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Immediate versus delayed post mastectomy breast reconstruction

The authors review and analyse the current literature comparing the psychosocial outcomes of immediate versus delayed post mastectomy breast reconstruction. Breast cancer is the most prevalent cancer in women and has a lifetime incidence of one in nine. Mastectomy may...

Classification and assessment of midfacial fractures: no more Le Fort facial fractures

There is some evidence that severe or complex midfacial or orbital fractures have declined over the last decade. Interestingly there is also evidence of an increase in road traffic accidents but a decrease in facial injuries. This is possibly attributed...

The scandal of NHS contracts with the independent healthcare sector

Since March 2020 it was sensible medical practice to consider making all possible beds in the NHS available to potentially admit ill patients with COVID-19. The expected admission rate was supposed to risk overwhelming the NHS, so independent sector facilities apparently volunteered and were then contracted to the NHS as priority, with full remuneration for their losses, and all private practitioners were effectively frozen out from seeing, admitting and operating on their own self pay patients.

Venomous snake bite leaves arm unusable: boy waits seven years for life-changing surgery

An 11-year-old boy from Sierra Leone can finally go to school and use his right arm again after his severely deformed limb was operated on by international health charity, Mercy Ships. Without the free surgery, Yusif’s right hand and arm...

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....

A new treatment for genitourinary syndrome of menopause

Genitourinary syndrome of menopause (GSM) [1] is defined as a collection of symptoms and signs mainly associated with the progressive decrease in oestrogen levels. The lack of hormones, usually produced by the ovaries in fertile age, may lead to genital...

Enhancing performance and wellbeing for surgeons: the science of life coaching

Life coaching has emerged as a powerful personal and professional development tool, particularly for individuals navigating high-stakes environments. Life coaching emphasises self-awareness, self-management and self-efficacy, including establishing desired outcomes, goal setting and developing skills and action plans to achieve them....

Extracutaneous Merkel cell carcinoma or metastatic Merkel cell carcinoma with an occult primary?

Merkel cell carcinoma (MCC) is a rare and aggressive malignancy arising from dermal neuroendocrine cells, first described by Toker in 1972 [1]. It is predominately seen in the head and neck region of older, white males and risk factors include...

Sushruta and Indian rhinoplasty

Vijay Pothula explains rhinoplasty’s roots in ancient Indian Ayurvedic medicine, and how it was introduced to the Western world. In 1794 The Gentleman’s Magazine published a surgical operation which was long established in India but unknown in Europe [1]. A...

Modern laser-assisted acne therapy in practice

Laser and light-based technologies have expanded the therapeutic arsenal for acne, and can improve the skin appearance of inflammatory acne and scarring in a short time, which increases patient compliance and satisfaction. Acne is an inflammatory dermatosis in which pathophysiological...

Gross Negligence Manslaughter in Healthcare: The medico-legal dilemma (part 2)

In Volume 1, Issue 1 of this journal I wrote an article entitled: ‘From PIP to DC-CIK to the Sorcerer’s Apprentice: a medico-political minefield’. Little did I know or anticipate what a mess this was going to become: a medico-legal mess with ignorant lawyers and arrogant doctors demonstrating how stupidity and rapacious hypocrisy can twist and distort reality for the purposes of extracting a bizarre social revenge with little sense of justice.

Chin augmentation: filler versus prosthesis

Over recent years, aesthetic medicine and aesthetic surgery have become closer and more combined in daily practice. There is also a gradual shift, with aesthetic doctors performing more invasive techniques, whereas plastic surgeons are also, whenever possible, moving to less...