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Delayed improvement in Muller’s muscle ptosis surgery

This is a retrospective review of patients undergoing ptosis surgery. The authors had noticed anecdotally that although a posterior approach Muller’s muscle and conjunctival resection (MMCR) appeared to achieve similar results to an anterior approach levator resection (ALR) in the...

Lacrimal gland carcinoma outcomes

This is retrospective review of outcomes of lacrimal gland epithelial tumours treated between 1972 and 2014 at Moorfields Eye Hospital. Seventy-nine patients were reported, comprising 53 adenoid cystic carcinomas, 15 primary adenocarcinomas and 11 carcinomas ex-pleomorphic adenoma. The authors compare...

A suggested management pathway for rhinophyma and benign superficial skin lesions that includes the use of plasma

Rhinophyma is an aesthetic embarrassment to many people. It is the result of sebaceous gland hyperplasia within the skin over the alar cartilages of the nose. It has a familial tendency and in addition to being unsightly it can commonly...

Focus on Cosmeceuticals: Skin anatomy and photoageing

Skin anatomy The skin of the face provides crucial functions of temperature regulation, reparative functions following injury, facial expression, protective mechanisms against infection and ultraviolet radiation, as well as sensory perception. The integument consists of two principle layers, the epidermis...

How I Do It - Approaches to lip augmentation: surgical lip lift

A surgical lip lift is particularly effective in lips that require both an increase in vertical height and eversion. Upper lip lifts have been described since the 1980s [1,2] but the most commonly used form was described by Oscar Ramirez...

The importance of nitric oxide in medicine

The harmful effects exerted upon living and injured tissues by free radicals have been explored since the 1980s. Now in 2021 the free radical nitric oxide (NO) is not just a figment of imagination; it is known as one of...

How I Do It - Treatment of rheumatoid arthritis in the hand: addressing the cosmetic and functional deficit using joint replacements

In his work Orthopaedia Nicholas Andry was one of the first to define the ideal hand, in terms of ideal proportions and appearance [1]. Rheumatoid arthritis (RA) is a chronic, erosive inflammatory arthritis thought to affect approximately 1% of the...

Congenital ptosis and astigmatism

This is a review of the effect of congenital ptosis surgery on refractive error. Seventy-one eyes of 56 patients were reviewed. The unoperated eye in unilateral cases was used as the control group. The mean age at surgery was 5.1...

An epidemic of lower limb gunshot injuries

As the COVID-19 pandemic continues to impact upon us all, the author, a reconstructive plastic surgeon, provides a thought-provoking account of a different type of epidemic that is having devastating consequences. The Oxford English Dictionary defines an epidemic as “a...

The golden nose – reshaping the nose 100 years ago

Wolf Lűbbers (with the golden nose). Who with a crooked nose would not embrace the chance to go to bed in the evening wearing a surgical device and wake up the following morning with a straight one? And all this...

The arguments for polyurethane covered breast implants in cosmetic and reconstructive breast surgery

The surgeon’s viewpoint Medical grade silicone has been used for breast augmentation since the 1960s and is the preferred base material to use as the filler in breast implants. Cohesive gel silicone implants are now exclusively available in the UK....

Diced conchal cartilage with perichondrial attachment graft in rhinoplasty

This article shows the experience of a single surgeon with the use of diced conchal cartilage with perichondrial attachment in 37 consecutive patients. The graft was used to camouflage asymmetries on the lateral wall of the nose, for tip contouring...