RECONSTRUCTIVE SURGERY

 

Brandon Adams is a visiting reconstructive surgeon at Tauranga Hospital, plus he also sees private patients at Da Vinci Clinic in Tauranga.

In his public and private practices in Tauranga Mr Adams performs extensive reconstructive surgery procedures for head and neck cancer, breast cancer, skin cancer including melanoma. His services also include ACC funded reconstructive surgery.

Contact Mr Adams today to arrange a consultation in Tauranga.

Breast Reduction

Breast Reduction - Large heavy breasts are reduced in size. The nipple is lifted and the breast tissue is reshaped to create smaller, less droopy breasts. The procedure is aimed at reducing the problematic effects of large or heavy breasts.

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Mr Adams will take a history of your concerns and examine you and give you recommendations. Breast reduction surgery involves removal of excess skin, fat and glandular tissue. It requires a general anaesthetic. It can be performed as day stay or hosptial stay surgery. It is indicated when the size of the breasts are too large or the breasts are uneven in size. The surgery leaves a scar around the nipple and in an “inverted T” shape on the breast and in the fold under the breast. Complications of breast reduction surgery may include scars, wound healing problems, asymmetry, changes in position, shape and nipple sensation, breast feeding may be affected.

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Skin Cancer Surgery

Skin Cancer Surgery - New Zealand has one of the highest rates of Melanoma, basal cell carcinoma and squamous cell carcinoma in the world. Skin cancers need to be excised and repaired with care and skill.

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Mr Adams has extensive experience in managing even the most complex skin cancer problems. He is skilled in a comprehensive range of methods of repair and reconstuction so that you can be assured that if your cancer excision (removal) is extensive then the best repair will be available. Common techniques used for repair of skin cancer include direct closure, skin flaps, skin grafts or microsurgery techniques. Complications of skin cancer surgery include scars, wound healing problems, graft or flap failure, asymmetry or distortion, incomplete excision, need for revision or second surgery.

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Breast reconstruction

Breast reconstruction - For the best outcome, treatment of breast cancer may require mastectomy. Breast reconstruction can reduce the impact of mastectomy and help restore a woman's sense of self.

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Mr Adams performs breast reconstruction both immediately (at the time of mastectomy) and delayed (after initial breast cancer treatment is complete).   He will talk with you about your goals and wishes and together you can decide if breast reconstruction is right for you and what method of breast reconstruction is suitable for you.  Mr Adams performs reconstruction using free TRAM, DiEP, pedicled TRAM, Latissimus dorsi and Implant reconstructions.  Nipple reconstruction and areolar  pigmentation are important parts of breast reconstruction. Sometimes procedures to balance breast size and shape are needed.

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Abdominoplasty and Post weight loss surgery

Abdominoplasty and Post weight loss surgery - Excessive folds of skin and stretched abdominal muscles are common after pregnancy and large amounts of weight loss. Skin removal from the abdomen, hips, arms, thighs, breasts, and back are combined with muscle repair and suspension.

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Abdominoplasty (Tummy Tuck) surgery is indicated where there is excessive skin but there is little or a moderate amount of abdominal fat. Excess skin is lifted off the affected area, the excess excised and the remaining skin tailored to fit the body better. The belly button is re-positioned and a long scar is placed low enough to be hidden by underwear. The surgery requires a general anaesthetic and is performed as hosptial stay surgery. The complications may include wound healing problems, asymmetry, stretched scars, incomplete correction, distortion of surrounding tissues, need for secondary or revision surgery.

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Facial cancer surgery

Facial cancer surgery - Skin cancers affecting the face need careful attention and the best repairs possible to lessen disfigurement.

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Mr Adams is a highly trained microsurgeon with extensive experience in treating complex cancers of the face including the scalp, forehead, eyelids, nose, lips, cheeks, chin and neck. He frequently performs complex facial reconstruction when this is required following cancer surgery. Some of the trickiest problems arise when cancer or cancer removal surgery affects the eyes, skull bones, bones of the face, tongue or floor of mouth. Microsurgery techniques are commonly used to repair the largest and most complex defects. Smaller defects of the face may require simpler repairs, but require equally high skill and attention to detail.

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Hand surgery

Hand surgery - Our hands are unique. They are important for our personal, social and occupational needs. When a hand or finger becomes painful, stiff or unstable then function may be impaired.

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Injuries to skin, tendons, nerves and bones may be disabling and recovery can be challenging. Expert assessment and sometimes revision surgery can play a role in ensuring the best recovery possible. Ganglions, cysts, carpal tunnel (median nerve compression), cubital tunnel (ulnar nerve compression) as well as hand tumours are important medical conditions that Mr Adams is skilled in treating. Assessment and surgery of hand injuries may be eligible for ACC funding - Mr Adams does not charge a fee above the ACC rates. Following surgery, Mr Adams will refer you to highly skilled hand therapists who will help you get the best possible results.

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ACC surgery

ACC surgery - Assessment and treatment of scars, hand injuries, burns, traumatic wounds, loss of tissue and revision of surgery for the treatment of trauma may be funded by ACC.

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Mr Adams is one of five plastic surgeons who treat trauma patients at Waikato Hospital. He has experience in treating injuries of all parts of the body including hands, facial injuries, scars, and burns including scar revision, eyelid, lip, nose and facial reconstruction. Traumatic tissue loss or complications of surgery are also treated. Mr Adams is "Red List" approved by ACC to perform the most complex types of recontruction at Braemar Hospital Hamilton and Grace Hospital in Tauranga.

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Parotidectomy

Parotidectomy - Tumours of the head and neck can affect the large salivary glands of the cheek or can arise from within the gland itself.

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Mr Adams is skilled in performing removal of the parotid gland and aims to protect the important facial nerve that lies within the gland. He is trained in facial re-animation surgery which can be used to compensate for facial paralysis when severe parotid tumours affect the important facial nerve.

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Scar revision

Scar revision - Injuries and planned surgery leave scars which may cause problems in bodily appearance and function. Scars may tighten over time to distort the body and limit movement.

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Re-shaping and improving the appearance of injuries, scars, lacerations, hair loss, and burns are at the heart of plastic surgery. Mr Adams performs a detailed, individualised assessment and then gives you advice about what is possible in your situation. As a comprehenisively trained plastic surgeon Mr Adams offers a wide range of techniques to improve scarred tissues including scar re-alignment,scar revision, z-plasty, w-plasty, local flaps, fat grafting, and free tissue transfer.

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Gynaecomastia

Gynaecomastia - Adolescent males and men of all ages can experience excessive growth of breast tissue which can cause embarrassment and social isolation.

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Mr Adams performs a thorough history, examination and investigations to ensure that the cause of your breast growth is understood. Once this is understood the options for improvement of this condition are discussed. Common techniques used include liposuction, surgical excision of glandular and fatty tissue, and when needed, excision of excessive skin and/or nipple reduction and re-positioning. Sometimes staged surgery is needed to get the best result. Undertaking surgery to improve body image and confidence can be psychologically challenging and patients need to be well prepared.

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Gender reassignment

Gender reassignment - The decision to undertake surgery to change body appearance to a gender different from birth gender is important and complex.

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Mr Adams does not have experience in genital reassignment surgery or any laryngeal procedures and does not offer these procedures. He supports the WPATH principles of multidisciplinary care and the need for psychological and endocrine support. Mr Adams will consider chest, body and facial contouring surgery in appropriate patients where there is a referral from a general practitioner and support from the patient's psychiatrist.

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Microsurgery

Microsurgery - Microsurgery is a powerful technique that is used to address many complex reconstructive challenges.

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Mr Adams is a skilled and experienced microsurgeon. He performs microvascular and micro-neurosurgery to repair complex head and neck, hand and body wounds and surgical defects. Microsurgery allows tissue to be moved from one part of the body to another to create solutions for the most complex wounds. Tissue is harvested with a donor artery and vein and then these blood vessels are joined together with tiny stitches under an operating microscope.

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Nerve Surgery (carpal tunnel)

Nerve Surgery (carpal tunnel) - Nerve compression can cause tingling, pain, and weakness. Decompression and release can relieve or improve symptoms.

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The site and cause of nerve compression must be known to ensure that treatment is targetted to the correct area. Mr Adams uses history, examination and, where necessary, nerve conduction studies and imaging to accurately diagnose and help plan if surgery is appropriate for you. Complications of nerve release surgery include incomplete recovery, injury to nerves, recurrence of the compression and post operative pain syndromes.

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