What Is Neurofibromatosis Type 1?
Neurofibromatosis Type 1 (NF1) is a genetic condition that affects the growth and development of nerve tissue, most visibly through café-au-lait skin patches and benign nerve tumours called neurofibromas, which can develop on or under the skin. NF1 is a lifelong, multisystem condition, and care is best delivered by a co-ordinated team of specialists rather than any single clinician working in isolation.
Mr Naparus's role focuses specifically on the surgical management of skin and soft tissue neurofibromas — assessing which lesions may benefit from removal, and carrying out excision where surgery is the right option — working alongside the wider NF1 multidisciplinary team.
When Surgery May Be Considered
- A neurofibroma causing pain, irritation or recurrent catching on clothing
- A lesion that is growing, changing, or causing functional difficulty
- Cosmetically prominent lesions that are affecting a child or young person's confidence
- Plexiform neurofibromas requiring specialist assessment and, in selected cases, debulking surgery
Multidisciplinary Care
NF1 is a complex condition, and surgical management of NF1-related lesions is a specialist service. Mr Naparus is part of the UK national Neurofibromatosis multidisciplinary team, with care co-ordinated via Guy's Hospital, London's specialist centre for neurofibromatosis. This ensures that surgical decisions are made in the context of each patient's wider condition, and that patients and families have access to genetic counselling, dermatology, neurology and other specialist input as needed alongside any surgical care.
The centre manages the highest number of facial plexiform neurofibroma cases in the country, giving Mr Naparus and the wider team substantial collective experience in this complex, specialist area of facial surgery.
The Procedure
Surgical excision of a neurofibroma is tailored to the size, depth and location of the lesion, and is planned individually at consultation. Smaller, well-defined lesions can often be removed under local or general anaesthetic as a day case, with incisions placed to minimise scarring. Larger or plexiform lesions require more detailed pre-operative planning and are discussed at length before any decision to proceed.
Recovery
Recovery depends on the size and site of the lesion removed, but most patients return to normal activity within one to two weeks following straightforward excision. Scar care and long-term follow-up are discussed as part of ongoing NF1 management.