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, […]
PIP Implants – Removal or Exchange after Breast Augmentation
So Pandora’s box was finally opened. The eventual worldwide recall of French Polyimplant Prothese (PIP) silicone breast implants puts a final exclamation mark behind what everybody knows but hates to admit – cheap is bad, to be cheap you have to cut corners to cut costs and cutting corners – such as using industrial instead […]
A Cleft Pastiche
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 […]
Writing for the gallery
It has been said that it is the secret dream of any surgeon to leave this world with his or her name attached to at least one instrument. This is what makes craniofacial surgery real fun as Paul Tessier had his name attached to almost all instruments on an average craniofacial surgery instrument tray. So […]
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 […]
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. […]
The Culture of Aesthetic Surgery
It is entirely personal. The motivation to seek enhancement of physical appearance (e. g. shape) or rejuvenation (e. g. the reconstruction of a youthful shape) should come from within the individual person. The individual perceives some aspect of his/her shape, which in their totality makes up his or her appearance, as a problem in a […]
Specialist Treatment of Burn Injuries
The special expertise and training necessary to treat burn injuries is not widely available. Completion of a one year fellowship training in this area, as the lead surgeon of Trinidad Institute of Plastic Surgery has done 2001-2002 at the Tampa Bay Regional Burn Center, University of South Florida, is certainly desirable before embarking on the […]
Electrical Injuries – The “Great Masquerader” in Burn Surgery
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 […]