Reconstructive breast surgery
Adult

On this page

Emergency Referrals

Useful Management Information

It is strongly recommended that people who smoke stop 3 months prior to consultation. It is associated with delayed skin healing. Please consider directing your patient to a smoking cessation program
Breast cancer patients must be 6 months post chemotherapy and 12 months post radiotherapy
Breasts will usually be considered for reduction when their size is not attributable to excess weight and when a substantial health benefit can be expected.
If BMI is greater than 30, manage weight loss
A frailty assessment should be undertaken, where relevant, to ensure appropriate surgical management
Ruptured or painful breast implants can be removed but not replaced unless the primary reason for augmentation was reconstructive
Consider referring patient to support groups e.g.
- breast cancer network Australia
- community support groups
- cancer council connect
Lifestyle modification (increased activity, dietary, weight, smoking, alcohol)

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	Pre-operative mastectomy patients Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) positive patients
Category 2 (appointment within 90 calendar days)	Extracapsular implant rupture with severely incapacitating pain Those that have symptoms of BIA-ALCL or suspicion on imaging despite a negative aspirate
Category 3 (appointment within 365 calendar days)	Extracapsular implant rupture and/or severely painful implants Post mastectomy reconstruction 6 months post chemotherapy and 12 months post radiotherapy Macromastia: where breast size causes substantial disability and the patient’s BMI is <35 Post burn reconstruction Congenital abnormalities e.g. Poland syndrome, tuberous breast deformity and gross asymmetry Gynaecomastia where there is a substantial breast enlargement or significant breast tenderness and where breast size is disproportionate to body habitus Breast implant for removal Asymptomatic with recalled, suspended or undetermined implants. For consideration of replacement where the existing implant was placed in the context of breast cancer or Congenital abnormality.
If your patient does not meet the minimum referral criteria Assessment and management information may be found on a range of conditions at HealthPathways If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Height, weight and BMI (ideally BMI should be <35 for reconstruction and reduction surgery). Patients with a BMI 35-40 may be reviewed by a multidisciplinary team regarding the appropriateness of surgery.
Confirmation of type of implant product and when it was inserted if at all possible
Smoking status
Mammography results for women >40 years (unless contraindicated)

Additional Referral Information

History of surgery/chemotherapy/radiotherapy in breast cancer patients
Ultrasound +/- aspirate of seroma surrounding breast implant is insitu (if available)

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

Secure Web Transfer

Send to: Gold Coast Health Service District

Internal Referrals

(E-Blueslips)

Fax

(07) 5687 4497

Post

Enquiries

1300 559 083

Related HealthPathways

No directly related pathways found

HealthPathways home page

Service Availability

Dr Raja Sawhney

Medical Director Plastics and Reconstructive Surgery

Facilities

Gold Coast University Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Reconstructive breast surgeryAdult