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MD/PhDs or MD/MBAs: which do we need more to innovate in plastic surgery?

I would like to thank Arlen Meyers and Victor Castro for submitting this article. One of the problems that I have seen in my professional lifetime is the failure of entrepreneurs to grasp that there is no infinite health care...

Adherence in Dermatology

Dermatology is a medical specialty in which successful patient outcomes are often dependent on strict adherence to treatment protocols. This may be difficult for some patients to achieve. Adherence in Dermatology by Scott A Davis addresses the issue of patient...

Submandibular haematoma with airway obstruction following a warfarin overdose

Submental and submandibular abscesses are frequent in oral and maxillofacial surgery; on the other hand submandibular haematomas are uncommon. However, we encountered a submandibular haematoma, initially masked as a Ludwig’s angina, which was compromising the airway of a warfarinised patient...

OPINION - Who should decide the qualification to do cosmetic surgery?

In my opinion – certainly not the Royal College of Surgeons of England (RCS), if the new requirements in their Cosmetic Surgery Certification Scheme are read correctly, because self-certification without a formal training assessment and formal examination is meaningless. The...

How I Do It - Surgical tear trough treatment and periorbital procedures

It is very helpful to use the patient’s old photographs as a guide to addressing the bothersome changes that have occurred in order to plan an approach that maintains an individual’s natural appearance. Periorbital rejuvenation should be considered in the...

Modified reversed superficial peroneal artery flap in reconstruction of ankle and foot defects following severe burns

Deep burns involving the foot and ankle represent a significant reconstructive challenge. This paper serves as a clinical review of the modified reversed superficial artery flap. The authors describe key anatomy, surgical steps and clinical outcomes in a small series....

Melasma treatment – what have we achieved in 42 years?

Melasma is a hyperpigmentation disorder which has been the subject of intense research over the last 40 years. As yet no definitive therapeutic strategy has been demonstrated to eradicate it or to avoid relapse. The author provides an up to...

Management of keloid and hypertrophic scars

The management of keloid and hypertrophic scars is commonplace in all burns and plastic surgery outpatient clinics, and in this paper the authors review many of the current treatments available for this difficult problem. They start with an introduction about...

Medical racism and the surgical ‘correction’ of the nose in Brazil

Anthropologist Professor Carmen Alvaro Jarrín has conducted extensive research into plastic surgery practice in Brazil. Here, she explains why social and cultural ideas about race may shape rhinoplasty objectives for patients and surgeons in the country. Health professionals worldwide are...

Airway first in patients with facial trauma

Anyone that has ever been on an advanced trauma life support (ATLS) or indeed any other trauma course will be well indoctrinated with the principles of airways, breathing and circulation (ABC). Securing the airway is of paramount importance; but what...

Skin grafts vs local flaps in reconstruction of nasal defects

Nasal defects commonly are a result of removal of skin lesions. Cosmetic outcomes of local flap reconstructions are commonly accepted to be superior in comparison to skin grafts. However, local flap reconstructions require more adjunctive procedures than single-stage operations based...

Diagnosis and management of orbital vascular malformations

This is an authoritative review of a controversial and difficult clinical area. The authors have experience of over 350 cases and provide a well-structured review of the classification and management of orbital vascular malformations. They emphasise the need to understand...