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A cosmetic surgeon who botched operations and had inadequate medical insurance showed a lack of professional integrity, and dishonesty, a medical tribunal has said.

Dr Arnaldo Paganelli was found to have breached his patients' trust - and some are still waiting for compensation.

He worked privately for The Hospital Group in Birmingham and the small print of the contract given to patients told them to check their doctor's insurance.

But his policy did not cover UK work.

In 2011 Dr Paganelli's had taken out insurance with an Italian company he knew did not apply to his role in Britain.

The tribunal chair Sarah Fenoughty said: "He has deliberately frustrated the purpose of the professional insurance he is bound to hold. This would demonstrate a lack of professional integrity. Further it would be regarded as dishonest."

The tribunal heard complaints from four women.

Natasha Stewart had a breast augmentation with Dr Paganelli in 2008 at The Hospital Group's Dolan Park hospital in Birmingham. It left her with lopsided breasts and excessive scarring.

She was awarded damages of £27,000 and costs of £39,000 at Bristol Crown Court in May 2012, but has not received the money.

Dr Paganelli had UK insurance for her but failed to submit a proper claim.

Another patient, Dawn Knight, had an eye lift with Dr Paganelli and The Hospital Group in 2012. She says too much skin was removed and she now cannot close her eyes properly.

She told ´óÏó´«Ã½ Radio 4's You and Yours after the operation: "My eyes are constantly sore, gritty and tight. I set an alarm on my phone every two hours to remind me to put in eye drops. And then at night when I go to bed I wear special contact lenses to stop the eyes drying out."

Dr Paganelli has always denied any problems with Ms Knight's operation.

The tribunal did not hear evidence on this. But it concluded she could not pursue a claim because his insurance was not valid and he was declared bankrupt in February 2013.

Joanne McKay is also waiting for a pay out to be made. She was awarded £121,000 costs and £22,000 damages in 2015 after a rhinoplasty [nose job] operation with Dr Paganelli.

She says: "As soon as the plasters came off I said I wasn't happy. It was bigger than I expected. My nostrils are a different shape. I then had steroid injections to try to reduce the size of the tip but it didn't really achieve anything."

The tribunal heard that some of Dr Paganelli's patients were compensated for botched operations by The Hospital Group itself, without accepting liability.

The money was deducted from Dr Paganelli's fees. Meanwhile, he continued operating, earning around £338,000 from The Hospital Group.

The tribunal meets in March to consider if Dr Paganelli is fit to practice.

Dr Paganelli denies any wrong doings or dishonesty and says he will be appealing the findings.

He says he is suing his insurance broker for not making him aware he was not covered in the UK. He also says he can't comment further because of patient confidentiality.

The Hospital Group now has new owners who stopped employing Dr Paganelli in 2016. It says it now takes full responsibility for all surgeons that work there, which includes ensuring they have a UK-based insurance policy in place. And it offers a multi-year aftercare package.