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Plastics and reconstructive surgery (adult) Referral Access Criteria

Plastics and reconstructive surgery (adult) Referral Access Criteria

Patient requires immediate (within 7 days) attention
Immediate referrals (patient to be seen within 7 days) should be sent directly to the relevant hospital. Do not send immediate referrals via Central Referral Service (CRS).

 Contact the on-call registrar or service to arrange immediate plastics and reconstructive surgery assessment for:

  • All
    • Animal bites (including human)
  • Breast reconstruction 
    • Post-reconstruction breast abscess, without sepsis or septic shock
    • Patients with breast implants with a large seroma confirmed by ultrasound plus:
      • enlargement of the breast
      • swelling
      • pain
      • overlying skin changes, e.g. redness, induration, and tenderness
      • palpable lump
      • lymphadenopathy

    NB: Where appropriate, contact the surgeon/service that completed the initial surgery

  • Craniofacial conditions
    • Infection post-reconstructive surgery/cancer treatment
    • Difficulty eating/drinking after surgery/cancer treatment

    NB: Where appropriate, contact the surgeon/service that completed the initial surgery

  • Facial Fractures 
    • All acute facial fractures (<6 weeks) with no threat to eye or visual disturbance
    • Acute nasal fracture requiring surgical intervention i.e. external bone displacement
      • best results for acute nasal fracture are achieved within 2 weeks from time of injury
  • Non-healing wounds and ulcers
    • Skin threatening injury e.g. large haematoma, large skin tear
    • Soft tissue loss greater than 5cm2
  • Peripheral nerve palsies and compressions/entrapments
    • Symptomatic malignant tumour
  • Reconstructive hand surgery 
    • Acute closed hand fractures where alignment or management is uncertain
      • patients should be seen within 2-3 days of injury for best outcomes
    • Acute closed tendon rupture
    • Acute scapho-lunate or triangular-fibrocartilage (TFCC) injury
    • Failed internal fixation
  • Subcutaneous tissue malignancies and masses
    • Infected cysts around critical areas (e.g. eyes, lips)
    • Clinically large fungating lesion or exophytic tumours with delayed presentation to healthcare
Plastics and Reconstructive Surgery (adult) conditions with Referral Access Criteria

These conditions are routinely seen by Plastics and Reconstructive Surgery (adult) outpatient services. This is not an exhaustive list of all conditions seen by the outpatient service. Consideration for referral will not be excluded unless the condition is listed on the exclusion list. If the condition you are referring for is not listed, or is unknown, please include details in the body of the referral.

Referrals missing 'mandatory information' with no explanation provided may not be accepted.
Excluded conditions and services

Exclusions

Referrals to public endocrinology and diabetes (paediatric) outpatient services are not routinely accepted for the following conditions:

Excluded condition Details
Gender dysphoria or gender incongruence
Isolated lipid abnormalities  

Excluded elective procedures

All elective procedures must meet an identified clinical need to improve the health of the patient. Procedures are not to be performed for cosmetic or other non-medical reasons. Excluded procedures will not be performed unless under exceptional circumstances and where a clear clinical need has been identified. For excluded procedures, the referral must clearly state:

  • that the request is for an excluded procedure
  • the clinical exception reason as to why it should be considered.

Access the WA Elective Surgery Access and Waiting List Management Policy at WA Health Policy Frameworks.

Excluded procedure Clinical exception reason
Gender reassignment procedures
  • Congenital abnormalities in children
Penile procedures for sex transformation
  • Congenital abnormalities in children
Last reviewed: 15-08-2025
wa.gov.au