A breast cancer surgeon has been accused of conducting a series of "completely unnecessary" breast operations to earn extra money.

Ian Paterson is on trial for causing grievous bodily harm to 10 patients by inventing cancer diagnoses and conducting invasive surgery.

The court was told Paterson lied to his alleged victims, "exaggerating or quite simply inventing risk of cancer", then often claimed payments for more expensive procedures.

And he did so for "obscure motives" which may have included a desire to "earn extra money", a jury of seven men and five women at Nottingham Crown Court was told.

His alleged victims included a 25-year-old woman who was left "devastated" when told unnecessary operations had profoundly affected her ability to breastfeed.

Leanne Joseph was told by Paterson a scan revealed pre-cancerous cells in her milk ducts - with the surgeon recommending she returned two days later for surgery.

The court heard Paterson said the removal of her ducts - leaving her unable to breastfeed - would be a "small price to pay for her life".

The court heard Ms Joseph's scan had been "entirely normal" and that this operation - and a similar one on her other breast - were "quite unnecessary".

Prosecutor Julian Christopher said: "It would appear that not only were the operations entirely unnecessary, they were not even done properly.

"Mrs Joseph was profoundly affected by her inability to breastfeed, and even more so once she learnt that the operations were unnecessary."

The court heard another patient, 47-year-old Judith Conduit, was told by Paterson she may have a rare condition and underwent a double mastectomy in May and July 2001, the latter operation leaving her with problems which led to 94 hospital appointments in the following 12 months.

Paterson, 59, who was formerly employed by Heart of England NHS Trust and Spire Healthcare, denies 20 counts of wounding with intent against nine women and one man relating to procedures he carried out between 1997 and 2011.

Opening the case, Mr Christopher told the jury the charges relate to a period when Paterson was a busy surgeon with an "excellent bedside manner".

He said: "He was extremely experienced and knowledgeable in his field - breast surgery - which makes what happened in this case, the prosecution say, all the more extraordinary and outrageous.

"The 20 counts of wounding relate to individual operations which he told the patients were necessary, usually, but not always on the basis that the patients had or were at risk of developing cancer.

"All of the operations, the prosecution allege, were in fact completely unnecessary."

Mr Christopher said the operations carried out by Paterson were ones which "no reasonable surgeon at the time would have considered justified".

The opening will continue on Wednesday and the trial is due to last up to 10 weeks.