ORCID Profile
0000-0002-5285-8266
Current Organisations
Fremantle Hospital
,
Royal Perth Hospital
,
Dr Mark Lee, Specialist Plastic Surgeon
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Related Links
Publications
Preoperative CT angiography to facilitate pedicle selection for high-risk breast reduction patients
Publisher: Australian Society of Plastic Surgeons
Date: 03-2018
Abstract: Introduction: This study aimed to investigate the dominant vascular supply to the nipple areolar complex (NAC) using CTA and whether the preoperative CTA could change surgical planning and reduce the incidence of nipple necrosis after breast reductions for patients considered to be at a high risk of nipple loss.Methods: All female CT thoraces performed at a single centre between January and May 2013 were reviewed by a single cardiothoracic radiologist to find arterial sources, which intercostal space that was perforated, glandular/subcutaneous course and vessel entry point into the NAC of each breast. Preoperative planning CTA’s performed for the 28 cases of high-risk breast reductions of the 392 breast reductions between 2008 and 2014.Results: Analysis was performed on CTAs of 69 patient cases, involving 132 breasts. The dominant blood supply was the internal mammary artery (IMA) in 96 breasts, with long thoracic artery (LTA) in 21 breasts. A dominant vascular supply was identified in all cases. In 27 of the 28 cases, preoperative planning was undertaken as guided by the CTA. Of the 28 cases, there was one case of unilateral infection, one hematoma, and a single case of partial thickness areolar necrosis. No free nipple grafts were required.Conclusion: Preoperative CTA for large-volume breast reduction may be a useful surgical planning tool for high-risk patients. With CTA, pedicle design can be tailored to the specific patient’s blood supply in order to reduce the incidence of necrosis and avoid the need for free nipple grafts.
Australasian Journal of Plastic Surgery: first edition
Publisher: Australian Society of Plastic Surgeons
Date: 03-2018
Abstract: N/A
Breast Implant Illness: A Biofilm Hypothesis
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2020
DOI: 10.1097/GOX.0000000000002755
Abstract: “Breast implant illness” (BII) is a poorly defined cluster of nonspecific symptoms, attributed by patients as being caused by their breast implants. These symptoms can include joint pain, skin and hair changes, concentration, and fatigue. Many patients complaining of BII symptoms are dismissed as psychosomatic. There are currently over 10,000 peer-reviewed articles on breast implants, but at the time of commencing this study, only 2 articles discussed this entity. At the same time, mainstream media and social media are exploding with nonscientific discussion about BII. We have prospectively followed 50 consecutive patients, self-referring for explantation due to BII. We analyzed their preoperative symptoms and followed up each patient with a Patient-Reported Outcome Questionnaire. All implants and capsules were, if possible, removed en bloc. Explanted implants were photographed. Implant shell and capsule sent for histology and microbiological culture. BII symptoms were not shown to correlate with any particular implant type, surface, or fill. There was no significant finding as to duration of implant or location of original surgery. Chronic infection was found in 36% of cases with Propionibacterium acnes the most common finding. Histologically, synoviocyte metaplasia was found in a significantly greater incidence than a matched cohort that had no BII symptoms ( P = 0.0164). Eighty-four percent of patients reported partial or complete resolution of BII symptoms on Patient-Reported Outcome Questionnaire. None of the 50 patients would consider having breast implants again. The authors believe BII to be a genuine entity worthy of further study. We have identified microbiological and histological abnormalities in a significant number of patients identifying as having BII. A large proportion of these patients have reported resolution or improvement of their symptoms in patient-reported outcomes. Improved microbiology culture techniques may identify a larger proportion of chronic infection, and further investigation of immune phenotypes and toxicology may also be warranted in this group.
Devil's advocate
Publisher: Australian Society of Plastic Surgeons
Date: 14-03-2019
Abstract: Is our speciality vulnerable to "groupthink"? Probably so. We are a relatively small and cohesive group, from similar backgrounds, who believe in our own inherent morality. It is important to remember that some of the techniques we are using today may be modified or even totally reversed in time and so it is imperative that we, as a specialty, continually reflect on what we do. We must all challenge accepted dogma. We must allow those with dissenting opinions to speak up. Valid advances and new techniques are able to withstand questioning and o win over even the most vocal critics. It is not the act of questioning which is at fault. Indeed, the questioning of new and established surgical dogma is integral to any worthwhile scientific discussion. Hopefully this journal can in some way be our specialty’s advocatus diaboli.
Light at the end of the tunnel
Publisher: Australian Society of Plastic Surgeons
Date: 30-03-2021
Abstract: It is not hard to list some of the profound effects COVID-19 has had on the specialty of plastic surgery. World-wide many of our colleagues have suffered serious illness and many have died. Even in countries like Australia and New Zealand, relatively spared from the ravages of the disease, we have all had significant disruptions to our lives and practicesLimitations on elective surgery during lockdown, reduced rates of screening for breast cancer and melanoma (Figure 1), consulting with masks—all affect our ability to provide a safe and effective service for our patients. Eminent plastic surgeons choosing to take early retirement is a great loss of institutional memory. Opportunistic governments and administrators taking advantage and using COVID-19 as an excuse to push through ‘urgent’ changes challenge our ability to provide a safe and effective service
Intraoperative Interpectoral and Subserratus Nerve Blocks in Breast Augmentation Surgery.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2022
DOI: 10.1097/GOX.0000000000004584
Abstract: An essential component in ambulatory breast augmentation surgery is good analgesia. The demographic undergoing this operation is usually fit, low risk with few comorbidities. These patients do not require long-term hospitalization and do not want to spend excessive time in the hospital for financial reasons. Opiate analgesia can have significant side effects such as nausea, vomiting, and sedation. Reducing volumes of postoperative opiates allows faster ambulation and discharge from day surgery. We have developed two targeted nerve blocks that the operating surgeon can apply in minutes under direct vision, not requiring imaging. Anecdotally, we found that these targeted nerve blocks reduced opiate requirements and allowed accelerated discharge and faster return to normal activities. We conducted a prospective randomized, double-blind trial to test this theory. Twenty patients were randomized into saline (n = 10) or ropivacaine adrenaline solution (n = 10). The operating surgeons and anesthetists were blinded to the solution. All patients were closely followed up, and morphine equivalents were accurately recorded. Follow-up pain scores were recorded using the Overall Benefit of Analgesia pain questionnaire. The ropivacaine nerve blocks significantly reduced opiate requirements postoperatively ( P 0.05). Pain scores were significantly decreased in the study group ( P 0.05). There were no side effects attributable to the nerve blocks. Intraoperative targeted nerve blocks significantly reduce postoperative opiate requirements in breast augmentation surgery resulting in faster recovery and higher patient satisfaction.
Related Organisations
Related Funding Activities
No related grants have been discovered for Mark Andrew Lee.