Reconstructive surgery
Explore our comprehensive range of reconstructive procedures to improve form and function and enhance your quality of life. Whether you're considering reconstruction due to injury, illness, or congenital conditions, we'll discuss your options and create a personalised treatment plan.
What is lymphedema?
Lymphedema is painful swelling in the arms or legs due to improper drainage of lymph fluid. It can be primary (congenital) or secondary (caused by infection, trauma, or cancer treatment). Cancer survivors, especially those treated for breast cancer, gynaecologic cancers, melanomas, and other skin and urologic cancers, may experience lymphedema. The onset of symptoms can be delayed by months or even years after the initial injury. Symptoms may include swelling, changes in skin quality, tenderness, redness, and excess fat in the affected area.Lymphedema treatment
Once lymphedema is diagnosed, non-surgical treatment begins promptly. This includes elevating the affected limb, proper skincare, wearing elastic stockings, physical therapy, and pneumatic compression devices. Complete decongestive therapy (CDT) has been the primary approach for managing lymphedema prior to surgery. Surgery may be considered if non-surgical methods are inadequate.
Generally there are two surgical approaches to try improve lymphedema:
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Lymphatic Bypass Procedures, where lymphatic vessels are connected to the body's venous system.
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Vascularized Lymph Node Transfer, where lymph nodes are surgically implanted in the affected area to rebuild the system.
Who is a good candidate for lymphedema surgery?
Lymphedema treatment plans are individualized based on the patient's stage of lymphedema and anatomical factors. Before considering surgery, maximizing nonsurgical treatments is crucial. Surgery may be an option for those who can cope with their diagnosis, have no hindering medical conditions, and have realistic restoration goals after exhausting nonsurgical therapies.
Lymphedema surgery can improve symptoms, but results may vary. Visible incision lines will be present on the extremity, depending on the procedure. Some techniques leave incision lines at the donor site in less exposed areas like the neck, abdomen, or groin.
What should I expect during a consultation for lymphedema surgery?
When preparing for your lymphedema surgery consultation, be ready to discuss your surgical goals, medical history, current medications, and previous surgeries. Your plastic surgeon will evaluate your health, examine your limbs for skin quality, fibrosis and take circumferential measurements. A discussion will follow regarding treatment options, potential outcomes, and any associated risks. Don't hesitate to ask questions and share any preoperative stress or anxiety with your surgeon.
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What is body contouring?
After significant weight loss, whether from weight loss surgery or lifestyle changes, the skin and tissues may not have enough elasticity to adjust to the reduced body size. Excess skin and fat can be removed through surgical body contouring to improve body shape. Procedures may include arm lift, breast lift, facelift, lower body lifts, medial thigh lift, and tummy tuck.
Who is a good candidate for body contouring?
Good body contouring candidates are adults with stable weight loss, healthy individuals without healing impairments or surgery risks, non-smokers, and those with a positive outlook, realistic goals, and commitment to a healthy lifestyle.
What should I expect during a consultation for body contouring?
During your body contouring consultation, be prepared to discuss your surgical goals, medical history, and current medications. Your plastic surgeon will evaluate your health, examine your body, take measurements and clinical photography, and discuss treatment options, likely outcomes, and potential risks. It's important to be candid and ask questions.
What is gynecomastia surgery?.
Gynecomastia is the condition of overdeveloped or enlarged breasts in men. It can be caused by hormonal changes, heredity, obesity, or certain drugs. This can cause emotional discomfort and self-confidence issues. Gynecomastia surgery flattens and reduces breast size, improving chest contours. In severe cases, excess breast tissue can cause sagging and stretched areola, which can be surgically corrected through breast reduction surgery (reduction mammaplasty).
Who is a good candidate for gynecomastia surgery?
Candidates for gynecomastia surgery include men who:
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Cannot correct the condition through alternative treatments
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Are healthy and have realistic expectations
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Have stabilised breast development
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Are bothered by the feeling that their breasts are too large
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Adolescents may also benefit from surgery, but may need additional procedures if breast development continues.
What should I expect during a consultation for gynecomastia surgery?
During your gynecomastia surgery consultation, you should be prepared to discuss your surgical goals, medical history, current medications, and previous surgeries. Your surgeon will evaluate your health, examine your breasts, take clinical photographs, and may organise diagnostic testing, such as assessing endocrine function or referring you to an endocrinology specialist. During the consultation, you will receive information about treatment options, likely outcomes, and potential risks. It's important to ask questions and address any concerns during the consultation.
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Breast implant safety: What patients should know
Breast implants are TGA and FDA approved devices for breast augmentation and reconstruction. The authorities recommend regular screenings after implant placement to verify integrity and detect complications. Potential risks include Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), Breast Implant-Associated Squamous Cell Carcinoma (BIA-SCC), and systemic symptoms known as breast implant illness (BII). Your surgeon will review this to ensure informed decision-making.
BIA-ALCL
BIA-ALCL is an uncommon form of cancer linked to textured breast implants, found in the scar tissue surrounding the implant. Early detection is crucial for effective treatment, which may include surgery, chemotherapy, and radiation therapy. The incidence of BIA-ALCL varies, with reported cases in patients with different types of implants, including both textured and smooth implants. It is important to recognize symptoms such as unexplained breast enlargement or pain for prompt medical assessment.
BIA-SCC
BIA-SCC is a rare but aggressive tumour that can occur in scar tissue around breast implants. Its association with implant types is still under study. Early detection is crucial for optimal treatment outcomes. Symptoms resemble those of BIA-ALCL and require prompt medical evaluation. Treatment typically involves surgery to remove the implant and surrounding scar tissue, with additional therapies based on the disease stage.
Breast implant Illness
Breast Implant Illness (BII) includes a range of symptoms that may be associated with breast implants and may improve after the implants are removed. Clinical studies over the years have struggled to establish definitive links to breast implants. As diagnosis can be difficult, it is recommended that patients undergo a thorough evaluation by a breast physician or surgeon.
Breast implant registry
In New Zealand, there is currently no mandatory national data registry for breast implants. However, your surgeon will make efforts to keep accurate records of your implants. You should also keep detailed records of the implants, and your surgeon should provide you with a copy of the implant data card/stickers from the manufacturer for safekeeping.
Recommendation
Individuals with silicone breast implants should undergo regular clinical reviews to confirm implant integrity and detect issues early, even in the absence of symptoms. If concerns arise, MRI or ultrasound screenings should be considered 5 to 6 years after the implants are placed, and then every 2 to 3 years thereafter. Continued surveillance and reporting of cases contribute to a better understanding and management of conditions related to breast implants, as well as improved patient care and safety.
What is breast implant removal surgery?
The aim of breast implant removal surgery is to remove breast implants from patients who have undergone breast augmentation or breast reconstruction. Implants may need to be removed due to implant leaks, capsular contracture with pain and breast distortion, or as a preventive measure at intervals recommended by the implant manufacturers.
Capsular Contracture is a tightening of the scar tissue that forms around the breast implant. This scar capsule is usually soft and does not need to be removed. However, it can harden over time, leading to pain and discomfort. In such cases, removing both the implants and scar tissue is often necessary.
Breast implant manufacturers generally recommend breast implants be exchanged or removed approximately every 10-15 years, as the outside shell of the implant may break down, causing silicone to leak and the scar tissue around the implant to harden.
Who is a good candidate for breast implant removal?
Breast implant removal surgery is a highly individualised procedure and should be considered if you have implant leaks or ruptures, capsular contracture, pain with implants, breast implant-related illnesses, or no longer desire implants. You may be a good candidate if you are physically healthy, have realistic expectations, and are bothered by the appearance of your implants. Preparation ahead of time helps patients have reasonable expectations and a smoother recovery.
What should I expect during a consultation for breast implant removal?
When you come in for your breast implant removal consultation, be prepared to discuss your surgical goals, medical history, current medications, and previous surgeries. Your plastic surgeon will evaluate your health, examine your breasts, and discuss treatment options, potential outcomes, and risks. Your complete honesty is crucial for the success and safety of the procedure. Don't hesitate to ask questions and discuss any concerns or anxiety with your plastic surgeon.
What is breast implant revision surgery?
Breast implant revision surgery aims to replace old implants with new ones and improve the appearance of the breasts. The procedure can also be done concurrently with a breast lift or reduction. Reasons for this surgery include wanting to change breast size, addressing pain from capsular contracture, concerns about implant rupture or migration, or switching to a different implant type. Over time, implants and breast tissue can change, prompting the need for revision surgery.
Who is a good candidate for breast implant revision?
Good candidates for breast implant revision surgery are those who have previously had breast augmentation and are now unhappy with their implants or concerned about their condition. Candidates should be physically healthy, at a stable weight, have realistic expectations, and be nonsmokers. It is important to carefully review information about breast implant revision surgery and to gain a clear understanding of the recovery process. This will help you set reasonable expectations and ensure a smoother recovery.
What should I expect during a consultation for breast implant revision?
During your breast implant revision consultation, you should be prepared to discuss your surgical goals, medical history, current medications, and previous surgeries. Your plastic surgeon will evaluate your general health, examine your existing breast implants, and discuss your options, likely outcomes, and potential risks. It's important to be candid during your consultation and not hesitate to ask questions. You should also feel comfortable discussing any feelings of anxiety or excitement with your plastic surgeon.
What is breast reconstruction?
The goal of breast reconstruction is to restore one or both breasts to near-normal shape and size following mastectomy, lumpectomy, or congenital deformities. This process can involve multiple procedures and falls into two categories: implant-based reconstruction or flap reconstruction. Factors to consider when choosing the best option include the type of mastectomy, cancer treatments, and the patient's body type. Although breast reconstruction can rebuild the breast, the results may be highly variable and may not have the same sensation or feel as the original breast. Visible incision lines will always be present on the breast, and certain surgical techniques may leave incision lines at the donor site.
What options are available for breast reconstruction?
If you're considering breast reconstruction, there are different techniques to consider. For implant-based reconstruction, there needs to be enough tissue on the chest wall to support the implant. Flap techniques, using tissue from other body areas, are an option if there isn't enough tissue on the chest wall or if you prefer not to use implants. Both options have their own considerations and require detailed discussions with your surgeon.
Who is a good candidate for breast reconstruction?
Breast reconstruction is a personalized procedure. You should do it for yourself, not to fulfil someone else's desires or to try to fit any sort of ideal image. You may be a candidate if you can cope well with your diagnosis and treatment, do not have additional medical conditions that may impair healing, and have realistic goals for restoring your breast and body image
What should I expect during a consultation for breast reconstruction?
During your breast reconstruction consultation, be prepared to discuss your surgical goals, medical history, current medications, and previous surgeries. Your plastic surgeon will evaluate your health, examine your breasts, take clinical photos, and discuss treatment options, likely outcomes, and potential risks. It's important to ask questions and share any feelings of anxiety with your surgeon.
What is rhinoplasty?
Rhinoplasty, also known as a "nose job" or "nose reshaping," can be both a cosmetic surgery and a functional procedure. As a cosmetic procedure, it aims to enhance the appearance and proportion of the nose. It can also address functional issues by improving breathing problems caused by structural inadequacies.
Facial balance significantly relies on the size and shape of the nose. Factors influencing the nose's appearance include the width at the bridge or nostrils, visible humps or depressions on the bridge, an enlarged or bulbous nasal tip, a drooping, upturned, or hooked nasal tip, large, wide, or upturned nostrils, and nasal asymmetry. However, it is essential to remember that all faces exhibit some degree of asymmetry, so results can vary.
Combining rhinoplasty with septoplasty, a procedure to correct a deviated septum, can enhance breathing function. A deviated septum, a common cause of breathing difficulties, can be rectified by adjusting the nasal structure for better alignment. This combination requires a thorough evaluation of the nasal structure to understand its impact on airflow and breathing.
Every nose is unique. To achieve the desired results, some noses require a reduction of existing components, while others may need additional volume or structural support. There are various options for implants, but the safest ones are biological cartilage, tissue fascia, or fat borrowed from another part of your own body.
Who is a good candidate for rhinoplasty?
Rhinoplasty is a procedure tailored to each individual's needs. It should be a personal decision, not something done to satisfy someone else's desires or conform to an ideal image. You may be a suitable candidate for rhinoplasty if you have completed your facial growth, are physically healthy, do not smoke, and have a positive outlook with realistic expectations for improving your appearance.
What should I expect during a consultation for rhinoplasty?
When you come in for a rhinoplasty consultation, be ready to talk about what you hope to achieve with the surgery, your medical history, any previous surgeries, current medications, herbal supplements, and lifestyle choices such as alcohol, tobacco, and drug use. Your surgeon will assess your health, examine your nose and face, and take clinical photographs. You will then discuss the treatment options, potential outcomes, and risks. It's important to understand the recovery process and the time it will take to achieve the best result. This is also the time to ask any questions and address any concerns you may have.
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