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Reconstruction paediatric lower facial defects with an expanded flap from the submental region

Lower facial and perioral scars from burns or defects following treatment of vascular lesions can lead to serious facial deformity with lip ectropion and asymmetry. Conventional reconstructive methods like skin grafts or free flaps do not always give a satisfactory...

Malar mounds and festoons

Periorbital rejuvenation and blepharoplasty, in particular, are very common procedures nowadays in aesthetic practice. More than 153,000 blepharoplasty procedures were peformed in the USA during 2012. Blepharoplasty can sometimes be a very challenging surgery, especially if the patient presents with...

Managing photodamage

The authors explore components of skin ageing, discussing extrinsic as well as intrinsic factors, with the focus upon the process of photoageing. The anatomy of the epidermis is discussed, supported by diagrams, in relation to extrinsic factors inducing photodamage, in...

Management of the thick skinned nose

The authors briefly present a surgical pearl that helps addressing the overly thick nasal skin envelope in cosmetic rhinoplasty. In order to optimise cosmetic results in thick-skinned noses, contour enhancement is best achieved by elongating and projecting the skeletal framework...

How long should you wait for your adrenaline to work?

The authors present a prospective, randomised, triple-blind study to see how long it really takes to obtain the lowest cutaneous haemoglobin concentration after lignocaine with adrenaline injection. Twelve healthy volunteers were injected simultaneously in each arm with either plain 1%...

Sliding lower lid tarsal flap

This is a retrospective review of a lower lid reconstructive technique utilising a sliding tarsal flap. Thirty-two patients who had undergone Mohs surgery were included and each had a shallow marginal defect with at least one remaining tarsal edge having...