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The medial gastrocnemius flap

This classic muscle flap is now being used with increasing frequency following revision knee joint surgery. Following the Nahai and Mathes classification, the gastrocnemius muscle is a Type I muscle with a single dominant vascular pedicle (Figure 1). The gastrocnemius...

How I Do It - Dorsal hand rejuvenation with dermal fillers: anatomical knowledge is essential

A youthful dorsal hand is characterised by a supple, smooth skin texture and contour, with minimal prominence of the dorsal veins. Over time, extrinsic (e.g. sun damage and smoking) and intrinsic (bone remodelling and soft tissue volume changes owing to...

Converse scalping flap for nasal reconstruction procedures

Case report This 78-year-old gentleman underwent excision of basal cell carcinoma overlying the left alar, nasal tip and nasal dorsum. The Converse scalping flap was raised and used to cover the defect. Non-adherent dressing was applied to provide temporary cover...

We need to talk about amputation – a difficult conversation in the developing world

What do you do when a patient refuses amputation? The author shares various cases and outlines her team’s approach to this scenario in Gaza. What to do when a patient refuses amputation for a severely damaged lower limb that will...

Raising the bar for safer cosmetic surgery in the UK – part 1

In part one of a two-series article Professor James Frame, from the Anglia Ruskin University, gives us his opinion on what needs to be done to improve cosmetic surgery and patient safety in the UK. Cosmetic surgery is most easily...

Reconstruction of complex wounds in the trunk and pelvis (part 2)

In this second part of this two-part article we begin by looking at component separation which is a technique of reconfiguring anatomical layers to allow intrinsic reconstruction of the integrity of the anterior abdominal wall. We then move into the...

Combined procedures: lipo-abdominoplasty and lipo-inner thighplasty (string technique) and face rejuvenation

From liposuction to adipose stem cells; from regenerative medicine to tissue engineering; and a vision of the future. Part 2 With the evolution of superficial suction lipectomy in the 1990’s the need for skin resection became less common and the...

The patient journey in DIEP flap breast reconstruction

In the UK approximately 40,000 women are diagnosed with breast cancer every year. About 40% of these need, or choose, to undergo mastectomy, where all of the breast tissue is removed. Currently around a third of these patients choose to...

The three stages of breast reconstruction

Breast cancer has become so common that most people reading this article will know someone (either professionally or personally) who has been affected by breast cancer. One of the most common treatments for breast cancer is removal of the ‘whole’...