Mater Specialist Quick Find

Plastic and Reconstructive – public patients 

Purpose

This page contains information for general practitioners on how to refer patients aged 16 years and over to Plastics and Reconstructive services at Mater Hospital Brisbane.

Patients less than 16 years of age with congential conditions should be referred directly to Children's Health QLD HHS

Service 

The Mater Plastics and Reconstructive Surgery unit is involved in all forms of reconstructive surgery and is available for all other services in the hospital for combined surgical approaches for elective and emergency surgery.

To establish individualised plans with the most appropriate care path and treatment for our patients we currently have Multidisciplinary team meetings scheduled fortnightly Dermatology and Breast and Endocrine specialists. Our Young Adult Cranio Facial Service also offers a combined clinical approach with Speech Pathology, Orthodontist and ENT collaboration. 

Onsite attendance is available in all clinics with Occupational Therapists, Breast Care Nurses, Clinical Nurses, Wound Care and Stomal Nurses.

We have patients attend the Mater for surgery here in Brisbane from all over Queensland.

Our service consistently reviews and treats our patients within the recommended OPD categorisation time frames. 

How to Refer 

If referral for care is indicated please list all of the General Referral Information and reason for request, and essential information as indicated below.

Please note that Mater Hospital Brisbane Plastics and Reconstructive services 

To refer, please fill in the Mater Adult Referral Form, available to download and embed into most major Practice Management software applications.

Referrals can be sent by:

Secure messaging  Medical Objects:   HM4101000R8
  HealthLink EDI:    materref   
Fax    07 3163 8548

 

 

 

 

Emergency 

If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department or seek emergency medical advice if in a remote region:

 

View list of conditions:

  • Airway compromise
  • Uncontrolled bleeding
  • Acute burns
  • Uncontrolled sepsis including hand infections
  • Complex facial fractures
  • Compound fractures
  • Threat to limb viability
  • Hand fractures (open or closed)
  • Acute fingertip injuries
  • Tendon injuries
  • Lacerations and wounds not suitable for primary health management e.g. lip lacerations, large facial lacerations, lacerations with altered sensation, large skin defects

 

Scope of Service

Conditions out of scope

The following conditions are not routinely provided at Mater Hospital Brisbane:

View list of conditions:

  • Redundant tissue, excision (anywhere)
  • Minor or asymptomatic scarring
  • Liposuction
  • Asymptomatic benign lesions
  • Cosmetic rhinoplasty
  • Cosmetic labioplasty
  • Tattoo removal
  • Replacement of breast implants
  • Small volume breast reductions done for re-shaping
  • Revisions after cosmetic surgery
  • Gender reassignment surgery - please refer to QLD Health Gender Clinic

This service does not have the capacity to accept referrals for:

  • Breast augmentation, except for reconstruction
  • Breast reduction without significant physical symptoms
  • Abdominoplasty without a substantial apron or a significant separation of the rectus muscles (not for cosmetic purposes)
  • Facelifts

Please note, many major elective breast and abdominal procedures require a BMI of 30 or below for safe outcomes.

 

Conditions in scope

Congenital Deformities - Cleft Lip and Palate Repair

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Photograph – with patient’s consent, where secure image transfer, identification and storage is possible

Other useful information for management (not an exhaustive list)

  • Cleft lip and cleft palate eligibility for scheme:
  • enrolled in Medicare
  • have a cleft lip or cleft palate condition
  • be registered for the scheme before turning 22 years old
  • have treatment before turning 28 years old

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Clefts for initial assessment

 

 

Secondary cleft lip and palate related conditions causing speech and other functional issues

Secondary cleft lip and palate related conditions

 

Congenital Deformities - Congenital Hand Surgery

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Photograph – with patient’s consent, where secure image transfer, identification and storage is possible

Other useful information for management (not an exhaustive list)

  • No other information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency clinically indicated:

  • Amniotic band compromising circulation

 

Congenital hand conditions e.g. syndactyly, duplicate thumb

Benign soft tissue lesions e.g. lipoma, ganglion

 

Congenital Deformities - Craniofacial Deformities

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Photograph – with patient’s consent, where secure image transfer, identification and storage is possible
  • Skull XR result for craniosynostosis

Other useful information for management (not an exhaustive list)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Visual or feeding compromise,  neurological symptoms or potential airway involvement

 

Primary diagnosis or deteriorating condition

Stable known condition

 

Congenital Deformities - Ear Deformities

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Diagnostic audiology report
  • Photograph – with patient’s consent, where secure image transfer, identification and storage is possible

Other useful information for management (not an exhaustive list)

  • Microtia – suggest concurrent referral to ENT for management of aural atresia if appropriate

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Ear reconstruction (traumatic abnormalities)

 

 

 

 

 

Microtia

Other congenital or acquired deformities of the ears

 

Congenital Deformities - Neurofibromatosis

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Photograph – with patient’s consent, where secure image transfer, identification and storage is possible

Other useful information for management (not an exhaustive list)

  • No other information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Suspected malignant transformation or serious pressure effects

 

No category 2 criteria

Disfiguring effects of the tumours

 

Congenital Deformities - Vascular Anomalies and Haemangioma

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Deterioration of a lesion

Other useful information for management (not an exhaustive list)

  • No other information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Obstruction of vision, potential airway compromise , rapid growth, bleeding, incipient ulceration

Deterioration of a lesion

 

Stable vascular anomalies for review

 

 

Basal Thumb Arthritis

Essential information (Referral will be declined without this)

  • General referral information
  • XR results - AP and lateral hand and wrist - instruct patient to bring imaging films/results to clinic appointment.

Additional referral information (useful for processing the referral)

  • Management to date

Other useful information for management (not an exhaustive list)

Management

  • Analgesia/NSAIDs as appropriate
  • Consider intra-articular steroid injection
  • Splint and activity modification
  • Occupational therapy/physiotherapy
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Refer directly to emergency if clinically indicated e.g. suspected septic arthritis

 

 

 

 

Associated with inflammatory arthropathy affecting other joints

Rapid deterioration in function

Not responding to maximal management

 

 

Dupuytren's Contracture

Essential information (Referral will be declined without this)

  • General referral information
  • Medical management to date
  • ROM measurements
  • Details of functional impairment
  • History of anticoagulant therapy
  • Smoking status

Additional referral information (useful for processing the referral)

  • No Additional Information

Other useful information for management (not an exhaustive list)

  • It is strongly recommended that people who smoke stop before surgery, as it is associated with delayed skin healing.  Please consider directing your patient to a smoking cessation program
  • Most hand surgery units will soon be offering outpatient based non-surgical treatments for Dupuytren’s. Referral to these clinics may be fast tracked.
  • PIP joint contractures are more serious than MCP joint contractures
  • Splint and activity modification
  • Joint ROM exercises
  • Occupational therapy/physiotherapy

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Skin breakdown and/or infection secondary to severe contracture

 

 

 

 

 

Fixed flexion deformity of 90° at MCPJ  or 60° at PIPJ or

Multiple joints or recurrence after surgery with functional impairment or

Rapidly progressing disease

MCP flexion contractures > 30° or

PIP flexion contracture >20° or

Functional impairment

 

Facial Fractures

At the Mater Hospital Brisbane this condition is managed by the Maxillo-facial Service. Please refer to their referral guidelines and name the referral to their head of department 

General Plastic Surgery

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Photograph – with patient’s consent, where secure image transfer, identification and storage is possible

Other useful information for management (not an exhaustive list)

  • Facial reanimation is generally a category 3 procedure except when there is a threat to vision from lack of corneal protection.  The tarsorraphy / gold weight procedure may then become a category 1.

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Facial palsy with a threat to vision from lack of corneal protection

Acute facial palsy as a result of traumatic or surgical division of facial nerve

 

 

 

Ulcers with acute deterioration (e.g. sacral, ischial or lower limb)

 

Abdominal wall defects e.g. gross divarication or hygiene issues where medical treatment has failed to resolve skin conditions arising under redundant skin (photograph required)

Chronic facial palsy without threat to vision

 

 

Head and Neck Mass

Essential information (Referral will be declined without this)

  • General referral information
  • History of:
  • pain
  • rapid growth
  • neurological symptoms
  • presence of lymph nodes
  • Biopsy result
  • ELFT FBC ESR results
  • CT/USS neck results

Additional referral information (useful for processing the referral)

  • CT chest +/- FNA results

Other useful information for management (not an exhaustive list)

  • No other information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Appointment required within 7 days

Confirmed major head and neck malignancies including intra oral tumours and unconfirmed growths with any of the following:

  • pain
  • rapid growth
  • neurological symptoms
  • presence of lymph nodes
  • biopsy proven poorly differentiated SCC (intra oral)

 

No category 2 criteria

No category 3 criteria

 

Lower Limb Reconstruction

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Photograph – with patient’s consent, where secure image transfer, identification and storage is possible

Other useful information for management (not an exhaustive list)

  • No other information

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Threat to function of limb or exposed fixation plates

 

 

 

Limitation to weight bearing ability e.g. ulceration of sole, non-union of fracture requiring flap coverage

Stable disability

 

Post Burn Reconstruction and Scar Management

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • Photograph – with patient’s consent, where secure image transfer, identification and storage is possible

Other useful information for management (not an exhaustive list)

  • Scarring of minor or cosmetic nature is generally excluded

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Severe contracture or deformity causing severe pain, or threatening vision or joint function

Moderate contracture or deformity that is at risk of worsening

Hypertrophic or keloid scars causing severe symptoms and functional impairment

Stable contracture or deformity and failed conservative scar management

 

Reconstructive Breast Surgery

Essential information (Referral will be declined without this)

Additional referral information (useful for processing the referral)

  • History of surgery/chemotherapy/radiotherapy in breast cancer patients.

Other useful information for management (not an exhaustive list)

  • It is strongly recommended that people who smoke stop before surgery as 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
  • 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)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Pre-operative mastectomy patients

Post mastectomy reconstruction 6 months post chemotherapy and 12 months post radiotherapy

Extracapsular implant rupture and severely painful implants

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

 

Reconstructive Hand Surgery

Essential information (Referral will be declined without this)

  • General referral information
  • History of handedness, occupation, significant hobbies and anticoagulant therapy
  • Smoking status
  • Medical management to date
  • Comprehensive neurovascular assessment
  • Details of functional impairment
  • XR for confirmed or suspected fracture or rheumatoid hand deformity
  • Hand USS for stenosising tenosynovitis and soft tissue tumours of the hand

Additional referral information (useful for processing the referral)

  • Occupational therapy/physiotherapy report
  • Nerve conduction studies if referred for nerve compression syndromes or nerve palsies

Other useful information for management (not an exhaustive list)

  • Splint and activity modification
  • Consider steroid injections as appropriate)
  • Joint ROM exercises
  • Occupational therapy/physiotherapy to maintain mobility/ prevent stiffness and contracture/maintain extension/prevent/control pain/strengthening
  • Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Severe/disabling symptoms of nerve compression and/or muscle weakness or wasting

Soft tissue tumour of the hand with suspicion of malignancy

 

 

 

 

 

Frequent symptoms of nerve compression and any of the following:

  • rapidly progressing disease
  • recurrence of symptoms after surgery
  • failed medical management

 

Intermittent/mild symptoms of nerve compression without weakness or wasting

Secondary hand surgery after injury

Stenosing tenosynovitis and failed medical management

Rheumatoid hand deformity with impaired function or pain and failed maximal medical management

Symptomatic or enlarging ganglion of the hand

 

Skin Cancer / Lesion

Essential information (Referral will be declined without this)

  • General referral information
  • Features of pigmented lesions: size, shape, colour, inflammation, oozing, change in sensation.
  • Biopsy results unless clinically contraindicated – excision biopsy is the preferred method for suspected melanoma
  • Smoking status
  • History of anticoagulant therapy

Additional referral information (useful for processing the referral)

  • Photograph – with patient’s consent, where secure image transfer, identification and storage is possible
  • USS lesion result (for a suspicious lipoma)

Other useful information for management (not an exhaustive list)

  • Advise patient regarding sun avoidance and use of sun screens
  • Educate patient on skin cancer surveillance and arrange annual skin checks

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

Appointment required within 7 days

Skin lesion highly suspicious for melanoma or excision biopsy proven melanoma

Rapidly growing skin lesions especially on the face

Complex non-melanoma skin malignancies and any of the following:

  • ulceration and bleeding
  • rapidly enlarging
  • neurological involvement
  • lymphadenopathy
  • poorly differentiated or infiltrative tumour on biopsy

Other subcutaneous and deep tissue malignancies e.g. Merkel, sarcoma

Skin lesion causing substantial obstruction to vision

Suspicion of malignant liposarcoma

Poorly differentiated SCC

 

Appointment required within 30 days

Prior malignancy at the same site

 

Uncomplicated non melanoma skin malignancies (BCC/SCC/IEC)

      Skin lesions

  • Causing functional problems or significant disfigurement or
  • Diameter exceeds ≥ 5cm in size or rapid growth over short period of time or
  • Significant persistent pain that is not solely pressure related or
  • Fixed to deep tissues, i.e. muscle or fascia or
  • Recurring after a previous excision or
  • Prone to recurrent infection or
  • Diagnosis in doubt or needs confirmation

Benign soft tissue lesions e.g. lipoma, ganglion not suitable for primary health management

Clinically significant benign lesions

 

Other Plastics and Reconstructive Surgery Condition

Essential information (Referral will be declined without this)

Categorisation

Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.

Category 1 – urgent

Clinically recommended timeframe for initial appointment is 30 days

Category 2 - Priority

Clinically recommended timeframe for initial appointment is 90 days

Category 3 - Routine

Clinically recommended timeframe for initial appointment is 365 days

 

 

Our Specialists 

Dr Dan Kennedy

Director of Plastic Surgery

Dr Catherine Darcy 

Plastic Surgeon

Dr Scott Ingram

Plastic Surgeon

Dr Brendan Louie

Plastic Surgeon

Dr Justin Perron

Plastic Surgeon

Dr Yun Phua

Plastic Surgeon

Dr Shireen Senewaratne

Plastic Surgeon

Dr Christine Rogers General Practitioner - Minor Skin Lesions 

 

Bulk Billed Clinics 

Mater Health offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed clinic, please provide a named referral to one of the specialists listed above.

Contact Us 

If you would like to discuss a referral, including clinical criteria, or update the status of a current patient please contact our priority GP phone line on 07 3163 2200 

Current Waiting Time for Appointments 

We provide up to date data on how long patients are waiting for their first appointment by specialty here.

Referral Guideline Development

These Mater Referral Guidelines align with standardised best practice tools for referral to publicly funded specialist outpatient services developed in Queensland through the Clinical Prioritisation Criteria project.

 

Content last reviewed: 16 February 2018

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