Dr Warren Chan is at fault for pressing on with a fat-removal operation in which the patient woke and screamed in pain, an anaesthetist said.
The liposuction patient has told the Medical Practitioners Disciplinary Tribunal of begging Dr Chan to stop mid-operation because of the extreme pain.
Dr TimothyShort, Auckland Hospital's deputy head of anaesthesia, told the tribunal today Dr Chan's continuing with the operation at that point was substandard.
This patient and others were given sedatives and local anaesthetic - as opposed to general anaesthesia.
Dr Short says the "conscious sedation" technique used with these patients depresses the central nervous system to an extent that the treatment can be performed, yet verbal contact can be maintained with the patient throughout.
Some of Dr Chan's former patients have told the tribunal of drifting in and out of consciousness when he was performing surgery on them.
Dr Short said it was not unusual for a patient to awaken during an operation using sedation.
"... but it is usual practice to cease operating whilst pain control is re-established to minimise distress and pain for the patient."
The tribunal is hearing evidence against Dr Chan about nine charges - including six of disgraceful conduct - relating to eight former patients, whose names have been suppressed.
Three received breast surgery.
Dr Short said it was usual in New Zealand to use general anaesthetic rather than conscious sedation with patients receiving breast enlargement or reduction surgery.
This was because of the high degree of pain likely to be experienced by these patients, he said.
