Reconstructive Surgery, Breast Reconstruction and More – Melbourne

Every year, plastic surgeons perform millions of reconstructive procedures to correct acquired and congenital defects in adults and children. With reconstructive surgery, we can restore function that may have been lost or hampered by injury, congenital deformities, disease (including skin and breast cancer), and infection. From scar revision to breast reconstruction, Melbourne plastic surgeon David Ross, M.D. undertakes a variety of procedures designed to address every type of trauma, disorder, or deformity.

While the goal of reconstructive surgery is always to improve function, modern surgical techniques now allow us to make remarkable improvements in aesthetic form. With skin grafting, laser surgery, flap surgery, microsurgery, and more, we can restore appearance in ways previously thought impossible.

To find out more about reconstructive surgery, contact our Melbourne plastic surgery practice today.

» Breast Reconstruction
» Scar Revision
» Skin Cancer Surgery
» Other Reconstructive Surgeries

Breast Reconstruction

Breast reconstruction is a popular choice for women who have undergone a mastectomy as part of their treatment for breast cancer. Plastic surgeons can now reconstruct the breasts using transplanted tissue or breast implants. The technique will vary by the individual, but recent advances make it possible to construct a breast that looks and feels completely natural. It is generally up to the patient and her breast surgeon when to undergo breast reconstruction surgery, but it is possible for a breast reconstruction to be performed immediately following a mastectomy, minimizing the number of operative procedures and achieving the best possible aesthetic result. Patients can delay the procedure if they feel it may interfere with further treatment or if they wish to consider other options.

There are several surgical alternatives available to patients who have chosen to undergo breast reconstruction. Melbourne plastic surgeon David Ross is available to discuss each surgical option, and he will make a recommendation based on health, age, and the personal goals of the patient. During the initial consultation, patients will have to decide whether they wish to reconstruct the breast(s) with their own tissue, or with an implant. There is no correct option. Both procedures are good choices, and each has its own benefits.

The information below is designed to provide a brief overview of breast reconstruction surgery. Dr. Ross has also written some further personal views about breast reconstruction which we invite you to consider.

Please click here to read Dr. Ross's views on breast reconstruction after Mastectomy.

Please click here for clinical examples

Breast Reconstruction With Implants

Dr. Ross undertakes breast reconstruction with implants in several stages. During the initial operation, which lasts one to two hours, Dr. Ross places a tissue expander beneath the muscle of the chest on the side of the mastectomy, which is partially filled with fluid. Over the course of several weeks or months, more fluid is added in order to slowly stretch the skin and make room for the permanent implant. When the skin has reached the desired shape, the tissue expander is removed in a second procedure, and replaced with a permanent breast implant. The size and shape of the implant is matched to the shape of the opposite natural breast.

Candidates for Breast Reconstruction with Implants

Breast reconstruction with implants is ideal for younger, active women who may not have enough abdominal tissue for a successful flap reconstruction. The procedure is also appropriate for women who have undergone bilateral mastectomies, and women who elect to have a subcutaneous (preventative) mastectomy.

Results

A breast reconstruction with implants will look very similar to the natural breast, but patients should expect a certain amount of asymmetry, which is natural. The implant reconstruction will feel firmer than the natural breast, and may lie differently when the patient is horizontal or leaning over.

Breast Reconstruction With Own (Autologous) Body Tissue

During a breast reconstruction with a patient's own (autologous) body tissue, Dr. Ross removes a section of fat and skin from the lower abdomen and transfers it to the chest wall in order to create a natural breast mound. There are two techniques that can be used to deliver the section of fat and skin to the anterior chest wall. The first abdominal flap method requires mobilization of the living abdominal tissue, which is then transferred to the chest on a muscle pedicle in the abdomen or by microsurgical reattachment of blood vessels. The second type of breast reconstruction requires mobilization of tissue from the back, which is then transferred to the anterior chest on a muscle pedicle from the armpit. Usually an implant is also required with this type of breast reconstruction to create adequate symmetry with the contralateral breast.

What to Expect

Both types of breast reconstruction surgery have a similar recovery period and may require 5-10 days in hospital to allow for adequate recovery. Those patients undergoing abdominal flap reconstruction will require a longer recovery period to return to full duties, due to recovery of abdominal muscle strength. However, the abdominal procedure is usually favored as it leads to the best long term natural aesthetic result. Candidates for abdominal flap surgery must have a certain amount of excess fat and skin in the abdomen for the procedure to be successful. Younger patients who do not wish to sacrifice abdominal strength might be better suited for breast reconstruction with implants. During a breast reconstruction consultation at our Melbourne practice, Dr. Ross will go over each surgical option in detail.

Breast reconstruction with autologous body tissue is undoubtedly a complex procedure, and the procedure can take between 3 and 5 hours to complete in the operating room. However, autologous breast reconstruction surgery remains the "gold standard" because it produces a breast that looks and feels completely natural as it is made of living body tissues.

Please click here to read Dr. Ross's views on breast reconstruction in congenital breast asymmetry.

Please click here for clinical examples

Why Choose Dr. Ross

Breast reconstruction after mastectomy is one of Dr. Ross's special interests since his plastic surgery training in Melbourne and subspecialty training in Atlanta. He currently runs the breast reconstruction clinic at Monash Medical Centre and has lectured extensively on the subject to other plastic surgeons, breast surgeons, and related allied health professionals managing women with breast cancer.

To find out more about breast reconstruction, contact our Melbourne plastic surgery practice today.

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Scar Revision

The development of a scar from a trauma or surgery can be very unpredictable. Several variables affect the healing of a scar, including the size of the wound or incision, the condition of the skin, and the location of the scar. If a scar appears to require revision, plastic surgeons generally recommend waiting a year or so to allow the scar to reach its full maturity. At that time, reconstructive surgery, performed through our Melbourne practice, can successfully improve the appearance of a scar and make it less noticeable.

Scar Revision – Reconstructive Surgery

There are several treatments available for patients seeking scar revision. Less invasive methods include steroid injections and the use of silicone compression dressings. Surgically the scar can be repositioned, with the use of a local skin flap, to make it less noticeable, or excising the scar and closing the wound in multiple layers to remove tension that will cause a scar to stretch. Certain facial scars can be improved with either surgical or non-surgical skin rejuvenation procedures, including laser skin resurfacing.

For severe scarring, skin grafting or flap reconstructive surgery is often the best option. Dr. Ross performs both types of reconstructive surgery at a Melbourne hospital or surgical centre. During a skin grafting procedure, Dr. Ross removes healthy skin from a donor site, and then transfers the skin to cover the affected area. If the procedure is successful, new blood vessels will form and new tissue will replace the former scar.

Flap reconstructive surgery is a more invasive procedure than grafting, but often produces better cosmetic results. During the surgery, a larger flap of skin, fat, and sometimes muscle is removed from the patient's body and reattached to the location of the scar. In some cases, microsurgery is required to reattach the blood vessels to the injured area.

Following both skin grafting and flap reconstructive surgery, patients will face significant recovery time. There is also a slight risk that the body will reject new tissue from a skin graft, resulting in delayed healing. Results can be reevaluated after several months to determine if further treatment is necessary. Dr. Ross will be able to give you a scar assessment and make recommendations as to which treatment modality may be applicable in your situation. Please contact any of our Melbourne offices to schedule a consultation with Dr. Ross.

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Skin Cancer Surgery

Skin cancer is a very common condition in Australia. In fact, it is the most common form of cancer suffered by Australians. Most skin specialists agree that surgical excision of skin cancer is the most effective treatment modality and is recommended in most situations. Simple skin cancers and non-cancerous growths can be simply excised and directly closed. These procedures can often be undertaken directly in our Melbourne office at the time of consultation. More complex skin cancer on the face and body will also require surgical excision, but will require the skill of a reconstructive plastic surgeon to prevent disfiguring scarring or deformity following surgical excision. The use of plastic reconstructive surgery techniques at the time of skin cancer excision will optimize the aesthetic outcome following the removal of these tumours.

Skin cancer monitoring and surveillance can be undertaken by review appointments in our office. Dr. Ross will usually arrange for further surveillance to be undertaken by your own general practitioner following uneventful recovery from surgery. If there is some concern about the adequacy of the excision margin or the quality of the aesthetic outcome of the reconstruction, Dr. Ross will continue to review your outcome until it is clear that the risk of recurrence has been eliminated. Dr. Ross will arrange referral to other cancer specialists if other forms of adjuvant cancer therapy are thought necessary after the surgical excision of the skin cancer.

Skin Cancer – Diagnosis and Treatment

Many patients will be referred directly to a plastic surgeon by their general practitioner with the suspicion of skin cancer, for surgical intervention. Some general practitioners will refer to a skin specialist first for confirmation of the diagnosis of skin cancer. Usually those patients with skin cancer best treated by surgery will then be referred on by the skin specialist to a reconstructive plastic surgeon for surgical removal and immediate reconstructive surgery to the body area where the cancer arose.

There are three common types of skin cancer, each which has certain differences in growth, behaviour, and prognosis:

basal cell carcinoma is the most common type of skin cancer and characterised by slow persistent growth if not completely excised but is rarely life-threatening,
squamous cell carcinoma is less common but generally appears on the face, ears, lips and lower limbs, and can become dangerous if left untreated,
malignant melanoma is the least common, but most dangerous, it is usually but not always pigmented and its growth may be signaled by a change in the appearance of an existing mole or a newly arisen pigmented growth.

The majority of cancerous growths can be removed with a simple excision by a dermatologist or plastic surgeon. When large growths begin to spread, they can often affect the tissue and structures beneath the skin, requiring more extensive excision and reconstructive surgery at a Melbourne surgical facility. The skills of a plastic surgeon can be extremely effective in repairing structures damaged by skin cancer, especially on the face. Using skin grafts, flap surgery, and other reconstructive surgery techniques, Melbourne plastic surgeon David Ross can remove both cancerous and non-cancerous growths and lesions, and reconstruct any structural deformities caused by the growth. Excision of most skin cancers can be undertaken as a small day surgery procedure under general anaesthesia or sedation. Follow up is usually required in the form of weekly postoperative appointments until complete healing has been achieved.

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Other Reconstructive Surgeries

Dr. Ross can perform reconstructive surgery on any area of the body affected by acquired traumas, including the hands, face, limbs, and torso. Modern techniques now allow experienced surgeons like Dr. Ross to restore the body's function and appearance, even following severe trauma from burns, fractures, accidental injury, or invasive cancer treatments. With skin grafts, flap reconstructions, and even transplantation, Dr. Ross can repair injuries with hand surgery, correct facial trauma, remove cancerous and non-cancerous tumors and growths, repair tendons, and more.

For specific information about reconstructive surgery of the face, hands, and body, contact Melbourne plastic surgeon Dr. David Ross at Bayside Plastic Surgery.

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