Plastic & reconstructive surgery

About Dr James Finkemeyer

Dr James Finkemeyer is a Specialist Plastic and Reconstructive Surgeon who undertook his surgical training in Victoria, earning a Fellowship of the Royal Australasian College of Surgeons (FRACS) in 2018. Following qualification in Australia, he completed two international fellowships: a Microsurgical Fellowship at Oxford University Hospitals, and a Craniofacial Surgery and Rhinoplasty Fellowship at Vancouver General Hospital.

Dr Finkemeyer holds appointments at St Vincent's Hospital, The Royal Melbourne Hospital, and The Royal Women's Hospital. His practice encompasses a broad range of plastic surgery disciplines, combining the aesthetic and reconstructive principles of his training. He has a particular interest in skin cancer surgery, head and neck surgery, craniofacial surgery, and rhinoplasty. He has also established a Facial Palsy Multidisciplinary Team in collaboration with facial therapy and ENT specialists, which accepts referrals from across Australia.

What is reconstructive surgery in the context of dermatology?

When a skin cancer is surgically excised, the resulting defect, which is the area of skin and tissue removed with the cancer, must be closed in a way that achieves both complete clearance of the cancer and the best possible functional and cosmetic outcome. For small, straightforward excisions, direct closure by a dermatologist is appropriate. For larger defects, or defects in cosmetically sensitive locations such as the face, scalp, ears, or nose, specialist plastic surgical reconstruction achieves significantly better outcomes.

Reconstructive techniques used by Dr Finkemeyer at Skindepth include:

• Primary closure where appropriate, using careful tissue handling and suturing techniques to minimise scarring
• Local flap reconstruction, where adjacent tissue is rearranged to fill a defect while maintaining blood supply and optimising the cosmetic result
• Skin grafting, where a piece of skin is taken from a donor site elsewhere on the body and used to cover a defect
• Complex head and neck reconstruction, drawing on Dr Finkemeyer's specialist training in craniofacial and head and neck surgery
• Scar management, including laser and light-based treatments available through Skindepth to address any scarring that requires further attention following healing,

When is plastic and reconstructive surgery recommended?

Your dermatologist will discuss the most appropriate surgical approach at your initial consultation. Referral to Dr Finkemeyer is generally recommended in the following circumstances:

• Larger skin cancers requiring wide excision where direct closure would result in significant deformity or functional impairment
• Skin cancers in cosmetically sensitive or functionally important locations, including the face, nose, ears, eyelids, and scalp
• Melanoma excision requiring wide margins
• Cases where previous surgery has resulted in unsatisfactory scarring requiring revision
• Complex cases where the combination of dermatological expertise and plastic surgical skill provides the optimal outcome
• Patients who prefer to have more complex procedures performed under sedation, which can be facilitated by our team.

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