A paralysed or raised diaphragm robs one lung of the room to breathe — worst when you lie flat, bend over, or get into water. Most patients are never told that an operation exists to fix it. Mr Marco Scarci performs keyhole diaphragmatic plication: tightening the slack diaphragm so your lung can expand again.
Recognised by all major UK health insurers
Paying for yourself? You’ll receive a clear written quote before any treatment — no hidden extras.
Your diaphragm is the main muscle of breathing. When it’s paralysed or weakened — often after heart or neck surgery, a viral illness, or sometimes with no cause ever found — it stops pulling down and instead sits high in the chest, squeezing the lung above it.
Sitting or standing, gravity helps hold things down and you cope. Lie flat, and the abdominal organs push the slack diaphragm even higher — which is why beds, bending down, and getting into water are exactly where your breathing fails you. That pattern isn’t anxiety and it isn’t lack of fitness. It’s mechanics — and mechanics can be fixed.
Been told you have a “raised hemidiaphragm” on an X-ray and then heard nothing more? That finding is often exactly this condition, waiting to be taken seriously.
Book a consultationSudden or rapidly worsening breathlessness, chest pain, or blue lips — call 999 now. This page is about long-standing breathlessness that has already been investigated.
“Nothing can be done” usually means “nothing I can do.” Plication is a long-established operation performed regularly in only a small number of specialist centres — which is why so many patients have simply never been offered it.
With over 20 years at the forefront of thoracic surgery, Mr Scarci operates on the chest exclusively. Diaphragm surgery is performed regularly in only a handful of UK centres, and it is a genuine subspecialty of his practice — he literally wrote a complete patient guide to diaphragmatic plication. He has performed more than 5,000 minimally invasive procedures and holds fellowships from four leading international surgical colleges.
“The goal is never just a better-looking X-ray. It’s sleeping flat, climbing the stairs, and getting back in the water — without thinking about your breathing.”
Patients come to him after years of unexplained breathlessness and being told to live with it. They leave with a mechanical explanation, an honest assessment — and, where surgery is right, a fix.
A selection of verified patient reviews. Read them all on the testimonials page.
“Mr Marco Scarci is an exceptional professional as well as amazing human being. He is a pivotal member of the healing team I’ve convened. Every interaction with him in our short tenure has added value to my goals in achieving NED. I am blessed to have had Marco appear in my life at this time. Truly exceptional and engaging.”
“Mr Scarci is an exceptional surgeon who truly cares about his patients. He explains everything clearly, is always approachable and available to answer questions, and was extremely thorough when completing my surgery. I felt at ease and well looked after under his care.”
“I was referred to Mr Scarci for a small lung procedure. Even though it was a minor operation, I felt that Mr Scarci gave me plenty of his time to explain how he was going to perform it, and made sure I was comfortable. His manner was kind, caring and considerate at all times.”
New to private care? Here is exactly what happens — and how quickly.
Call, WhatsApp, or complete the form below. Namita, the practice manager, confirms your appointment, checks your insurance cover, and requests your existing X-rays, scans and breathing tests — so nothing is repeated unnecessarily.
Your consultation is with Mr Scarci himself — he will have reviewed your imaging before you arrive. Where needed, the confirmatory tests are arranged promptly: breathing tests sitting and lying down, and the “sniff test” that shows the diaphragm’s abnormal movement in real time.
If the tests show your diaphragm is genuinely the cause and surgery is likely to help, you’ll be told exactly why — and if it isn’t, you’ll be told that too. The decision is always yours. Insurance pre-authorisation is handled for you.
Keyhole plication at whichever of five London hospitals suits you best, with a short hospital stay. Mr Scarci performs your operation personally and follows you up directly, with a staged plan back to full activity — stairs, sleeping flat, and swimming included.
Choose whichever location and clinic time suits you. Patients travel from across the UK for diaphragm surgery — video consultations are available for the first appointment.
The most common causes are injury to the phrenic nerve — the nerve that drives the diaphragm — during heart or neck surgery, viral illnesses, and pressure from other structures in the chest. In a significant number of patients no cause is ever found. Part of a proper assessment is making sure nothing treatable is behind it before deciding on the diaphragm itself.
Plication has existed for decades — the problem is access, not science. It’s performed regularly in only a small number of UK specialist centres, so many clinicians simply never see it done and understandably say “learn to live with it.” Being told nothing can be done very often means nothing can be done here. A specialist assessment settles whether it can be done for you.
Honestly: not everyone is a candidate, and that’s exactly what the testing is for. The best results come when the paralysed or raised diaphragm is clearly the cause of your breathlessness and the lung itself is healthy — the sitting-versus-lying breathing tests and sniff test predict this well. If the numbers say surgery is unlikely to help you, you’ll be told so plainly before anyone talks about operating.
Through small keyhole incisions between the ribs, the slack diaphragm is folded and stitched flat and tight, giving the lung above it room to expand. Hospital stay is short, and most patients build back to normal activities progressively over the following weeks, with heavier exertion staged. Many notice the difference lying flat early, with improvement continuing over the months as breathing retrains. Your individual timeline is set out clearly at consultation.
Plication for symptomatic diaphragm paralysis is established, medically necessary surgery — Mr Scarci is recognised by all major UK insurers and pre-authorisation is handled for you. If you’re paying for yourself, you’ll receive a clear written quote before any treatment, covering the surgical, anaesthetic and hospital fees — no hidden extras.
No referral is needed if you’re paying for yourself; some insurers require one, and the team will guide you through it. Your appointment is confirmed the same working day you get in touch, and most patients are seen within one week — in person at five London locations, or by video for your first consultation if you’re travelling from further afield.
Complete the form and Namita, the practice manager, will come back to you the same working day. Prefer to talk it through first? Call or WhatsApp.
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