Singapore surgeon pioneers minimal-scar breast cancer techniques, improving patient outcomes

A woman in her fifties sat across from surgeon Lim Geok Hoon and saw the photograph of what her chest would look like after a mastectomy. The scar stretched long and visible. She nearly fainted. The question came immediately: Did the scar have to be that extensive? Could her nipples survive the surgery without requiring reconstruction afterward?

That moment of anguish, in the years before 2017, became the seed for one of Lim's signature innovations. She developed a minimal scar mastectomy technique that preserves both the nipples and the areolas—the darker skin surrounding them—while removing the breast tissue beneath. The scar, when it heals, sits inconspicuously around the areola itself. The technique works best for women with smaller breasts who do not wish to undergo reconstruction. More than thirty patients have benefited from it so far. The woman from that initial consultation was, Lim recalls, very happy with the result.

Lim is an associate professor and head of the breast department at KK Women's and Children's Hospital, a surgeon with fifteen years of experience and a track record of turning clinical frustration into practical tools. Her path to this work began with a fellowship in Britain from 2013 to 2014, where she trained in oncoplastic surgery—a discipline that marries tumor removal with plastic surgery technique, allowing larger cancers to be excised while preserving the breast and its appearance. She returned to Singapore determined to share what she had learned. In January 2015, while six months pregnant with her second son and managing severe nausea, she organized the first Singapore Breast Oncoplastic Surgery Symposium. The event succeeded beyond expectation. It became annual, eventually drawing more than a thousand medical professionals and community partners from around the world. The eleventh edition took place in August of this year.

But Lim recognized a constraint: one surgeon, no matter how skilled, can only treat so many patients. In 2018, she co-developed VBOSS—the virtual breast oncoplastic surgery simulator—with the National University of Singapore. While virtual surgery trainers existed for other breast procedures, none focused specifically on the techniques needed for breast-conserving oncoplastic work. The simulator is free to use online and has attracted over seven hundred and fifty users worldwide. Each surgeon trained on the platform multiplies the number of patients who can access these techniques.

In 2020, she introduced another innovation: SMART, the skin mark clipped axillary nodes removal technique. Breast cancer that has spread often requires removal of lymph nodes in the armpit. Traditionally, surgeons use tracers—some radioactive—to locate cancerous nodes. SMART uses ultrasound-guided skin markings instead, eliminating the need for radioactive material and reducing the risk of lymphoedema, the painful arm swelling that follows extensive node removal. About thirty eligible patients have undergone the procedure. The technique is also cheaper than conventional approaches.

Lim speaks with visible excitement about these developments, but she is candid about the path to them. "I failed a lot of times," she says. The 3D-printed breast moulds now used to teach surgical marking to other doctors took considerable trial and error to perfect—she needed models that were soft and flexible, that drooped naturally like living tissue. She persevered. In 2025, she received an Outstanding Clinician Award from SingHealth's Group Chief Executive Officer Excellence Awards. Yet what sustains her, she says, is not recognition but the daily evidence of her patients' recovery. She recalls a pregnant woman in her thirties, devastated by a cancer diagnosis and terrified that chemotherapy would harm her unborn child. That child is now six years old and thriving. "People ask for wealth in terms of money," Lim says, "but I'd rather chart my wealth in how many patients' lives I have touched in this lifetime." Over the past decade, KK Hospital's breast conservation rate—the proportion of cancer patients able to keep their breasts—has risen by fifteen percent as more women seek to retain their bodies if medically possible. Lim's innovations have helped make that possible.