Clinical Lead - Dr James Allen
Catchment criteria applies for referrals for this service. Patient referrals from outside the Mater SEQ Catchment (which includes Metro South and West Moreton Hospital and Health Services) may not be accepted.
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.
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.
Patients from across Queensland, attend Mater Hospital Brisbane for surgery.
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
Emergency care
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:
- 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
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.
Bulk Billed Clinics
Mater Health Services offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed specialist clinic, please provide a named referral to one of our specialists.
Current Waiting Time for Appointments
We provide up to date data on how long patients are waiting for their first appointment by specialty here.
Conditions in scope
Congenital Deformities - Cleft Lip and Palate Repair
Essential information (Referral will be declined without this)
- General referral information
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)
- Refer to local HealthPathway and guidelines
- 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)
- General referral information
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)
- Refer to HealthPathways or local guidelines
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 |
No Category 1 Refer directly to emergency clinically indicated:
| 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)
- General referral information
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)
- Craniosynostosis have a wide range of urgency and early referral is helpful. Please refer these patients to the Queensland Children's Hospital Craniofacial Service.
- Refer to HealthPathways and local guidelines
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)
- General referral information
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
- Refer to HealthPathways or local guidelines
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)
- General referral information
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)
- Refer to HealthPathways or local guidelines
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)
- General referral information
- USS lesion result
Other useful information for management (not an exhaustive list)
- Refer to HealthPathways or local guidelines
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
- Describe functional assessment, (pinch grip, knob grip, key grip, pen grip)
- 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)
- Refer to HealthPathways or local guidelines
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 |
No category 1 criteria (Refer directly to emergency if clinically indicated e.g. suspected septic arthritis)
| Significant ADL or occupational limitation | 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)
- Management to date (including non-surgical)
Other useful information for referring practitioners (not an exhaustive list)
- Refer to HealthPathways or local guidelines
- It is strongly recommended that people who smoke stop three months prior to consultation (smoking is a contraindication for both autologous and prosthetic breast reconstruction). 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
- Chronic disease requires to be optimized prior to referral, or the patients may not proceed to surgery
- 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
This condition is managed by the Maxillofacial 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)
- General referral information
- History of anticoagulant therapy
- Ptosis - BCVA (vision with most recent distance spectacles)
- Blepharochalasia – Ophthalmologist or optometrist report including measure and impact of symptoms
- Height, weight and BMI
- Smoking status
Additional referral information (useful for processing the referral)
- Ptosis - Ophthalmologist or optometrist report including VA, refraction and impact of symptoms
- 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 tarsorrhaphy / gold weight procedure may then become a category 1.
- For eyelid laxity:
- Formal reduction in visual fields as measured by an optometrist
- Patients should have seen an optometrist within 12 months to exclude pressure problems, dry eye and other contraindications.
- Patients would not usually be seen before 55 years of age
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) Dermatochalasis of the eyelid
| 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 Symptomatic ptosis not involving visual axis Blepharochalasia which obstructs the visual axis and >55 years age |
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)
- Refer to HealthPathways or local guidelines
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 |
Confirmed major head and neck malignancies including intra oral tumours and unconfirmed growths with any of the following:
| No category 2 criteria | No category 3 criteria |
Lower Limb Reconstruction
Essential information (Referral will be declined without this)
- General referral information
- Height, weight and BMI
- History of anticoagulant therapy
- Smoking status
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)
- Refer to HealthPathways or local guidelines
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)
- General referral information
- Medical management to date
- History of anticoagulant therapy
- Smoking status
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
- Refer to local healthpathways or local guidelines
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)
- General referral information
- Height, weight and BMI (ideally BMI should be <32 for reconstruction and reduction surgery). Patients with a BMI 32-40 may be delayed and reviewed by a multidisciplinary team (MDT) regarding the appropriateness of the surgery.
- Confirmation of type of implant product and when it was inserted if at all possible
- Smoking status (confirmed non-smoker status for previous three months)
- Mammography results for women >40 years (unless contraindicated)
Additional referral information (useful for processing the referral)
- History of surgery/chemotherapy/radiotherapy in breast cancer patients.
- Ultrasound +/- aspirate of seroma surrounding breast implant insitu (if available)
Other useful information for referring practitioners (not an exhaustive list)
Refer to HealthPathways or local guidelines
It is strongly recommended that people who smoke stop 3 months prior to consultation (smoking is a contraindication for both autologous and prosthetic breast reconstruction). 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)
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 Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) positive patients
|
| 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 the breast size is disproportionate to body habitus Breast implant for renewal 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. |
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 (include Allied Health input and steroid injections)
- Detailed clinical examination with sensory mapping and functional assessment (include impacts on ADL and employment)
- Comprehensive neurovascular assessment
- Details of functional impairment
- XR for confirmed or suspected fracture or rheumatoid hand deformity
- NCS required for Cat 1 cases only
- 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 and NCS confirmation of diagnosis Soft tissue tumour of the hand with suspicion of malignancy
| Frequent symptoms of nerve compression and any of the following:
Major impacts on ADLs and/or employment
| 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
- Refer to healthpathways or local guidelines
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 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:
Other subcutaneous and deep tissue malignancies e.g. Merkel, sarcoma Skin lesion causing substantial obstruction to vision Suspicion of malignant liposarcoma Poorly differentiated SCC Prior malignancy at the same site
| Uncomplicated non melanoma skin malignancies (BCC/SCC/IEC) Skin lesions with any of the following:
| 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)
- General referral information
- Relevant condition information
- Relevant pathology and imaging reports
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 |
Conditions not in scope
Non-routine 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.