Raised naevi may be removed surgically by cutting down to the level of the skin but naevi that may have become cancerous will be cut out entirely and stitches will be required.

Surgery to increase breast size involves inserting silicone implants filled with silicone gel or saline under the breast tissue (sometimes under the chest muscle depending on your surgeon's preference) and skin. The procedure involves making an incision either in the armpit, under the breast or around the areola (nipple) from where the implant is inserted.

This is an operation that can lift and reshape sagging breasts. The procedure usually involves removing skin from an area below the nipple and reshaping the breast.

Following surgery for breast cancer (mastectomy), a silicone implant filled with either silicone gel or saline is inserted underneath the chest muscle and skin. Before being inserted, the skin will sometimes need to be stretched to the required breast size. This is done by placing an empty bag where the implant will finally go, and gradually filling it with saline over weeks or months. The bag is then replaced by the implant in another operation.

Surgery to reduce breast size involves making an incision around the areola (nipple) straight downwards and along the crease beneath the breast. Glandular tissue, fat and skin are removed and the breast is reshaped. All breast tissue removed is sent to the laboratory for cancer testing as an added precaution.

Carpal tunnel syndrome (CTS) is a condition where there is excessive pressure on one of the main nerves (median nerve) as it passes through the wrist to the hand. The median nerve supplies sensation and movement to parts of the hand and passes through a tunnel (carpal tunnel) in the wrist to reach the hand. Excessive pressure on this nerve can result in symptoms of numbness, tingling, weakness or muscle damage. Patients who suffer from this condition often report waking up at night with pain and requiring to “shake” their hand to relieve their symptoms. The cause of this condition is attributed to multiple factors but excessive repetitive movements can be associated with this condition. Surgery to relieve CTS involves making an incision from the middle of the palm of your hand to your wrist. Tissue that is pressing on the nerve is then removed to release pressure on the median nerve relieving CTS symptoms.

Surgery to repair a cleft lip involves making an incision on both sides of the gap in the lip (cleft). The surgeon then turns the dark-coloured edge of the cleft under and pulls the muscle and skin of the lip together to close the gap. Surgery to repair a cleft palate involves making incisions in the roof of the mouth on each side of the gap. Tissue and muscles are moved towards the centre of the roof of the mouth and joined together, closing the gap.

Dupuytren's contracture (or Dupuytren's disease) is a fixed flexion contracture of the hand due to thickening of some of the tissues in the hand resulting in the fingers bending towards the palm and unable to be fully extended (straightened). It is an inherited proliferative connective tissue disorder that involves the hand's palmar fascia (layer of tissue within the palm of the hand) The ring and little are the fingers most commonly affected. Dupuytren's contracture progresses slowly and is often accompanied by some aching and itching. In patients with this condition, the palmar fascia thickens and shortens so that the tendons connected to the fingers cannot move freely. The incidence of Dupuytren's contracture increases after age 40; at this age, men are affected more often than women. Beyond 80 the gender distribution is about even. Surgery is currently the mainstay of treatment for symptomatic Dupuytren's contracture (however there is currently a worldwide trial with collagenase although this is still considered experimental at this stage). Surgery involves either a general anaesthetic or regional block and involves excising all of the thickened tissue which includes the palmar fascia and may include the overlying skin but retaining the important neurovascular structures within the hand and fingers. The joints can also be involved in the more severe cases and all attempts are made to improve the function of the joints. The reconstruction of the resulting wound is performed using either a skin lengthening procedure or with a skin graft. The length of time for the procedure is dependent on the severity and number of the contractures involved in the hand. At RSC, our specialists usually perform this operation on one hand at a time as a day stay procedure. Post Operative Care After your procedure your operated hand will be in a splint and a sling for approximately 1- 2 weeks depending on the type of reconstruction performed. You will need to keep this hand dry at all times.

Some children and adults are unhappy with the shape of their ears because they stick out too much (prominent ears, bat ears) or are uneven (asymmetrical). Teasing can result in loss of self confidence. Surgical correction of prominent ears known as “otoplasty” or “pinning back of ears” can help restore self confidence. Otoplasty procedures performed at Remuera Surgical Care are generally done under either a general anaesthetic or a local anaesthetic as a day stay case. The operation takes approximately one hour and involves making an incision on the back of the ear (so the scar is hidden) and reshaping the cartilage of the ear to improve the contour and set the ears back. All stitches are dissolvable so that there are no stitches to remove.

Blepharoplasty (cosmetic eyelid surgery) is a procedure which improves the appearance of upper eyelids, lower eyelids or both. The aim of the procedure is to give a more youthful and restful appearance. Blepharoplasty procedures are performed in adult men and women who have excess or laxity in the skin, fat or muscle bulk in the upper eyelid, lower eyelid or both. The excess / laxity in the eyelid tissues can result in bags in the lower eyelid, droopy lower eyelids, overhanging skin or puffiness (due to excess fatty deposits) in the upper eyelids. An incision is made on the eyelid (upper and/or lower) within the natural creases to give you the best natural result. The excess tissues are then removed/repositioned to give you a more youthful and rested appearance.

There are a wide variety of face lift procedures and each procedure is highly individualised to your specific needs after a full assessment and discussion with your specialist. Face lift techniques range from simple, minimally invasive approaches completed through incisions in front of, around and behind the ear where tissue lying deep below the skin is repositioned, skin is replaced with any excess removed, to the more extensive face and neck lift procedures. Face lift procedures at Remuera Surgical Care are performed under either local anaesthetic with sedation or general anaesthesia depending on your specialist's preference and all require an overnight stay.

Implants can be put into your chin, cheeks or jaw to improve the shape and/or size of the bones in these areas. In most cases, small cuts (incisions) are made on the inside of your mouth, through which the implants can be inserted.

In this procedure, small cuts (incisions) are made on the inside of the lip and the tissue is reshaped.

This procedure removes unwanted pockets of fat from under your skin in specific parts of the body such as the chin, neck, upper arms, stomach, hips and thighs. A small cut (incision) is made through which a narrow, hollow tube (cannula) is inserted. The tube is moved around to loosen the fat cells, which are then sucked out with a vacuum device.

Rhinoplasty is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils. Through these incisions, the skin that covers the nasal bones and cartilages is gently raised, allowing access to reshape the structure of the nose. Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed. Additional incisions may be placed in the natural creases of the nostrils to alter their size.

This usually involves cutting out the old scar, closing the wound with stitches and, in some cases, moving the scar so that it is hidden by natural features of the body. If the scar to be revised is particularly large, it may be necessary to have a skin graft. This involves transferring skin from another, healthy part of the body (donor site) to the injured site (recipient site).

Abdominoplasty is a plastic surgical procedure which removes excess skin and subcutaneous tissue as well as tightening the muscles from the abdomen. This sort of surgery is normally sought by people who have saggy tissues after pregnancy or massive weight loss. It is ideal for patients who are fit and healthy but have resistant excess skin and subcutaneous tissue despite a healthy lifestyle. This procedure is not a substitute for exercise and a healthy diet. Abdominoplasties performed at Remuera Surgical Care require a general anaesthetic. The operation takes approximately 3-4 hours and usually requires 2 nights' stay.

Skin cancer (also known as "skin neoplasms") are skin growths with differing causes and varying degrees of malignancy. The three most common malignant skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma, each of which is named after the type of skin cell from which it arises. Skin cancer generally develops in the outermost layer of skin, so a tumour can usually be seen. This means that it is often possible to detect skin cancers at an early stage. Unlike many other cancers, only a small minority of those affected will actually die of the disease, though it can be disfiguring. Melanoma survival rates are poorer than for non-melanoma skin cancer, although when melanoma is diagnosed at an early stage, treatment is easier and more people survive. The choice of technique in excision and reconstruction is dictated by the size and location of the defect. Excision and reconstruction of facial skin cancers is generally more challenging due to presence of highly visible and functional anatomic structures in the face. Reconstruction is best performed by a specialist reconstructive plastic surgeon to give you the best result possible. When skin defects are small in size, most can be repaired with simple repair where skin edges are approximated and closed with sutures. This will result in a linear scar. If the repair is made along a natural skin fold or wrinkle line, the scar will be hardly visible. Larger defects may require repair with a skin graft, local skin flap, pedicled skin flap, or a microvascular free flap. Skin grafts and local skin flaps are by far more common than the other listed choices. Skin grafting is patching of a defect with skin that is removed from another site in the body. The skin graft is sutured to the edges of the defect, and a bolster is placed atop the graft for seven to ten days, to immobilize the graft as it heals in place. There are two forms of skin grafting: split thickness and full thickness. In a split thickness skin graft, a shaver is used to shave a layer of skin from the abdomen or thigh. The donor site, regenerates skin and heals over a period of two weeks. In a full thickness skin graft, a segment of skin is totally removed and the donor site needs to be sutured closed. Split thickness grafts can be used to repair larger defects, but the grafts are inferior in their cosmetic appearance. Full thickness skin grafts are more acceptable cosmetically. However, full thickness grafts can only be used for small or moderate sized defects. Local skin flaps are a method of closing defects with tissue that closely matches the defect in colour and quality. Skin from the periphery of the defect site is mobilized and repositioned to fill the deficit. Various forms of local flaps can be designed to minimize disruption to surrounding tissues and maximize cosmetic outcome of the reconstruction. Pedicled skin flaps are a method of transferring skin with an intact blood supply from a nearby region of the body. All lesions removed are sent to the laboratory for testing. Your specialist will discuss the diagnosis and treatment plan at your consultation and follow up appointment.

Haemorrhoids, often called piles, are areas in the anal canal where tissue containing blood vessels has become stretched or swollen and may extend beyond the anal canal opening either intermittently or permanently. The main types of haemorrhoids are: Internal haemorrhoids – arising from the lining of the lower rectum and anus External haemorrhoids – arising from the skin around the opening of the anus It is not unusual to have both internal and external haemorrhoids at the same time. Surgical Excision – Haemorrhoidectomy or surgical excision is usually undertaken for the treatment of combined internal and external haemorrhoids and less commonly for permanently prolapsed non-reducible large haemorrhoids. Haemorrhoidectomy is undertaken in a hospital operating theatre under general anaesthetic. Haemorrhoidectomy is very effective in achieving relief of symptoms and it is relatively uncommon for symptomatic recurrence to occur, although occasionally minor anal skin tags can persist after surgery and will be removed under local anaesthetic as an office procedure. The procedure can be quite painful and for this reason post-operative analgesia, dietary advice and stool softening medication is arranged for the post-operative period. Complications such as post- operative infection and significant post-operative bleeding are uncommon and any evidence of these should be reported to your surgeon as soon as possible. Information covering your post-operative management and expectations will be provided pre-operatively. Return to normal activities occurs usually within 2-4 weeks. You will routinely be contacted by the clinic nurse during the early post-operative period and be seen by the surgeon for review 2-3 weeks post operatively or beforehand if there any concerns. Small thrombosed haemorrhoids can be excised surgically using local anaesthetic as a Room’s procedure.

Labiaplasty is a surgical technique to reduce the size of the labia minora. This technique can also be used to equalise the two labia if one side is larger than the other. Labiaplasty can be helpful for patients who experience pain, or even ulceration, of the labia due to their size. Labiaplasty is usually performed under local anaesthetic with sedation. During the operation the labia minora is reduced and then stitched. Healing is generally rapid and takes approximately 7 days. Our specialists will discuss the options and likely outcomes with you during a consultation. During examination patients are always chaperoned by a nurse to make you feel more comfortable.

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Laparoscopic (minimally invasive) hernia repair uses a laparoscope, a thin, telescope-like instrument that is inserted through a small incision at the umbilicus (belly button). This procedure is usually performed under general anaesthesia, so before the surgery, you will have an evaluation of your general state of health, including a history, physical exam (and possibly lab work) and an electrocardiogram (ECG). You will not feel pain during this surgery. The laparoscope is connected to a tiny video camera, that projects an "inside view" of your body onto television screens in the operating room. The abdomen is inflated with a harmless gas (carbon dioxide), which creates space to allow your doctor to view your internal structures. The peritoneum (the inner lining of the abdomen) is cut to expose the weakness in the abdominal wall. Mesh is placed on the inside to cover the defects in the abdominal wall and strengthen the tissue. After the procedure is completed, the small abdominal incisions are closed with a stitch or two or with surgical tape. Within a few months, the incisions are barely visible. Benefits of laparoscopic hernia surgery include three tiny scars rather than one larger incision, less pain after surgery, a quicker return to work and a shorter recovery time (days instead of weeks).