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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...

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...

How I Do It - Treatment of lower eyelid bulging: transconjunctival laser approach

Ageing related weakening of the inferior orbital septum and increase of orbital fat volume is considered to result in lower lid prominence. Attenuation of the septum allows the gradual herniation of one or more of the three intraorbital fat pads....

How I Do It - High-energy acne scar treatment with a fractional Q-switched Nd:YAG laser

Acne vulgaris is one of the most common skin diseases, affecting one out of two people in their lifetimes. About 80% of people between the ages of 11 and 30 suffer from acne, of which many will further experience some...

How I Do It - Non-ablative laser treatment of surgical and acne-induced scars

Scars tell stories of life – almost everyone has at least one. The disappearance of postoperative scars is important to many of our patients. This is particularly indicated for aesthetically dominant areas such as the face, neck and décolleté, but...

How I Do It - Er:YAG treatment for eyebrow tail elevation and upper eyelid rejuvenation

Following patient demand for eyebrow tail elevation inspired by the ‘Foxy eye’ trend, we have developed this protocol using the Fotona VectorLift technique with hyperstacking of Smooth Mode pulses, to produce a non-invasive enhancement of periocular aesthetics for patients who...

How I Do It - Non-surgical skin cancer treatment: topical photodynamic therapy

The incidence of skin cancer is rising exponentially in the UK; in particular non-melanoma skin cancer, yet the current statistical data surrounding exact figures is thought to be underestimated. Topical photodynamic therapy (PDT) provides a non-invasive, safe and efficacious modality...

Old dogs can learn new tricks: the use of an often overlooked treatment modality for pathologically fractured mandibles

Figure 1: Timeline detailing key events in the patient’s treatment. Whilst commonly affecting the feet, spine and hips in adults, osteomyelitis (OM) can also present to the oral and maxillofacial surgery (OMFS) clinic as pathology of the jaws. Case reports...

Botulinum toxin (BoNT) for depression: A review of the mechanism of action and its potential place as an adjuvant treatment

BoNT is becoming a recognised efficient treatment for depression, endorsed by several disciplines including psychiatry. Clare Amrani examines the potential mechanism of action and explores the appropriate place of BoNT in the therapeutic armamentarium for depression. How did BoNT become...

How I Do It - Scar treatment with sequential combination of short full beam and photo-acoustic fractional 1064nm QS laser

Wound healing takes place by two distinct mechanisms. The first involves cellular proliferation and migration resulting in regeneration. This occurs in the epidermis and leaves no scarring. The dermis is a collagen-rich connective tissue and when this is damaged the...

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...

Medico-legal forum (VASEP liposuction)

The PMFA Journal and Hamilton Fraser Cosmetic Insurance have teamed up to provide a series of articles that will give examples of claims that occur from different procedures. The case in question The patient underwent VASER to the abdomen and...