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Dr John de Waal - Plastic Surgery

Private Service, Plastic Surgery

Today

8:30 AM to 5:00 PM.

Description

Plastic surgery can generally be divided into:
 
Reconstructive surgery which is performed on parts of the body that are abnormal or have been affected by a birth defect, accident or disease.  Dr de Waal specialises in the following areas of reconstructive surgery:
  • Skin cancers and soft tissue tumours especially of the nose, ears, eyelids, parotid etc including basal cell and squamous cell carcinomas and melanomas (including sentinel node biopsy).
  • Repair of scarred/burned/infected tissue, including ingrown toenails, scar revision, foreign body removal, post traumatic wounds and ulcers.
  • Hand surgery including Dupuytren's contracture, carpal tunnel syndrome, de Quervain's tendonitis/tenosynovitis, mallet finger, ganglia, congenital problems, traumatic injuries, arthritis of tendons, bones and ligaments.

Cosmetic surgery improves appearance or body image by reshaping features of the face or body.  Dr de Waal specialises in the following areas of cosmetic surgery:

  • Prominent ears correction
  • Breast Reduction
  • Gynaecomastia
  • Blepharoplasty
  • Facelifts
  • Rhinoplasty
  • Liposuction
  • Abdominoplasty
  • Labiaplasty.
 
What is Plastic Surgery?
Plastic surgery covers a wide range of different surgical procedures that repair, reconstruct or replace structures in many different parts of the body.  It does not involve the use of plastic materials.

Consultants

Referral Expectations

If you have been referred by your GP please phone the Rooms to make an appointment. You will need to bring the referral letter and any other relevant information e.g. x-rays, blood tests etc with you on the day of your appointment. If you have a skin lesion or tumour requiring removal this can, in most cases, be perfomed on the same day as your consultation. Cosmetic consults are for one hour and generally on Mondays and Thursday. If you are an ACC patient please bring with you : 1. Your referral letter 2. Your ACC claim number 3. Any x-rays or reports relating to the injury

Fees and Charges Description

Contact the rooms on (09) 486 1190 for charges.

Southern Cross Affiliated Provider for skin cancers and carpal tunnel release.

ACC Accredited Provider - ACC patients - no charge.

Hours

8:30 AM to 5:00 PM.

Mon – Thu 8:30 AM – 5:00 PM
Fri 8:30 AM – 3:30 PM

Procedures / Treatments

Naevi

A naevus is a common skin growth composed of special pigment-producing cells. Naevi can vary in size, with small naevi requiring only simple surgery for removal, while the removal of larger naevi may require more than one operation and may involve skin grafts.

A naevus is a common skin growth composed of special pigment-producing cells. Naevi can vary in size, with small naevi requiring only simple surgery for removal, while the removal of larger naevi may require more than one operation and may involve skin grafts.
Hand Surgery

Problems with the appearance or function of the hand can be the result of injury, birth defects or degenerative conditions. Arthritis Arthritis is a condition in which a joint and the surrounding tissue become swollen and painful. If surgery is necessary, it may involve replacement of the joint with an artificial joint or removal or repair of swollen or damaged tissue. Birth Abnormalities Surgery may sometimes be required for hand abnormalities that are present at birth such as too many or too few fingers, webbed fingers or joints that won’t bend. Carpal Tunnel Syndrome A pinched nerve in the wrist that causes tingling, numbness and pain in your hand may require surgery to make more room for the nerve. This operation is usually performed under local anaesthetic (the area being treated is numb but you are awake). Injuries Damage to tendons, nerves, joints and bones in the hand may require surgical repair. In some cases, tissue may be transferred from a healthy part of your body to the injured site (grafting). Ganglia Swellings may develop on the wrist, in the palm or on fingers; these ganglia are fluid-filled and communicate with underlying joints or tendon sheaths. Surgery is needed to remove them. Dupuytren's Contracture This condition occurs when there is abnormal thickening of the deep tissue between the palm of your hand and your fingers. This thickening occurs very gradually and will start to make your fingers curl toward your palm. If this condition gets to the stage where it significantly limits your hand function, surgery may be recommended. This usually involves removal of the thickened tissue, allowing you to straighten your fingers again.

Problems with the appearance or function of the hand can be the result of injury, birth defects or degenerative conditions.
 
Arthritis
Arthritis is a condition in which a joint and the surrounding tissue become swollen and painful. If surgery is necessary, it may involve replacement of the joint with an artificial joint or removal or repair of swollen or damaged tissue.
 
Birth Abnormalities
Surgery may sometimes be required for hand abnormalities that are present at birth such as too many or too few fingers, webbed fingers or joints that won’t bend.
 
Carpal Tunnel Syndrome
A pinched nerve in the wrist that causes tingling, numbness and pain in your hand may require surgery to make more room for the nerve. This operation is usually performed under local anaesthetic (the area being treated is numb but you are awake).
 
Injuries
Damage to tendons, nerves, joints and bones in the hand may require surgical repair. In some cases, tissue may be transferred from a healthy part of your body to the injured site (grafting).
 
Ganglia
Swellings may develop on the wrist, in the palm or on fingers; these ganglia are fluid-filled and communicate with underlying joints or tendon sheaths. Surgery is needed to remove them.
 
Dupuytren's Contracture
This condition occurs when there is abnormal thickening of the deep tissue between the palm of your hand and your fingers.  This thickening occurs very gradually and will start to make your fingers curl toward your palm.
 
If this condition gets to the stage where it significantly limits your hand function, surgery may be recommended.  This usually involves removal of the thickened tissue, allowing you to straighten your fingers again.
Scar Revision

Scar appearance can be improved by various methods including a surgical procedure known as scar revision. 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. Scar revision is usually performed under local anaesthesia (the area around the scar is numbed by injecting a local anaesthetic). Sometimes you may also be given steroid injections at the time of surgery. Immediately following the procedure, you will need to remain at the clinic for about an hour, during which you will be encouraged to walk around. You may or may not have a dressing put on the wound and it is important to keep the area dry for 24 hours. Stitches may be removed in 1-2 weeks. You may need to take a few days off work after the surgery.

Scar appearance can be improved by various methods including a surgical procedure known as scar revision. 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.
Scar revision is usually performed under local anaesthesia (the area around the scar is numbed by injecting a local anaesthetic). Sometimes you may also be given steroid injections at the time of surgery. Immediately following the procedure, you will need to remain at the clinic for about an hour, during which you will be encouraged to walk around. You may or may not have a dressing put on the wound and it is important to keep the area dry for 24 hours. Stitches may be removed in 1-2 weeks. You may need to take a few days off work after the surgery.
Skin Lesions

Skin lesions can be divided into two groups: benign (non-cancerous): e.g. moles, cysts, warts, tags. These may be removed to prevent spreading (warts), stop discomfort if the lesion is being irritated by clothing/jewellery or to improve appearance. malignant (cancerous): basal cell and squamous cell carcinomas are generally slow growing and unlikely to spread to other parts of the body. Melanoma is a serious skin cancer that can spread to other parts of the body. Urgent removal is recommended. Surgery to remove skin lesions usually involves an office or outpatient visit, local anaesthesia (the area around the scar is numbed by injecting a local anaesthetic) and stitches. You may or may not have a dressing put on the wound and it is important to keep the area dry for 24 hours. Stitches may be removed in 1-2 weeks. You may need to take a few days off work after the surgery.

Skin lesions can be divided into two groups:
  • benign (non-cancerous): e.g. moles, cysts, warts, tags. These may be removed to prevent spreading (warts), stop discomfort if the lesion is being irritated by clothing/jewellery or to improve appearance.
 
  • malignant (cancerous): basal cell and squamous cell carcinomas are generally slow growing and unlikely to spread to other parts of the body. Melanoma is a serious skin cancer that can spread to other parts of the body. Urgent removal is recommended.
 
Surgery to remove skin lesions usually involves an office or outpatient visit, local anaesthesia (the area around the scar is numbed by injecting a local anaesthetic) and stitches. You may or may not have a dressing put on the wound and it is important to keep the area dry for 24 hours. Stitches may be removed in 1-2 weeks. You may need to take a few days off work after the surgery.
Skin Grafting

If the scar to be revised or skin lesion being removed is particularly large, a skin graft may be performed. This involves transferring skin from another, healthy part of the body (donor site) to the injured site (recipient site). While skin grafting can improve the function of a damaged area, some scarring will be left at both the donor and recipient sites. Skin grafting is likely to be performed under general anaesthesia (you will be asleep during the procedure) in a hospital. The wound may take weeks or months to heal and you may need to wear a support bandage for a similar period.

If the scar to be revised or skin lesion being removed is particularly large, a skin graft may be performed. This involves transferring skin from another, healthy part of the body (donor site) to the injured site (recipient site). While skin grafting can improve the function of a damaged area, some scarring will be left at both the donor and recipient sites. Skin grafting is likely to be performed under general anaesthesia (you will be asleep during the procedure) in a hospital. The wound may take weeks or months to heal and you may need to wear a support bandage for a similar period.
Breast Lift

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. The surgery is performed under general anaesthesia (you will sleep through it) and will take about 2 hours. You will probably stay in hospital overnight and will need to arrange for someone else to drive you home the next day. Your breasts will be bruised and swollen for several days and you may need to take some medication for pain relief. You will need to wear a special support bra continuously for 3-4 weeks after surgery. You will probably be able to return to work after about 1 week. It will take several months for the scars to fade.

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. The surgery is performed under general anaesthesia (you will sleep through it) and will take about 2 hours. You will probably stay in hospital overnight and will need to arrange for someone else to drive you home the next day.
Your breasts will be bruised and swollen for several days and you may need to take some medication for pain relief. You will need to wear a special support bra continuously for 3-4 weeks after surgery. You will probably be able to return to work after about 1 week. It will take several months for the scars to fade.
Breast Reduction

Surgery to reduce breast size involves making a cut (incision) around the areola (the dark area around the nipple) straight downwards and along the crease beneath the breast. Glandular tissue, fat and skin are removed and the breast reshaped. The surgery is performed under general anaesthesia (you will sleep through it) and will take 2-4 hours. You will probably stay in hospital 1-2 nights and will need to arrange for someone else to drive you home. You may need to take some medication for pain relief for several days and you must wear a special support bra continuously for 2 weeks after surgery. You will probably be able to return to work after about 2 weeks. It will take several months for the scars to fade.

Surgery to reduce breast size involves making a cut (incision) around the areola (the dark area around the nipple) straight downwards and along the crease beneath the breast. Glandular tissue, fat and skin are removed and the breast reshaped. The surgery is performed under general anaesthesia (you will sleep through it) and will take 2-4 hours. You will probably stay in hospital 1-2 nights and will need to arrange for someone else to drive you home.
You may need to take some medication for pain relief for several days and you must wear a special support bra continuously for 2 weeks after surgery. You will probably be able to return to work after about 2 weeks. It will take several months for the scars to fade.
Tummy Tuck (Abdominoplasty)

This procedure involves removing excess skin and fat from the stomach and tightening the muscles of the stomach wall. Cuts (incisions) are made across the lower stomach and around the tummy button and the muscles underneath are pulled together and stitched. The skin flap is stretched down and the excess skin removed. A new hole is made and the tummy button replaced. The surgery is performed under general anaesthesia (you will sleep through it) and will take 3-4 hours. You will probably have to stay in hospital for 2 days and will need to arrange for someone else to drive you home. Your stomach will be swollen and painful at first and you may need to take medication for pain relief for several days. You will possibly have to wear a special support garment for 2-3 weeks after surgery. You will probably be able to return to work after about 2 weeks. It will take 9-12 months for the scar to lighten.

This procedure involves removing excess skin and fat from the stomach and tightening the muscles of the stomach wall. Cuts (incisions) are made across the lower stomach and around the tummy button and the muscles underneath are pulled together and stitched.  The skin flap is stretched down and the excess skin removed. A new hole is made and the tummy button replaced. The surgery is performed under general anaesthesia (you will sleep through it) and will take 3-4 hours. You will probably have to stay in hospital for 2 days and will need to arrange for someone else to drive you home.
Your stomach will be swollen and painful at first and you may need to take medication for pain relief for several days. You will possibly have to wear a special support garment for 2-3 weeks after surgery. You will probably be able to return to work after about 2 weeks. It will take 9-12 months for the scar to lighten.
Liposuction

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. Liposuction should not be regarded as a means of general weight loss, but instead as a way to improve the shape of particular areas of your body. 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. During the procedure you will lose a lot of fluid, so you will be given intravenous (injected straight into the vein) fluid to stop you becoming dehydrated. The procedure usually takes 1-3 hours and is carried out under local anaesthetic (the area being treated is numb but you are awake). You will probably be able to go home the same day but will need someone to drive you. However, if the procedure is more extensive and numerous areas are being treated at the same time, it may require general anaesthesia (you will sleep through it) and you may have to remain overnight in hospital. The area treated will be swollen and bruised after the surgery and you may need to take pain relief medication for several days. You will be given an elastic dressing or support garment that you may have to wear continuously for 2-3 weeks. You will probably be able to return to work after 1-2 weeks.

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. Liposuction should not be regarded as a means of general weight loss, but instead as a way to improve the shape of particular areas of your body.
 
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. During the procedure you will lose a lot of fluid, so you will be given intravenous (injected straight into the vein) fluid to stop you becoming dehydrated. The procedure usually takes 1-3 hours and is carried out under local anaesthetic (the area being treated is numb but you are awake). You will probably be able to go home the same day but will need someone to drive you. However, if the procedure is more extensive and numerous areas are being treated at the same time, it may require general anaesthesia (you will sleep through it) and you may have to remain overnight in hospital.
The area treated will be swollen and bruised after the surgery and you may need to take pain relief medication for several days. You will be given an elastic dressing or support garment that you may have to wear continuously for 2-3 weeks. You will probably be able to return to work after 1-2 weeks.
Eyelid Surgery (Blepharoplasty)

Excess skin and/or fat can be surgically removed from your upper and/or lower eyelids to give your skin a less wrinkled and puffy appearance. The procedure typically involves making a small cut (incision) in the fold of the eyelid (for the upper lid) or just below the eyelashes (for the lower lid) and removing any excess skin and/or fat. The surgery will take 1-3 hours and is performed under local anaesthetic (the area being treated is numb) together with a sedative to make you feel drowsy. You will be able to go home the same day. It is recommended that you have complete rest and keep eye pads on for a couple of days after surgery. You should be able to return to work within 1 week.

Excess skin and/or fat can be surgically removed from your upper and/or lower eyelids to give your skin a less wrinkled and puffy appearance.
The procedure typically involves making a small cut (incision) in the fold of the eyelid (for the upper lid) or just below the eyelashes (for the lower lid) and removing any excess skin and/or fat. The surgery will take 1-3 hours and is performed under local anaesthetic (the area being treated is numb) together with a sedative to make you feel drowsy. You will be able to go home the same day. It is recommended that you have complete rest and keep eye pads on for a couple of days after surgery. You should be able to return to work within 1 week.
Nose Surgery (Rhinoplasty)

Surgery can be carried out to improve the appearance of your nose e.g. straightening it if it’s crooked or increasing or decreasing its size. Small cuts (incisions) are made either on the inside or outside (in the creases) of the nose. Excess bone and/or cartilage is removed and the nose reshaped. The surgery takes about 2 hours and is performed under general anaesthetic (you sleep through it). You may be able to go home the same day or, in some cases, you may have to stay in hospital overnight. You will need to arrange for another person to drive you home. Your nose will be covered with a splint that you will have to wear for about 1 week. It will take about six weeks for the worst of the swelling to disappear.

Surgery can be carried out to improve the appearance of your nose e.g. straightening it if it’s crooked or increasing or decreasing its size.
Small cuts (incisions) are made either on the inside or outside (in the creases) of the nose. Excess bone and/or cartilage is removed and the nose reshaped. The surgery takes about 2 hours and is performed under general anaesthetic (you sleep through it). You may be able to go home the same day or, in some cases, you may have to stay in hospital overnight. You will need to arrange for another person to drive you home. Your nose will be covered with a splint that you will have to wear for about 1 week. It will take about six weeks for the worst of the swelling to disappear.
Ear Surgery (Otoplasty)

The appearance of ears that are misshaped or protruding (‘bat ears’) can be improved surgically. This type of operation is often carried out in children. Cuts (incisions) are made behind the ears through which the cartilage in the ear can be reshaped or removed. The surgery lasts 1-2 hours and can be performed under local anaesthetic (the area treated is numb but you are awake), allowing you to go home the same day. For children, the procedure would be performed under general anaesthetic (they sleep through it) and they will remain in hospital overnight. You will need to wear head bandages for about 1 week and will probably be able to return to normal daily routines after that.

The appearance of ears that are misshaped or protruding (‘bat ears’) can be improved surgically. This type of operation is often carried out in children.
Cuts (incisions) are made behind the ears through which the cartilage in the ear can be reshaped or removed. The surgery lasts 1-2 hours and can be performed under local anaesthetic (the area treated is numb but you are awake), allowing you to go home the same day. For children, the procedure would be performed under general anaesthetic (they sleep through it) and they will remain in hospital overnight. You will need to wear head bandages for about 1 week and will probably be able to return to normal daily routines after that.
Lip Enhancement

A surgical procedure can be performed to make your lips to appear fuller without having foreign material injected into them. In this procedure, small cuts (incisions) are made on the inside of the lip and the tissue is reshaped. The surgery takes about 1 hour for the upper or lower lip and it is performed under local anaesthetic (the area is numb but you are awake). It will probably take 1-2 weeks for the swelling to disappear.

A surgical procedure can be performed to make your lips to appear fuller without having foreign material injected into them.
In this procedure, small cuts (incisions) are made on the inside of the lip and the tissue is reshaped. The surgery takes about 1 hour for the upper or lower lip and it is performed under local anaesthetic (the area is numb but you are awake). It will probably take 1-2 weeks for the swelling to disappear.
Face Lift

A face lift can include several different procedures such as a neck lift and/or a brow lift, all designed to reduce lines and wrinkles and lift sagging skin. In a typical face lift, cuts (incisions) are made within the hairline in front of and around behind the ears. Tissue lying deep below the skin is repositioned, then the skin replaced and any excess is removed. The surgery varies in duration, but can take up to 4 or 6 hours if it is combined with other procedures. General anaesthesia (you sleep through the operation) is usually required, but in some cases you may be given a local anaesthetic and a sedative so the area being treated is numb and you feel drowsy but not asleep. In most cases, you will stay in hospital overnight following the procedure. It may take 2-3 weeks for the worst of the swelling to disappear and up to 1 year for the scars to fade.

A face lift can include several different procedures such as a neck lift and/or a brow lift, all designed to reduce lines and wrinkles and lift sagging skin.
In a typical face lift, cuts (incisions) are made within the hairline in front of and around behind the ears. Tissue lying deep below the skin is repositioned, then the skin replaced and any excess is removed. The surgery varies in duration, but can take up to 4 or 6 hours if it is combined with other procedures. General anaesthesia (you sleep through the operation) is usually required, but in some cases you may be given a local anaesthetic and a sedative so the area being treated is numb and you feel drowsy but not asleep. In most cases, you will stay in hospital overnight following the procedure. It may take 2-3 weeks for the worst of the swelling to disappear and up to 1 year for the scars to fade.
Facial Implants

Implants can be put into your chin, cheeks or jaw to improve or change 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. The length of the operation depends on the type of procedure but is typically 30-60 minutes. In most cases, you will probably receive a general anaesthetic (you will sleep through the procedure) and you will stay in hospital overnight. Your face will be swollen and bruised for several days after the surgery and you will probably need at least 1 week off work.

Implants can be put into your chin, cheeks or jaw to improve or change 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. The length of the operation depends on the type of procedure but is typically 30-60 minutes. In most cases, you will probably receive a general anaesthetic (you will sleep through the procedure) and you will stay in hospital overnight. Your face will be swollen and bruised for several days after the surgery and you will probably need at least 1 week off work.

Refreshments

Tea and coffee available at rooms.

Travel Directions

Rooms are situated in the Specialist Centre (North Shore Hospital end of Shakespeare Rd).

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Public Transport

The Auckland Transport website is a good resource to plan your public transport options.

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Parking

Off road parking available.

Pharmacy

Closest pharmacy at Shore Care Pharmacy Smales Farm Takapuna, or North Shore Hospital Pharmacy.

Contact Details

8:30 AM to 5:00 PM.

 

Specialist Centre
181 Shakespeare Rd
Milford
Auckland 0620

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Street Address

Specialist Centre
181 Shakespeare Rd
Milford
Auckland 0620

Postal Address

PO Box 331631
Takapuna
Auckland 0740

This page was last updated at 9:44AM on September 12, 2024. This information is reviewed and edited by Dr John de Waal - Plastic Surgery.