A surgeon who carried out needless breast operations has had his 15-year jail sentence increased to 20 years by judges.
Ian Paterson, who left victims scarred and disfigured, was ordered to serve extra time behind bars by the Court of Appeal on Thursday.
Lady Justice Hallett, Mrs Justice Carr and Mr Justice Goss, sitting in London, declared that the original jail term imposed in May was "unduly lenient".
Their ruling came after the sentence was referred to the court for review by Solicitor General Robert Buckland.
Paterson, 59, from Altrincham, Greater Manchester, watched proceedings via video-link from prison.
He was convicted by a jury at Nottingham Crown Court of offences of wounding with intent and unlawful wounding against 10 patients.
The decision was announced by Lady Justice Hallett, who said: "Both the harm and culpability here were exceptionally high."
She said the court was satisfied that the sentence imposed was "unduly lenient", and that a "just" term was one of a total of 20 years for "multiple" offences.
After the ruling, Mr Buckland said: "Throughout our lives we are told and expected to trust doctors. Paterson woefully abused that trust - he deliberately preyed on people's worst fears and then mutilated them on the operating table.
"This is a truly sickening crime and my thoughts are with the victims and their families. I hope the increased sentence will help bring some closure for them."
Paterson was convicted by a jury of offences of wounding with intent and unlawful wounding against 10 patients.
Sentencing him to a total of 15 years, Mr Justice Jeremy Baker told Paterson: "You deliberately played upon their worst fears, either by inventing or deliberately exaggerating the risk that they would develop cancer, and thereby gained their trust and confidence to consent to the surgical procedures which you carried out upon them.''
His trial heard evidence from nine women and one man who were treated in the private sector at Little Aston and Parkway Hospitals in the West Midlands between 1997 and 2011.
Victims told the court that Paterson's crimes had left them in constant pain and struggling to trust medical professionals.
Lady Justice Hallett said: "How any doctor, let alone one who had earned an enviable reputation, could have engaged in this level of offending we will never know.
"Greed, self-aggrandisement, power - however, they do not come close to explaining how a doctor can falsely tell a patient he or she has cancer when they have not, with all that such a diagnosis entails for a patient and members of their family.
"Nor how a doctor can then insist that he or she undergo unnecessary operations, including mastectomies, with all the physical and psychological pain such operations cause.
"Patients trusted him implicitly. They could never have imagined that he would put them through the agony of a diagnosis of cancer and mutilation of their breasts when there was no justification for it.
"With some of his patients, he put them through their ordeal more than once.
"They must feel no sentence could properly reflect their suffering and that of their families."
Lady Justice Hallett said the trial judge had faced a difficult and "unprecedented" sentencing exercise.
The appeal court had heard, in mitigation, how Paterson had lost his career and his home and was suffering symptoms associated with an adjustment disorder.
But Lady Justice Hallett said the adjustment disorder "does not compare to the suffering he has inflicted on his victims, and his behaviour has led to some of those victims losing everything dear to them".
In 2012, more than 700 patients of Paterson, who also worked in the NHS, were recalled after concerns about unnecessary or incomplete operations.
Following his trial, Paterson was struck off from the medical profession.
A tribunal ruled that his actions were "serious" and "intentionally harmful" over a period of 14 years.
His failure to acknowledge any of his faults showed a lack of insight that indicated he still posed a serious risk to patients, the medical practitioners tribunal also concluded.