A male patient was left feeling like a "cigarette was being held against my nipple" after breast surgeon Ian Paterson performed a needless mastectomy, a court heard.

John Ingram first saw Paterson in 2006 who advised him to have a double mastectomy because he was "on the road to breast cancer."

After the operation on June 7 that year, Mr Ingram, who was aged 42 at the time, said Paterson told him he had "dodged a bullet".

Tests later revealed the lump in Mr Ingram's breast was in fact benign.

Paterson is accused of carrying out a string of needless breast operations, including mastectomies, in a bid to earn extra cash and boost his reputation.

Giving evidence at Nottingham Crown Court, Mr Ingram said: "I was an orthotist which is a medical professional, I worked in hospitals.

"I was fortunate enough to have private health care because of my wife's job.

"Mr Paterson sent me for an ultrasound immediately and came back to the consultation room.

"He looked at the scan and then said he would like to take a sample of cells from the lump.

"He said there was a lump and it was unclear what that lump was and he said one of the best ways to find out was to take a sample.

"Surprisingly, he did it there and then.

"Mr Paterson chose a needle and a syringe and he rammed the needle under my nipple in one of the most painful things I have ever endured.

"He said he would get back to me with the results and where to go from here and he also asked me about my family history.

"I went back to see him for the results and my wife went with me three days later on April 24.

"It was quite a different demeanour with a grim face and he said there were some worrying features in the samples he took and described a condition he termed as 'pre-cancer'.

"He drew a diagram with an end that was cancer and an end that was non-cancer.

"He said that you only go in one direction once you are on it, you didn't go back you just went forwards, towards cancer.

"He said the best thing to do was to have it all out.

"He didn't show me the lab report.

"He said because it was pre-cancer that would be it, done and dusted, because I was only pre-cancer.

"I was offered no alternatives to this at any time."

Mr Ingram, who suffers from a phobia of surgery, went for the operation on May 3 at Paterson's private Spire Healthcare hospital in Solihull, West Mids., but it was cancelled.

He told the jury: "I was scared and I was sitting behind a cupboard in tears.

"Mr Paterson rushed to see me and we had a brief conversation.

"He was reassuring and sympathetic and he said the operations never go well when you are in this state.

"I may have asked him if there were any alternatives and at that point I would have done anything other than surgery.

"Mr Paterson did not offer me a further scan to my knowledge.

"I would have grabbed the opportunity with both hands if I was offered that.

"I had the operation and saw Mr Paterson afterwards and he came in in his scrubs and reassured me the operation had gone well and as far as he was concerned I had dodged the bullet."

A week later Mr Ingram went back to see Paterson who told him he now needed both breasts removed.

He said: "As we walked in, it was grim faces from Mr Paterson and the breast care nurse.

"The results were worse than expected on the histology and more treatment would be needed to get rid of any potential for developing breast cancer.

"He recommended that I had both breasts removed and then I would not have any breast tissue left to have breast cancer in.

"He said that he shared my results with other surgeons at a consultation he had in Edinburgh but the general consensus was that I should have a double mastectomy.

"He spoke of no alternatives to having both breasts removed.

"My reaction was shock.

"I agreed to it because I was told I was on the road to developing breast cancer and the lumpectomy had not been the answer.

"He told me it had been a success and I would not need chemo or regular therapy.

"He or the breast care nurse said I had had my brush with cancer.

"I was to have six-monthly scans for some other sort of cancer but other than that he was pretty upbeat about it.

"It was very plausible that this was the right thing to do, he had an excellent bedside manner.

"I took everything he said as gospel at that point."

"I returned with lumps in my breast again and I was told it was post-surgical knobbles and that put my mind at rest.

"I absolutely had pain because of it yes.

"It developed slowly, one was a sharp pain that went from my left breast to my armpit and the other was like a phantom nipple, an itch I couldn't scratch.

"It felt like someone was holding a cigarette to my nipple.

"I am still having the medication ten years later."

Paterson, 59, of Altrincham, Greater Manchester, denies 20 counts of unlawfully and maliciously wounding nine female patients and one male between 1997 and 2011.