Electrical injuries comprise only a small fraction of burn injuries admitted to specialized centers. High voltage injuries may not be survivable. The flow of current through the body interferes with tissues conducting electricity on their own (nerves, heart) and expends its energy on tissues with highest resistance, the bones, causing high temperature damage from the […]
Correcting Crooked Noses and Faces
The correlation between structure and appearance is most straightforward when the skeleton is involved. Today’s case involved a young women after a motor vehicle accident more than a decade ago. The forehead was uneven, the brows in unequal position, old hardware palpable over the roof of the eye socket and the nose was crooked and […]
Cosmetic and Plastic Surgery Abroad for the Medical Tourist
I would like to look at the medical tourist more as a discerning costumer in an ever shrinking world where all of us are moving closer and closer together and our lives become intertwined in a real-time environment. “Abroad” is also a very relative term. Some of my patients in my US practice come from […]
What is cosmetic surgery, what is reconstructive surgery, what is everything in between ?
All too often a difference is made between reconstructive and cosmetic surgery, most often to elevate the status of reconstructive surgery and lower the one of cosmetic surgery. I am a cosmetic surgeon and I do complex reconstrucive surgery. So I never could understand how someone could come up with something so artificial, neither based […]
Six Packs and the Male Abdominal Wall
A not infrequent request by male clients is the “six pack” stomach and if there is a cosmetic procedure to enhance/produce it. The look of a “six pack” stomach is created by a very well trained midline muscle group – two about 10cm wide muscles on each side of the midline running from the chest […]
Difficult Wrists
During my hand fellowship I once asked my program director Al Hess MD why he had become a hand surgeon after completing his training in orthopaedic surgery. His answer was “In the other stuff I had become so perfect that it was boring”. Wrist surgery is a prime example why hand surgery is never boring, […]
Fronto-orbital advancement for correction of craniosynostosis
Numerous craniofacial deformities are characterized by orbital dystopia and anterior skull base deformities. Examples are Crouzon’s syndrome, Apert’s syndrome, coronal and metopic craniosynostosis. Two concepts developed by Paul Tessier (the father of craniofacial surgery) in the 1960’s are crucial to the understanding of the correction of these deformities. Firstly, the superficial skeleton of the eyesocket […]
A Cleft Pastiche
Aesthetic Craniomaxillofacial Surgery of the Midface
The techniques of skeletal surgery of the midface were originally developed to treat problems related to congenital and posttraumatic deformities affecting the occlusion. Occlusion – the way the upper and lower teeth come together – is determined by the position of the tooth bearing arches of the upper and lower jaws relative to each other. […]
Cleft Lip and Palate – Yardsticks for Perfection
Cleft lip and palate implies an often 20+ years rehabilitation process for the affected individual starting a few days after birth. The reward of this multistage, interdisciplinary process can be a near normal appearance. The luxury of this treatment in a global perspective is restricted to a privileged few in highly affluent countries. Children born […]