Breast Reconstruction
Scope & Referral
Dr John Gault performs implant-based and latissimus dorsi flap reconstruction on the Gold Coast. For microsurgical free-flap work like DIEP, he refers you to a plastic surgeon whose scope matches the technique - and stays involved in your care.
Quick answers
Implant-based reconstruction (including two-stage expander and implant) and latissimus dorsi flap reconstruction, often combined with an implant.
No. DIEP and other microsurgical free flaps are performed by plastic surgeons. Dr Gault refers you to one when that is the right technique for you.
No. Gault Surgery remains your central contact through diagnosis, treatment planning and long-term follow-up, working alongside the plastic surgeon.
Where our in-house scope ends
Two categories, stated plainly. On the left, the reconstruction techniques Dr Gault performs himself. On the right, the techniques he refers to a plastic surgeon who works primarily in microsurgical breast reconstruction.
Performed by Dr Gault, in-house
Implant-based and latissimus dorsi reconstruction
- Two-stage expander and implant reconstruction. Tissue expander placed at (or after) mastectomy, gradually filled in the practice rooms, then exchanged for a silicone implant at a second operation.
- Direct-to-implant reconstruction where suitable, without a separate expander stage.
- Latissimus dorsi flap reconstruction, using skin, fat and muscle rotated from the back - most often combined with an implant. Useful where chest skin needs additional healthy tissue after radiotherapy.
- Nipple reconstruction as a later step, once the reconstructed breast has settled.
- Revision and symmetrising procedures on the reconstructed or opposite breast.
Performed at accredited Gold Coast hospital facilities. Immediate or delayed timing is decided with you.
Microsurgical free-flap reconstruction
- DIEP flap (Deep Inferior Epigastric Perforator) - abdominal skin and fat, muscle-sparing, microsurgical anastomosis to chest vessels.
- TRAM flap (Transverse Rectus Abdominis Myocutaneous), including muscle-sparing and free variants.
- SIEA flap (Superficial Inferior Epigastric Artery), where anatomy allows.
- PAP flap (Profunda Artery Perforator), using upper inner thigh tissue.
- TUG flap (Transverse Upper Gracilis), also thigh-based.
- Stacked, bipedicled and bilateral free-flap variants where a single flap does not provide enough tissue.
Performed by a plastic surgeon who works primarily in microsurgical breast reconstruction, at a hospital equipped for that work.
Not sure which side of this line your situation sits on? Book a consultation - the whole point of the visit is to walk through the options in your specific case.
Why a referral is in your interest, not against it
Microsurgical free-flap breast reconstruction is a distinct field of practice. When it is the right technique for you, having it done by a surgeon who works primarily in that field is part of good care - not a compromise.
The technique matches the training
Microsurgical free-flap reconstruction requires substantial ongoing volume in microsurgery. Referral to a plastic surgeon who works primarily in that area means the person operating on you is doing the technique they do most.
The facility matches the procedure
Free-flap surgery is long, needs microsurgical instruments, and requires a hospital set up for the postoperative flap monitoring these operations involve. Referral makes sure your operation happens where the whole system is built around it.
You keep continuity where it counts
Referral is not handoff. Dr Gault often still performs the mastectomy and cancer clearance, works alongside the plastic surgeon during joint operations where that's the plan, and remains your point of contact for the breast cancer side of your care and long-term follow-up.
Options aren't narrowed to what we perform
Because Dr Gault refers when it's right, the conversation in your consultation is about which technique fits you - not only which technique fits our rooms. That's the difference between a menu and a plan.
Everyone works from the same record
The referring letter carries your diagnosis, imaging, pathology, medications and plan across in one document. Correspondence flows back to Dr Gault and your GP, so the plastic surgeon, our rooms and your GP are all working from the same information.
The choice isn't rushed
Reconstruction can be immediate at the time of mastectomy, or delayed by weeks, months or years. Referral does not always mean waiting longer - but where a delay is safer (for example, when radiotherapy is planned), taking the time to plan the right technique matters more than doing something now.
What a referral realistically involves
An honest map has to include the practical downside. If your best option is a microsurgical free-flap reconstruction, there is more logistics to it than an in-house pathway, and we would rather you go in knowing.
A second consultation and a second wait. You add a consultation with the plastic surgeon, and their operating list has its own timeline that Gault Surgery does not control.
Possibly travelling for the operation. Microsurgical free-flap breast reconstruction is not performed at every hospital. Depending on the surgeon Dr Gault refers you to, part of your care may take place in Brisbane or interstate rather than on the Gold Coast.
A longer, more complex operation and recovery. Free flaps are longer operations than implant reconstruction, involve a donor site (usually abdomen or thigh) with its own healing, and have their own set of risks including partial or complete flap loss, fat necrosis, seroma, and abdominal wall weakness. These are covered in detail in your consultation with the plastic surgeon.
None of this is a reason to avoid a technique that suits you. It is a reason to make the choice with clear information.
How Gault Surgery navigates the referral
The role we take when a plastic surgeon is the right next call is a coordination role - organising the referral, holding the plan together, and staying your point of contact for the breast cancer side of your care. Here is how that plays out step by step.
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Options conversation, not a script
At your consultation Dr Gault reviews your diagnosis, imaging, treatment plan, body shape, general health and personal preferences, and explains each reconstruction option that is medically reasonable for you - including options he does not perform himself. There is no push toward what we do in-house.
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If a referral is right, we say so plainly
If a microsurgical free-flap technique fits your situation better than what Dr Gault performs, that is stated openly - with the reasoning - rather than steered around.
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Detailed referral letter to a plastic surgeon whose scope matches
Dr Gault writes a full referral letter with your history, imaging, pathology and treatment plan, addressed to a plastic surgeon whose ongoing work matches the technique you want. The choice of surgeon is discussed with you.
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Our rooms help you book the consultation
Our breast care nurse and reception team help you understand what to expect from the plastic surgeon consultation, what to bring, and how to prepare questions. You are not left to work out the next appointment alone.
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Joint planning where the operation is combined
Where mastectomy and reconstruction are being performed at the same operation, Dr Gault and the plastic surgeon plan the operation together. Dr Gault performs the cancer clearance; the plastic surgeon performs the reconstruction.
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Ongoing correspondence and shared records
Operative notes, pathology, plans and follow-up all flow back between Dr Gault, the plastic surgeon and your GP. Nobody is left holding an incomplete picture.
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Long-term breast cancer follow-up with Dr Gault
Cancer surveillance and long-term breast follow-up continue with Dr Gault and your GP on the Gold Coast, regardless of where the reconstruction itself was performed.
Reconstruction: what to expect when you refer to Gault Surgery
If your patient's presentation makes reconstruction likely to be part of the conversation, you can refer to Gault Surgery either way - implant-based and latissimus dorsi work stays in-house, and Dr Gault coordinates onward referral when microsurgical free-flap reconstruction is the better fit.
Correspondence flows back to your practice from Dr Gault at each stage: diagnosis, treatment plan, operative notes, pathology, and long-term surveillance schedule. If the reconstruction pathway involves a plastic surgeon, your patient's ongoing breast cancer follow-up remains with Dr Gault and you, on the Gold Coast.
Useful with your referral
- Presenting complaint, examination findings and clinical question
- Imaging (mammogram, ultrasound, MRI where relevant)
- Any pathology or biopsy results to date
- Current medications and comorbidities relevant to surgery and anaesthesia
- Any known patient preference on reconstruction (helps with initial triage - final decision is made in consultation)
- Flag urgency where applicable
Talk to us before you decide
A reconstruction consultation with Dr Gault is a full options conversation - including options he does not perform himself. If a referral is right for you, we organise it. If in-house reconstruction is the right choice, we plan it with you.
Our breast care nurse and reception team support you through each step: from your first phone call through consultation, surgery and follow-up.
- Rooms
- 07 5539 3999
- Address
- Suite 11, Pindara Place
13 Carrara Street, Benowa QLD 4217 - Hours
- Monday to Friday, clinic hours
Frequently asked questions
Short-answer versions of the questions we hear most often about scope and referral.
What breast reconstruction techniques does Dr John Gault perform in-house on the Gold Coast?
Dr John Gault performs implant-based reconstruction - including two-stage expander and implant, and direct-to-implant where suitable - and latissimus dorsi flap reconstruction, often combined with an implant. Nipple reconstruction, revision procedures and symmetrising surgery on the opposite breast are also performed in-house. Operations take place at accredited Gold Coast hospital facilities.
Does Dr Gault perform DIEP flap reconstruction?
No. DIEP (Deep Inferior Epigastric Perforator) flap reconstruction is a microsurgical free-flap procedure performed by plastic surgeons who work primarily in microsurgical breast reconstruction. If DIEP is the direction you would prefer, Dr Gault will refer you to a plastic surgeon who performs this technique so you can proceed with confidence.
Why would I be referred to a plastic surgeon for breast reconstruction?
You would be referred if the reconstruction technique that best fits your body, cancer treatment plan and personal goals is a microsurgical free-flap procedure such as DIEP, TRAM, SIEA, PAP or TUG. These are the province of plastic surgeons working primarily in microsurgical breast reconstruction. Referral is part of Dr Gault's standard practice when it is in your interest, not an exception.
Can I still see Dr Gault for my breast cancer surgery if I need a DIEP reconstruction with someone else?
Yes. In many cases Dr Gault performs the mastectomy and cancer clearance and works alongside the referred plastic surgeon, who performs the reconstruction. Your care is coordinated across both surgeons, with Gault Surgery remaining your central point of contact through diagnosis, treatment planning and long-term follow-up.
Do I have to travel out of the Gold Coast for microsurgical breast reconstruction?
No. There are plastic surgeons on the Gold Coast who perform these procedures and work closely with Dr Gault. He can refer you to an appropriate local plastic surgeon and remain involved in coordinating your ongoing care.
Who decides which reconstruction technique is right for me?
You do, with clear information. Dr Gault reviews your diagnosis, treatment plan, body shape, health status and personal preferences, explains each option that is medically reasonable for you (in-house or by referral), and helps you weigh trade-offs including recovery time, scarring, donor site effects and future revision surgery. No option is presented as guaranteed.
What does the referral process actually look like?
Dr Gault writes a detailed referral letter with your history, imaging, pathology and treatment plan, and sends it to a plastic surgeon whose scope of practice matches the technique you want. Our rooms help you book the plastic surgeon consultation. After that consultation you come back to Dr Gault, or continue with joint planning, so both surgeons and your GP are working from the same plan.
Is Gault Surgery a specialist plastic surgery practice?
No. Dr John Gault is a general surgeon who trained in breast surgery through BreastSurgANZ and works primarily in breast, melanoma, thyroid and general surgery. Reconstruction techniques he performs are implant-based reconstruction and latissimus dorsi flap reconstruction. Microsurgical free-flap reconstruction is performed by plastic surgeons; where that is the right choice for you, Dr Gault will refer you.
Does referral mean I have to start again from scratch?
No. The referral letter carries your diagnosis, imaging, pathology and treatment plan across. You are not asked to re-explain your history from the beginning. Dr Gault's rooms remain in contact with the plastic surgeon and with your GP so the whole picture stays together.
What if I change my mind about the technique later?
Reconstruction decisions can be revisited. Some women choose to delay reconstruction, some come back years later for a different technique, and some choose not to reconstruct. If your preference changes at any point, book back in with Dr Gault to talk it through - the door does not close.
Ready to talk through your reconstruction options?
A consultation with Dr Gault is the fastest way to get an honest picture of what suits you -
including options he does not perform himself. If a referral is right, we organise it.
Related pages
Breast Reconstruction Gold Coast
The full page on techniques Dr Gault performs in-house - expander and implant, direct-to-implant, latissimus dorsi flap, nipple reconstruction, timing, recovery and risks.
Oncoplastic Breast Surgery
How cancer clearance and reconstructive technique are planned together, and where oncoplastic surgery fits between lumpectomy and mastectomy with reconstruction.
Communication & Follow-Up
Our standards for results calls, follow-up appointments and long-term surveillance - the connective tissue that holds a referral pathway together.