Unfortunately gravity is constant! As the skin ages and looses some of its elasticity the effect of gravity on breasts can be devastating. Fortunately there are surgical options to lift the breast and restore a more youthful appearance. Women with sagging breasts will generally fall into one of two categories- those who have lost breast volume, say after breast feeding, and those with very heavy breasts. The first group will need a lift and occasionally augmentation with an implant, whereas the second group will need a reduction in breast volume along with the lift. Dr Pratt is always happy to meet you to explore your specific needs.
Improving the contour of the abdominal area is a common request from patients visiting plastic surgeons. There are numerous techniques which can be used to achieve the results you desire. These problems can be related to excess fat, excess skin and weakness of the muscles of the abdominal wall. Usually there is a combination of all three issues. Proper assessment and planning will help select the technique which is best for you and achieve the best possible result. Dr Pratt is always happy to see new patients to explore aesthetic goals and surgical options.
Surgery to improve the volume and shape of the breasts is called breast augmentation. While this is usually achieved with silicone implants, there are many variations of device and technique. Choosing the best technique for you depends on your aesthetic goals and the shape and volume of your breasts and chest. Good results depend on careful planning, and expert execution. Dr Pratt is happy to see you to discuss your goals and formulate a personalized plan for you.
Problems with tired looking eyes are a common complaint. These problems can involve excess skin on the upper eyelids and bags and pouches on the lower eyelids. If tired looking eyes are a problem for you there are numerous surgical options to help rejuvenate the eyelids and improve the overall aesthetic of the periorbital region. Careful assessment of the exact nature of the problem is crucial in deciding which option is best and this is not a “one size fits all” region of the body. Dr Pratt is always happy to meet new patients to explore options for restoring a youthful appearance to the eyes.
The carpal tunnel is a tight space in the wrist through which structures pass from the arm to the hand. For various reasons this space can become tight and result in compression of these structures including the median nerve. The carpal tunnel syndrome is a syndrome of pins and needles and numbness in the thumb, index finger and middle finger caused by compression of this nerve. In severe cases it can also cause weakness of the thumb and clumsiness.
Carpal tunnel syndrome can be diagnosed by clinical examination and nerve conduction studies.
Carpal tunnel syndrome is usually best treated by surgical release of the tunnel- this involves a small incision over the wrist and about 4 weeks of recovery time. Non-surgical options are worth considering in some cases and can include steroid injections and splinting.
Ganglions are the most common hand lumps encountered by the hand surgeon. They are fluid filled bulges which originate from the joints of the wrist and fingers. They can come up quite suddenly and feel like a firm bulge. Occasionally they fluctuate in size. The most common places are the front and back of the wrist and the base of the fingers.
Whilst ganglions are usually painless occasionally they cause problems and can be removed surgically.
There are a number of other possible causes of hand and wrist lumps ranging from the common to the rare. We are happy to assess any hand lumps and help you with a management plan
Osteoarthritis or “wear and tear” arthritis is the most common cause of joint pain in the wrist, hand and fingers as we age. Whilst any joints can be affected by osteoarthritis the most common problem areas are the base of the thumb and the small joints of the fingers. Most people will have some arthritis pain in their hands by the age of 60.
Whilst anti-inflammatory medications and paracetamol can help control this problem severe cases can be helped with surgery. Numerous options exist depending on the severity and the joint affected. These range from steroid injections to joint replacements and joint fusions. We are happy to see you for any arthritis problem and formulate a management plan.
Hand injuries (or trauma) are common in the workplace and the home. Fractures (broken bones), lacerations with or with damage to underlying structures (tendons, nerves, blood vessels) and crush injuries of the fingertips are the most common injuries seen.
Most lacerations and fingertip crush injuries can be treated with a dressing initially and then be fixed in surgery in the following 48 hours.
Most hand fractures can be treated initially with a splint or half cast and then managed surgically (if necessary) in the following 10 days.
Major hand injuries and mutilating trauma should obviously be managed immediately via emergency departments.
Dupuytren’s disease is an abnormal thickening of the skin and the fascia (connective tissue under the skin) of the palm of the hand. This is more common in older men of anglo-saxon background however can also happen in middle aged people. It typically begins as a small lump or “nodule” in the palm often in line with the little finger and gradually progresses. When the disease is advanced it starts to pull the fingers (typically the little and ring fingers) down into the palm- this is known as Dupuytren’s contracture.
Particularly when there is contracture, Dupuytren’s disease can cause problems with hand function. There are numerous treatments available however the most definitive is surgical removal of the diseased fascia or “fasciectomy”. This usually allows the fingers to come out straight and regain movement. The recovery time is around 4-6 weeks depending on the severity of the disease.
Basal cell carcinoma and squamous cell carcinoma are two common skin cancers in Australia- the so-called “Non melanoma skin cancers”. Both are associated with sun exposure although there are other causes of these cancers. Whilst not as aggressive as melanoma, these cancers have the potential to cause problems and should be excised with appropriate surgical margins. Depending on the location on the body excision may result in a skin defect requiring reconstruction with a flap or a graft.
Merkel cell carcinoma is a rare, aggressive skin cancer similar in some ways to melanoma. These tumours are more common in the elderly and can be hard to control. These cancers are usually best managed by a combination of surgical excision and radiotherapy. Dr Pratt is happy to manage your merkel cell carcinoma in conjunction with a hospital based multidisciplinary team.
When large areas of skin are lost either to an injury or to cancer excision the resulting wound can be too big to stitch closed. In these situations plastic surgeons use various techniques to solve the problem. Flaps are pieces of skin which are lifted up and stretched and moved across to cover a defect next door. Grafts are pieces of skin which are completely removed from one area of the body and stitched into place on the defect. Each of these techniques have pros and cons and your surgeon will help you decide which is best for your given problem.
Sentinel node biopsy is a surgical technique for sampling (biopsying) a lymph node. This is useful in some cases of melanoma as it may give important information about whether a cancer has spread to the lymph nodes or not. If your sentinel node biopsy is positive, you may require further treatment including removal of all the lymph nodes in the region. The subject of whether sentinel node biopsy improves a patient’s chances of beating melanoma is a complex discussion which you should have with your surgeon or oncologist.
Following mastectomy for breast cancer numerous options exist to reconstruct a breast. They include the use of implants and the transplantation of free flaps – blocks of tissue including skin, fat and sometimes muscle from a distant area of the body to the chest. Occasionally combinations of implants and flaps will be used. You may also require the use of a temporary tissue expander- a balloon device to stretch the skin of the chest wall to accommodate a soft silicone implant. The choice of which technique is best for you is complex and depends on your reconstructive goals and your available body tissue. Dr Pratt is happy to discuss your options with you.
After major trauma to the legs, patients may be left with exposed broken bones. These type of injuries are challenging to reconstruct- often the bony injury will require rods and screws to be placed but the skin injury will mean that this metalware is exposed. In these situations plastic surgeons will become involved to help provide coverage of the wound. Frequently these types of wounds will require microsurgical transplantation of blocks of skin and fat from other areas of the body- so called “free flaps”
Cancers of the mouth, tongue and throat can require radical surgery to remove them. This frequently results in complex defects which are difficult to repair. Whilst these can sometimes be reconstructed with smaller “local flaps” they frequently require microsurgical transplantation of large blocks of tissue from elsewhere on the body. These are major operations, usually undertaken by two teams- an ENT team to remove the cancer and a plastic surgical team to reconstruct.
Scars result from any injury to all the layers of the skin. This includes any surgical incision. Scars are permanent and even after many years they will be visible, although they typically mature and fade over 12- 18 months. There is no such thing as scarless healing however plastic surgeons have many techniques to try and minimise scarring.
Sometimes abnormal scarring can occur- these conditions include hypertrophic scars and keloid scars. These can be very large and unsightly and can sometimes be itchy or painful. There are many options for improving these scars and we would be happy to see you to discuss your scar management.
While moles and birthmarks are usually completely benign, many people come to see plastic surgeons for opinions on these lumps as they can be unsightly. We are happy to discuss the options with you for removal of these lumps often with very minimal scarring.
Melanomas are aggressive skin cancers caused mainly by sun exposure. They are cancers of the pigment producing cells of the skin (melanocytes) and are thus typically pigmented (brown). Whilst they can sometimes look similar to benign moles, trained clinicians can usually tell you which skin lumps are benign and which are suspicious. Any “mole” which changes rapidly or bleeds is very suspicious and warrants further assessment or biopsy (sampling). Melanomas have the ability to spread in the body even when very small and are dangerous cancers. They should be managed with surgical excision and some melanomas will require further treatment such as radiotherapy and chemotherapy.
Children being teased because of their prominent ears is a relatively common problem- kids can be so cruel! Often prominent ears are caused by differences in the shape of the underlying cartilage structure of the ear. Plastic surgeons have numerous techniques to improve the appearance and position of the ears. We are happy to see you to provide advice and formulate a management plan. It is usually advisable to only embark on this surgery if the child is mature enough to request the surgery themselves.
Various types of birth marks may be a problem for infants. These include pigmented (dark) birth marks and also hemangiomas of infancy which are pink fleshy birth marks (sometimes called strawberry nevi). Often these birthmarks do not require surgical intervention and sometimes medication can help in the management. However, in certain circumstances, surgical excision may be considered. We are happy to see you and formulate a management plan.
Congenital hand differences represent a broad spectrum of problems. These range from relatively minor differences such as small accessory digits through to complex problems involving all of the fingers, the thumb, and the hand itself. Minor problems may be easily fixed with one small operation whereas more complex problems may require multiple operations in specialist centres. We are happy to provide advice and a management plan for any pediatric hand problem.
Trigger thumbs are a common problem of early childhood. The child is unable to straighten the thumb or has a thumb that intermittently clicks or locks. This is frequently mistaken for a dislocation. There are many management options both surgical and non surgical for this common problem and we are happy to see you to provide advice and a management plan.
Small growth of skin in front of the ear, occasionally with firm cartilage inside are a relatively common problem of infancy. Whilst these usually don’t cause any problems they can be unsightly and occasionally can be associated with a deeper problem under the skin. Usually these are simple to manage and we are always happy to see you to provide advice and a management plan.
GEORGE PRATT SERVICES
HAND
Dr Pratt provides a broad range of elective and trauma hand surgery services, with a special interest in Dupuytren’s disease. Finger tip injuries, fractures and tendon injuries are also an area of specialty. All work place injuries of the hand are catered for.
DUPUYTREN'S DISEASE
SKIN
MELANOMA
SENTINEL NODE BIOPSY
FLAPS & GRAFTS
RECONSTRUCTIVE
PAEDIATRIC SURGERY
TRIGGER THUMBS
PROMINENT EARS
AESTHETIC SURGERY
EYELID SURGERY
BODY CONTOURING & ABDOMINOLPLASTY
Epworth Medical Centre
Level 1 173 Lennox St
Richmond 3121
Phone: (03) 8538 1747
Fax: (03) 8677 6574
Peninsula Private Hospital
525 McClelland Drive
Frankston 3199
Phone: (03 )8568 3616
CONTACT
reception@georgeprattplasticsurgery.com
- Tweets by @gprattplastics
Epworth Medical Centre
Level 1 173 Lennox St
Richmond 3121
Peninsula Private Hospital
525 McClelland Drive
Frankston 3199
Phone: (03) 8568 3616
Phone: (03) 8538 1747
Fax: (03) 8677 6574
CONTACT