Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • nil

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Southern Adelaide Local Health Network

Exclusions

Central Adelaide Local Health Network (CALHN):

  • body mass index (BMI) greater than or equal to 35
  • active smokers/vapers

Triage categories

Category 1 - appointment clinically indicated within 30 days

  • nil

Category 2 — appointment clinically indicated within 90 days

  • nil

Category 3 — appointment clinically indicated within 365 days

  • gynaecomastia

For more on outpatient referrals, see the general referral information.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • past medical/surgical history
  • history of previous breast surgery or breast cancer related treatment and dates/years of treatment
  • current medications and dosages
  • allergies and sensitivities
  • smoking/vaping status
  • body mass index (BMI)
  • stable weight (variation within 5 kilograms) for at least 12 months post bariatric surgery
  • ultrasound (US) breast

Clinical management advice

Male breast cancer may present similar to gynaecomastia and should be considered as part of initial assessment. Any suspected breast cancer should be referred to a surgeon with a special interest in breast cancer.

Referral for endocrinology opinion should be obtained to ensure any reversable contributing factors are addressed prior to referral for surgery.

Gynaecomastia surgery will usually be considered for reduction when breast size is not attributable to excess weight, hormonal therapy, or untreated endocrine disorders, and where a substantial health benefit can be expected.

People who have achieved massive weight loss following bariatric surgery, or diet and exercise alone, must also meet the essential referral criteria for assessment.

Gynaecomastia surgery will usually be considered for reduction when their size is not attributable to excess weight, hormonal therapy, or untreated endocrine disorders, and where a substantial health benefit can be expected.

It is strongly recommended that people who smoke or vape stop 3 months prior to consultation. Smoking/vaping is associated with delayed healing. Please refer to useful resources section for further information.

Plastic and Reconstructive surgery service s in South Australia have different thresholds for treatment and assessment related to the body mass index. Please ensure you are aware of these prior to referring for assessment.

Patients with body mass index (BMI) greater than or equal to 35 should be counselled around weight loss management. Please refer to useful resources section for further information.

Clinical resources

Consumer resources