding problems (particularly in breast feeding babies – painful nipples, poor latch, poor weight gain), then dividing the tongue-tie is the only effective treatment. Tongue-ties can cause problems with oral hygiene or make it uncomfortable for a child to stick out their tongue. The effects of tongue-ties and their division on speech is a controversial area. Some tongue-ties can cause problems with making front of mouth sounds such as ‘l’, ‘t’, ‘th’, and ‘s’. Additionally, the clicking sounds used in some African languages need the tongue to be extremely mobile. However, tongue-tie division can never be completely guaranteed to prevent your child from developing a speech problem or to improve an existing one. If your child has a tongue-tie and is less than 3-months of age, then I can release the tongue-tie in the clinic without the need for a general anaesthetic. The procedure takes just a few seconds and involves me wrapping them up tightly in a blanket, elevating the tongue with my finger and carefully releasing the tethering with a pair of sterile scissors. Although some babies cry, others can remain asleep throughout. The short moment of discomfort is worth it to avoid the risks of a general anaesthetic and to improve your child’s feeding. You should feed your child immediately following the procedure. I will then check the area following the feed to ensure there is no bleeding. If your child is older than 3-months of age then they will have head-control that is too good to safely have the procedure performed in the clinic. In this case I will perform the procedure on my next available list under general anaesthetic. For particularly thick or fleshy tongue-ties in older children I can also use electrocautery to more safely perform the procedure. Like in any operation there are small risks such as bleeding or infection – but thankfully these are often straightforward to treat. Following the procedure, I would expect your child to be feeding straight away and to go home the same day. So, if you’re worried that your child has a tongue-tie – why not get in touch? You can email me directly at info@mrbrianmaccormack.com or call 028 9066 7878 to book an appointment Until next time, take care of yourself and your family. Best wishes. Procedure information leaflet

Hi there, I'm Brian. It is my mission to provide exceptional surgical care to every child that comes my way. It’s important that every child receives the help they deserve and are treated with warmth and kindness every step of the journey. Services that I provide Where it all began At 16 years old, I knew that being a children’s surgeon was my calling, and I feel incredibly grateful to have the opportunity to make children’s lives happier, safer and healthier every single day. I was delighted to complete higher surgical training in four of the leading specialist paediatric and neonatal surgical institutions across the world, to include Edinburgh, Glasgow, Belfast and Auckland. This fantastic training and experience has given me advanced skills that allow precise and effective care of infants, children and young people (up to 16 years old). I have been practising since 2008 and now, you’ll find me working regularly in the Ulster Hospital, Altnagelvin Hospital, the South West Acute Hospital and the Royal Belfast Hospital for Sick Children. ​ As well as being devoted to the care of children, I am passionate about constantly improving surgical practice across the industry. I am proud to say that I have developed an electronic operative note platform that has directly enhanced patient safety, by furthering clarity and accessibility of children and young people’s surgical notes. ​ Children, their families and their bright futures matter to me. Together, we can make a difference. Your journey starts here My values It’s so important that you know and understand what I stand for and believe in. These values are the golden thread that weave throughout every step of your child’s journey. Compassion Every patient that comes my way will be greeted with compassion, understanding and warmth. It’s important that every person that engages with my services feels supported, cared for, understood and valued. Professionalism From the moment you enquire to the final step of your child’s surgical journey, professionalism will be at the forefront of the process. It’s crucial that you receive a high quality, outstanding service from me, every time. Therefore, a professional approach will always be championed. Dedication I am dedicated to the health and wellbeing of every child in need. It’s my job to do everything in my power that can help your child thrive. I am dedicated to my craft, I am dedicated to your family and I am dedicated to always growing, learning and enhancing my own skills to provide the best outcomes for you and your child. Honesty It’s vitally important that every patient is given honest information throughout the entire process. I value honesty and it’s my job to ensure that you understand every detail of your child’s journey. Leadership I will always strive to be a leader in my field. Every child deserves the best, and therefore I will always strive for excellence, chase greatness and educate myself to the highest standard. Read the reviews A letter to the patient Hi there! ​ My name is Brian, and I am a children’s surgeon. If you are not sure what that means, don’t worry! I didn’t know when I was your age either. A children’s surgeon is someone who helps kids like you feel much better when they need a little help. I have three little kids too. They are 12, 10 and 4 years old. I also love going camping and my favourite thing to do is spend some time with my best buddy - Poppy, the Goldendoodle. You can see a picture of her here! ​ I wanted to write you this letter to let you know that I am super excited to meet you. I can’t wait to find out more about you, and what kind of things you enjoy doing. ​ I’ll have to get back to see what Poppy is up to, so goodbye for now, and I’ll see you soon! ​ Brian.

Your thoughts matter Every patient and every child’s experience is valued, respected and learned from. It’s important for you to hear from real people how working with Mr. MacCormack has impacted their lives for the better. Have a read of some of the reviews and testimonials past patients have kindly sent through. Get in touch

Giving your child the care they deserve After a consultation you will receive an invoice from Medserv. This will include your reference number and online payment pin. ​ pay here ​ Phone: 0800 0124 011 | 0203 384 1952 Fax: 0203 393 1849 | Email: info@medserv.co.uk Fees Mr. MacCormack is a Private Consultant Paediatric Surgeon and is fee assured with all major insurance providers. Please bring your insurance details with you​ to the consultation. ​ Self-funding* patients are welcome: £180 new patient consultation £140 review appointment ​ * Kingsbridge will charge additional £19.50 admin fee for self-funding patients