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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...

Melasma treatment – what have we achieved in 42 years?

Melasma is a hyperpigmentation disorder which has been the subject of intense research over the last 40 years. As yet no definitive therapeutic strategy has been demonstrated to eradicate it or to avoid relapse. The author provides an up to...

Introducing ReSurge Africa

I have just stepped down from the chairmanship of the charity ReSurge Africa. First of all a bit of background... This charity was founded in 1992 by JC Mustarde, a well known ophthalmic plastic surgeon, working at Canniesburn Plastic Surgery...

Bruxism: a practical guide to treatment with botulinum toxin type A

The aetiology of bruxism is outlined and referenced, giving a clear context to the reader. Recommended treatment options are listed, with a brief summary of the evidence concerning pharmaceutical options, oral appliances, splints, psychology and physiotherapy. The author discusses a...

Cellulite: does wearing compression hosiery work?

Cellulite affects a large proportion of women. Recently several companies have produced compression hosiery claiming to reduce the appearance of cellulite. One of the latest products are ‘Silver Wave’ stockings, made by Solidea, which claim to reduce cellulite using ‘patented...

Masculinisation of the male face – ‘power-face’ surgery

What do men want when seeking facial improvement? Authors from the world-renowned European Face Centre explore the modern approach to ‘power-face’ surgery. A growing number of men are seeking the ‘ideal face’ for physical and psycho-social reasons. Orthofacial surgery aims...

Preservation rhinoplasty

Hump reduction and osteotomies to close the open roof, or lowering the whole nasal dorsum? Charles East explains how preservation techniques can improve outcomes by maintaining the integral structures of the nose. What is preservation rhinoplasty? The origins of reduction...

Rediscovering the Lost Art of Endonasal Rhinoplasty

The invention of modern rhinoplasty by Joseph transformed our understanding of nasal anatomy and surgery. His endonasal technique soon spread from Europe to the USA and dominated the surgical culture of the 20th century. The excessive removal nasal support structures...

Lipoedema awareness – the current state of play

Why do we need awareness? Around 40% of women in the UK are overweight or obese. Yet, within that 40% statistic, is a sub-set of women for whom that is not the full story. They suffer from a condition called...

Risks of tracheostomy in head and neck cancer

Tracheostomy is an accepted surgical procedure that is one of the oldest ways of securing the airway. It is widely accepted to protect the airway after big cases of head and neck cancer and especially following free flap reconstruction. It...

Gross Negligence Manslaughter in Healthcare: The medico-legal dilemma (part 21) - Clinical practice guidelines and indictments

Because of liability issues there is a reluctance to make clinical practice guidelines (CPG) statutory requirements; that is to say, guidelines are ‘suggestions’, not ‘instructions’. And why is this important to this case?

The Challenge of Renaissance, not Reconstruction: the aftermath of an acid attack

What madness makes a human being perpetrate a crime that is so horrible, so evil that makes it a capital offense (in Bangladesh) even though the death involved is of a person who remains alive? The motivation behind an interpersonal...