Breast Reconstruction

A Conversation with Dr Michelle Locke

Plastic and Reconstructive Surgeon
MBChB, MD, FRACS (Plast)

On a sunny day in Auckland, I chatted with Dr Michelle Locke, renowned Plastic and Reconstruction Surgeon at St Marks Breast Centre, Remuera, and first female Head of Department (HoD) of the largest Plastic Surgery department in Australasia (Department of Plastic, Hand and Reconstructive Surgery, Middlemore Hospital).

Michelle has a hugely impressive CV, from her advanced qualifications (MD), leadership (HoD), mentoring activities (Wāhine Connect, Women in Surgery), academic appointment (University of Auckland), and everything in between. Unlike many with razor-sharp minds, Michelle is very empathetic, and she is committed to improving women’s lives.

When did you know you wanted to be a Breast Reconstruction Surgeon?

I was drawn to it during my Plastic Surgery rotation as a Junior Doctor. I could see what a difference it made to women’s quality of life after cancer and how it really helped them to heal psychologically. Specialist reconstruction was appealing because it is a personalised branch of surgery that involves problem solving and finding solutions that are specific to each patient.

What services do you offer at St Marks Breast Centre?

I focus solely on breast surgery in my private practice – both reconstructive and aesthetic. I’m really fortunate to work with two great Breast Cancer Surgeons at St Marks, so we offer the full spectrum from cancer diagnosis and treatment to the full range of specialist breast reconstruction options after breast cancer.

My favourite operation is the DIEP Flap. This involves microsurgery techniques to transfer the woman’s own tissue and blood vessels from the lower tummy to create her new breast. This procedure has really good outcomes for fit and active women because the core tummy muscles are left in place. Many women prefer it to implants, as it is all natural and has the added bonus of lasting for life.

How importance is your aesthetic surgery training to your reconstruction work?

Aesthetic considerations are critical. Breast reconstruction really needs to look good, and be a suitable size and shape match for the other breast. Many women don’t realise that it’s common to have surgery on the other breast too so that the breasts look more similar. Having a year of additional Fellowship training in both areas helps me give my patients the best possible outcomes.

How do you discuss reconstruction with new patients?

It’s really important to me that my patients feel comfortable and supported throughout the breast reconstruction process. When a woman is first referred to me, I will initially spend an hour with her, getting to know her, understanding her life and situation, and only then do we talk about options for breast reconstruction, so that together we can come up with the best solution for her. I’d encourage all women who’ve had a breast removed, no matter what age, to have a consultation with a Plastic Surgeon to find out about their options, even if they decide it’s not the right thing for them.

What is your proudest achievement professionally?

Late 2019, I was unexpectedly offered the HOD role in Plastic Surgery at Middlemore. I experienced imposter syndrome as many women do, but decided to challenge myself, accept the offer and have confidence in my abilities. Three months later, the Whakaari/White Island eruption happened and I helped lead the department’s response. My amazing team pulled together so well, and treated the patients with empathy and care over many months. It really is this teamwork, combined with the ability to improve people’s lives, that makes surgery so worthwhile.

What do you do in your leisure time (if you have any!)?

I and my two daughters (8 and 10) are all keen hockey players. My husband Mike is at home fulltime with the girls, and I couldn’t do my work without his unwavering support.