GP Referral Resource

Surgical care that works with your practice

 

A structured shared-care framework for GPs supporting patients before and after plastic and reconstructive surgery.

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A clear, predictable referral process

Dr ILLIE’s practice is structured to make shared care straightforward. The following four-step pathway is designed to minimise uncertainty for both GP and patient.

Initial GP Review

Clarify the patient’s goals, review medical history and current medications, identify red flags, and initiate smoking cessation and weight stabilisation conversations where relevant.

Pre-Operative Investigations

Order procedure-specific investigations outlined in the Pre-Operative Tests section below. Early investigation prevents delays at the surgical consultation stage.

Referral to Dr ILLIE

Include a medical summary, relevant investigation results, current medication list, and any existing imaging. This enables a focused and productive first surgical consultation.

Shared Care Partnership

Dr ILLIE manages surgical planning and operative care. The GP continues medical optimisation, long-term monitoring, and provides reassurance to patients between surgical reviews.

What to Include in the Referral

  • Current medical summary and problem list
  • Relevant investigation results
  • Complete and current medication list (including supplements)
  • Anticoagulant or antiplatelet use — with indication
  • Any existing imaging relevant to the surgical site
  • Smoking and alcohol history
  • BMI and weight trajectory
  • Relevant mental health history, if applicable

What GPs Can Expect from Dr ILLIE

  • Timely specialist correspondence following consultation
  • Clear communication on complex or high-risk cases
  • Practical guidance when patients present to the GP
  • A framework that supports patient reassurance and continuity
  • Remote assessment support via secure clinical photography
  • Defined escalation pathways for post-operative concerns
  • Predictable shared-care with minimal ambiguity
Optimising the patient for surgery

GP-led pre-operative optimisation is one of the most meaningful contributions to a safe and predictable surgical outcome. The following framework supports that role.

Micronutrient & Metabolic

Micronutrient Correction

Addressing deficiencies in Vitamin C, Zinc, and Vitamin D supports collagen formation, immune function, and wound tensile strength.

Protein Optimisation

Adequate protein intake maintains positive nitrogen balance, supporting tissue repair and limiting post-operative muscle loss.

Blood Sugar Management

Stable glucose levels reduce collagen glycation, which can render healing tissues stiff and structurally fragile.

CRP Monitoring

Tracking C-Reactive Protein identifies systemic inflammation that may impair healing or degrade collagen post-operatively.

 

Inflammation & Hormonal Health

Chronic Low-Grade Inflammation

Systemic inflammation accelerates skin laxity, volume loss, and impaired healing. Addressing metabolic health, sleep, and stress is foundational.

Hormonal Support — Menopause & Perimenopause

Oestrogen plays a key role in dermal thickness and hydration. GP-led hormonal management can preserve the dermal matrix and improve long-term skin quality and surgical outcomes.

The Pre-Hab Protocol

 Vascular Health

Improving microcirculation through cardiovascular fitness enhances blood flow to surgical flaps and wound margins.

Sleep Hygiene

Deep sleep triggers natural growth hormone release — the body’s primary window for cellular repair and tissue regeneration.

Gut–Skin Axis

Supporting the microbiome may reduce systemic inflammation that contributes to impaired skin healing and poor tone.

Oxidative Stress Reduction

Guidance on UV exposure, pollution, and metabolic health reduces free radical damage that impairs tissue quality.

Medications to Review

Anticoagulants & Antiplatelets

Review indication and plan for perioperative cessation in liaison with the treating specialist and cardiologist if required.

Herbal Supplements & Omega-3

Advise cessation of Omega-3 supplements 2–3 weeks pre-operatively. Review fish oil, garlic, ginger, and Ginkgo biloba use.

Smoking Cessation

Smoking significantly impairs wound healing, flap perfusion, and scar outcomes. Cessation at least 6 weeks pre-operatively is strongly recommended.

Procedure-specific medical considerations for GPs

The following reference outlines the medical factors GPs should consider for each procedure category and the gold-standard surgical options offered by Dr ILLIE.

Facelift / Neck Lift / Blepharoplasty

Medical Considerations for GP

  • Hypertension — requires pre-operative optimisation; post-operative blood pressure spikes increase haematoma risk
  • Anticoagulants — review and plan perioperative management
  • Smoking history — impacts flap perfusion and healing
  • Sleep apnoea symptoms — CPAP compliance important for anaesthetic safety
  • Thyroid dysfunction — can affect healing, scarring, and volume changes

Patient Concerns Addressed

  • Facial and neck laxity with jowl formation
  • Neck banding and platysmal redundancy
  • Upper eyelid heaviness or visual field obstruction
  • Tired or aged appearance at rest
  • Loss of facial volume and definition

Gold-Standard Options — Dr ILLIE

  • Deep-plane facelift for durable, natural rejuvenation
  • SMAS neck lift with subplatysmal contouring
  • Upper eyelid blepharoplasty with fat preservation
  • Revision facial surgery including prior facelift correction
Breast Lift & Breast Reduction

Medical Considerations for GP

  • Chronic back, neck, or shoulder pain — important for PBS/Medicare documentation where applicable

  • Submammary or inframammary skin irritation and intertrigo

  • Bra-strap grooving with functional limitation

  • BMI — significant weight fluctuation should be stabilised pre-operatively

  • Family history of breast malignancy — up-to-date breast screening required

Patient Concerns Addressed

  • Breast ptosis — Grade I, II, or III

  • Breast asymmetry and volume mismatch

  • Disproportionately heavy breast volume

  • Loss of upper-pole fullness and projection

  • Nipple-areola malposition

Gold-Standard Options — Dr ILLIE

  • Vertical and Wise-pattern reductions

  • Auto-augmentation mastopexy — no implant required

  • Nipple-areola reshaping and repositioning

  • Revision breast surgery including implant removal and correction

Abdominoplasty & Abdominal Wall Reconstruction

Medical Considerations for GP

  • Rectus diastasis — consider ultrasound for confirmation

  • Hernia suspicion — CT imaging may be warranted

  • Chronic lower back pain related to abdominal wall laxity

  • Abdominal skin irritation or panniculitis

  • Weight stability — BMI should be stable for at least 6 months

  • Future pregnancy plans — surgery should ideally be deferred

Patient Concerns Addressed

  • Abdominal skin laxity and excess skin following weight loss or pregnancy

  • Rectus diastasis causing functional and aesthetic concerns

  • Persistent abdominal contour changes post-pregnancy

  • Umbilical malposition or distortion

Gold-Standard Options — Dr ILLIE

  • Full abdominoplasty with muscle repair (plication)

  • Mini-abdominoplasty for localised lower abdominal concerns

  • Umbilical reshaping and repositioning

  • Complex abdominal wall reconstruction including hernia repair

 

Supporting patients between surgical reviews

Some patients — particularly those in regional areas or with travel constraints — may present to their GP rather than return to Dr ILLIE’s rooms. The following structured framework supports safe and predictable GP-led assessment at each phase of recovery.

Phase 1 Early Recovery Weeks 1–2

Assess

  • Wound integrity and closure
  • Degree of bruising and oedema
  • Blood pressure control
  • Adequacy of pain management
  • Signs of infection or haematoma formation
Escalate to Surgeon If
  • Rapid or sudden swelling
  • Sudden asymmetry or firmness
  • Fever or spreading erythema
  • Wound breakdown or dehiscence
  • Visual changes following eyelid surgery

Phase 2 Intermediate Recovery Weeks 4–6

Assess

  • Scar progression and maturation
  • Range of movement and comfort
  • Mood, sleep quality, and psychological wellbeing
  • Return-to-work and activity readiness
  • Medication review and cessation where appropriate

If Surgical Review Was Missed

  • Encourage reconnection with Dr ILLIE’s rooms
  • Facilitate secure clinical photography for remote assessment
  • Document findings in GP clinical notes

Phase 3 Scar Maturation Months 3–12

Assess

  • Scar colour, texture, and thickness
  • Patient adherence to sun protection
  • Weight stability and lifestyle factors
  • Functional concerns or movement restrictions
Refer Back to Surgeon If
  • Hypertrophic or keloid scarring
  • Persistent asymmetry or contour irregularity
  • Functional limitation affecting daily activities
  • Patient distress regarding outcomes
GP-led wellness support across the surgical journey

The following represents general wellness support only. These are not therapeutic claims and should be individualised based on patient assessment and clinical judgement. Supplementation should be guided by confirmed deficiency or clinical indication.

Before Surgery 2–4 Weeks Pre-Operatively

  • Vitamin D (if deficiency confirmed)
  • Iron supplementation (if low ferritin documented)
  • Protein supplementation to achieve adequate daily intake
  • Probiotics to support gut-skin axis
  • Omega-3 supplementation — cease 2–3 weeks prior to surgery
  • Smoking cessation support and resources
  • Review and cease blood-thinning supplements

After Surgery 2–12 Weeks Post-Operatively

  • Vitamin C — supports collagen synthesis
  • Zinc (short course) — wound healing support
  • Protein supplementation — tissue repair and muscle preservation
  • Magnesium — sleep quality and muscle recovery
  • Gentle mobility and breathing exercises as tolerated
  • Sun protection for all healing scars
  • Avoid NSAIDs unless directed by treating surgeon

Long-Term Ongoing Wellness Maintenance

  • Vitamin D maintenance (if previously deficient)
  • Sustained protein intake for skin and muscle health
  • Weight stability and avoidance of significant fluctuations
  • Sleep optimisation for cellular repair
  • Metabolic health monitoring — glucose, lipids, CRP
  • Ongoing sun protection and skin quality maintenance
  • Review of hormonal health in perimenopausal patients
GP care versus surgeon care – a practical framework

Clear delineation of responsibility supports both patient safety and a confident, reassured patient experience. Use the following as a practical reference.

GP-Managed Concerns When patients should see their GP

  • Routine blood pressure review and antihypertensive management
  • Perioperative medication management and prescriptions
  • Wound checks where travel prevents attendance at surgical rooms
  • Sleep disturbance, mood changes, and psychological support
  • Chronic disease optimisation (diabetes, thyroid, cardiovascular)
  • Long-term wellness and metabolic health monitoring
  • Supplement and nutritional guidance
  • Smoking cessation and lifestyle support

Surgeon Review Required When patients should contact Dr ILLIE

  • Any concern regarding surgical site integrity or wound healing
  • Sudden swelling, asymmetry, or firmness at the surgical site
  • Suspected haematoma or seroma formation
  • Suspected surgical site infection unresponsive to initial management
  • Visual changes or eye discomfort following eyelid surgery
  • Contour, symmetry, or aesthetic outcome concerns
  • Hypertrophic scarring or abnormal scar development
  • Any uncertainty regarding the healing trajectory
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Frequently Asked Questions
What information should I include in a referral to Dr ILLIE?

A useful referral includes a current medical summary, relevant investigation results, a complete medication list (including supplements and complementary medicines), anticoagulant or antiplatelet use with indication, smoking and alcohol history, BMI and weight trajectory, and any existing imaging relevant to the anatomical area of concern. If there is a relevant mental health history, including this helps ensure a holistic assessment at the surgical consultation. The more thorough the referral, the more focused and productive the initial consultation can be for the patient.

My patient is on warfarin for atrial fibrillation. How should I manage this pre-operatively?

Perioperative anticoagulation management should be planned collaboratively between the GP, the treating cardiologist or haematologist, and Dr ILLIE’s surgical team. The bridging strategy — or decision to cease and withhold — depends on the indication, stroke risk (CHA₂DS₂-VASc score), and the nature and duration of the procedure. Dr ILLIE will advise on the surgical risk and preferred timing from a wound and haematoma-risk perspective. Please include anticoagulant use and indication clearly in the referral to facilitate this planning from the outset.

A patient presented to me post-facelift with swelling and firmness on one side. What should I do?

Unilateral, rapid-onset swelling and firmness following facial surgery — particularly in the early post-operative period — should raise suspicion for haematoma formation, which is a surgical emergency requiring prompt review. Contact Dr ILLIE’s rooms immediately for guidance. If the patient is in significant distress or the swelling is rapidly progressive and you are unable to reach the surgical team, present to the nearest emergency department. Do not reassure and discharge without surgical contact. Document blood pressure at presentation, as hypertension is a contributing factor.

How long should a patient stop smoking before plastic surgery?

A minimum of six weeks of smoking cessation prior to elective plastic surgery is strongly recommended. Nicotine and carbon monoxide impair microvascular perfusion, reduce oxygen delivery to tissues, and significantly increase the risk of wound ischaemia, dehiscence, and poor scarring — particularly in procedures involving skin flaps such as facelifts, breast reductions, and abdominoplasties. GPs play a critical role in initiating cessation conversations early and providing appropriate pharmacological support (varenicline, NRT) where indicated. Patients should be counselled that resuming smoking post-operatively also impairs the healing trajectory.

What blood pressure range is acceptable before elective plastic surgery?
While specific thresholds are determined by the anaesthetist at the pre-operative assessment, as a general guide, blood pressure should ideally be below 160/100 mmHg at the time of elective surgery. Poorly controlled hypertension significantly increases intraoperative bleeding risk and post-operative haematoma formation — particularly relevant in facial surgery. GP optimisation of antihypertensive therapy prior to referral is one of the highest-yield interventions to support a safe operative course. If a patient’s BP is labile or difficult to control, please note this in the referral so appropriate pre-operative planning can occur.
Can a patient with Type 2 diabetes undergo elective plastic surgery?
Yes, patients with well-controlled Type 2 diabetes can safely undergo elective plastic surgery, though careful pre-operative optimisation is essential. An HbA1c below 7.5–8% is generally a reasonable surgical target, though this is assessed in the context of individual risk. Poorly controlled glucose impairs collagen formation, reduces immune function, and significantly increases rates of surgical site infection and wound healing complications. GPs are well-placed to optimise glycaemic control and ensure a current HbA1c is included in the referral. Please also note the presence of peripheral neuropathy, nephropathy, or retinopathy, as these affect anaesthetic risk and pre-operative clearance.
My patient is perimenopausal and considering a facelift. Is hormonal management relevant?
Hormonal status is increasingly recognised as relevant to surgical and wound-healing outcomes. Oestrogen plays a significant role in maintaining dermal thickness, collagen density, and skin hydration. Declining oestrogen levels during perimenopause and menopause are associated with accelerated skin laxity and reduced tissue resilience. GP-led hormonal management — where clinically appropriate and consistent with current evidence-based guidelines — may support dermal matrix preservation and improve both the surgical result and its longevity. This is best discussed with the patient holistically. Dr ILLIE welcomes a note on hormonal status in the referral for perimenopausal and postmenopausal patients.
A patient has presented to me with a wound concern at Week 2 post-abdominoplasty. How do I assess this?
At Week 2, some degree of bruising, swelling, and minor wound edge changes can be within the expected recovery range. Assess for spreading erythema extending beyond the wound margins (cellulitis), purulent discharge, significant wound dehiscence, fluctuant collections, systemic fever, or deterioration in the patient’s general condition. If any of these features are present, contact Dr ILLIE’s rooms promptly for advice before initiating management independently. If the patient is systemically unwell, presentation to the emergency department is appropriate. For minor concerns, secure clinical photography forwarded to the surgical practice allows for remote assessment and guidance.
Are breast reductions or abdominoplasties covered by Medicare or private health insurance?
Medicare and private health fund benefits may apply to breast reduction and abdominoplasty procedures where specific clinical criteria are met — for example, documented macromastia with chronic musculoskeletal symptoms, or functional abdominal wall impairment including symptomatic rectus diastasis or panniculitis. GPs can support the patient’s case by documenting relevant clinical findings, symptoms, and their impact on daily function in the referral. Dr ILLIE’s team will assess eligibility at the surgical consultation and advise on applicable MBS item numbers and private health fund requirements. Note that cosmetic procedures without a documented functional indication are not Medicare-rebateable.
What should I tell a patient who has unrealistic expectations about surgical outcomes?
Managing expectations early — including at the GP level — is an important part of the pre-operative process. GPs are well-placed to explore the patient’s motivations, expectations, and psychological readiness in a trusted, established relationship. Healthy surgical decision-making involves realistic expectations about what surgery can and cannot achieve, understanding of recovery timelines and the commitment involved, and psychological stability and absence of active conditions that may affect body image or decision-making capacity. If there are concerns, it is appropriate to note these in the referral. Dr ILLIE conducts a thorough consultation process that includes discussion of realistic goals, surgical limitations, and individual risk factors before any decision to proceed is made. Patients are always given adequate time to reflect before confirming their decision.

Schedule  a  Consultation

 

Ph (02) 9101 4707
Fax (02) 9182 0092
office@drvladillie.com.au

 

Sydney Centre for Plastic Surgery

Suite 1702, Westfield Tower 2
101 Grafton St
Bondi Junction NSW 2022

 

Gosford Private Medical Centre

Suite 4, 12 Jarrett St
North Gosford NSW 2250

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