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

  • circumferential trunkoplasty
  • thigh/arm reduction

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 including bariatric surgery date and outcomes
  • current medications and dosages
  • allergies and sensitivities
  • smoking/vaping status
  • presenting symptoms
  • management history including:
    • associated features e.g. functional impairment, severe intractable intertrigo (skin fold rash)
    • onset and duration
    • pain/discomfort
    • severity of symptoms
    • impact on activities of daily living
    • treatments trialled/implemented prior to referral
  • maintained stable weight (less than 5 kilograms variation) for greater than 6 months
  • if massive weight loss surgery:
    • post bariatric surgery patients must be 18 months post their latest bariatric procedure

Additional information to assist triage categorisation

Additional referral criteria for Central Adelaide Local Health Network (CALHN):

Clinical management advice

Body contouring procedures other than abdominoplasty, apronectomy and breast reduction or mastopexy are performed infrequently. Thigh and arm reduction surgeries are rarely offered as these skin redundancies rarely cause significant health problems.

Post bariatric surgery patients must be 18 months post their latest bariatric procedure.

People can be considered for surgery in the following circumstances:

  • wedge excision of redundant non-abdominal skin and fat that is a direct consequence of significant weight loss of at least 5 BMI points, if:
    • there is intertrigo or another skin condition that risks loss of skin integrity and has failed 3 months of conventional (or non-surgical) treatment; and
    • the redundant skin and fat interferes with the activities of daily living; and
    • the patient’s weight has been stable for at least 6 months following significant weight loss (at least 5 BMI points) prior to the lipectomy.

It is strongly recommended that people who smoke or vape stop 3 months prior to consultation. Smoking/vaping is associated with delayed healing. Refer to Clinical management advice and resources 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.

If the patient requires urgent attention and/or fulfils category 1 triage criteria, please contact the on-call registrar to discuss and ensure your referral has been received.

Clinical resources

Consumer resources