Waiting time for Mohs Micrographic Surgery and the associated increase in lesion size of basal cell carcinoma.

Background: The first-line treatment for basal cell carcinoma (BCC) involved either surgical excision (SE) or Mohs micrographic surgery (MMS). The current waiting time for MMS and whether this is associated with worsening of outcome is unknown. We aim to look at the waiting time for MMS upon review at the Outpatient Specialist Dermatology Clinic and the increase in lesion size during this time period.

Fat Hypertrophy as a Complication of Fat Transfer for Hemifacial Atrophy.

Fat hypertrophy is a less commonly known complication of autologous fat transfer. We present a 32-year-old female with left hemifacial atrophy associated with systemic sclerosis, who was treated with 7 fat transfer procedures to correct the facial asymmetry. A total of 236.

Facilitating shared decision-making with breast augmentation patients: Acceptability of the PEGASUS intervention.

Background: PEGASUS is an intervention to facilitate shared decision-making by helping prospective patients consider their expectations of surgery, so that surgeons have a clear understanding of their individual goals. To date, shared decision-making interventions within aesthetic surgery are lacking. The present mixed methods study therefore explored the acceptability of implementing PEGASUS into routine private practice with breast augmentation patients and aesthetic providers.

A model for structuring the donor discussion in emergent transplant procedures.

Objective: To investigate the potential for maximizing organ and tissue donation by identifying an empirical basis for structuring donor discussions.

Design: Intentions to donate organs and tissues were recorded in 2 separate samples of participants and analyzed separately by using Guttman scaling, the second sample providing a replication of the findings from the first.

Participants: 304 participants were recruited from the Royal Society Summer Science Exhibition 2004, and 200 health professionals were recruited from the Royal Free Hospital.

Does severity predict distress? The relationship between subjective and objective measures of appearance and psychological adjustment, during treatment for facial lipoatrophy.

The intuitive or lay belief that the severity of a disfiguring condition predicts psychological distress is not demonstrated in clinical practice, nor in research studies. This within group study used standardised measures repeated at six month intervals, to investigate the relationship between subjective and objective measures of appearance and psychological adjustment in 51 patients undergoing treatment for facial lipoatrophy using a synthetic filler, Newfill. Results demonstrate a dissociation between objective and subjective measures with only subjective assessment predicting psychological outcomes.

Vertical rectus abdominis flap reconstruction in patients with advanced penile squamous cell carcinoma.

Objectives: To evaluate the role of radical surgical debridement and excision with a vertical rectus abdominis myocutaneous (VRAM) flap reconstruction in patients with advanced penile cancer and subcutaneous metastatic disease, as the quality of life in such patients is extremely poor, multimodal treatments often fail and the outlook for the patient is limited with the development of uncontrollable disease.

Patients And Methods: Four patients with advanced penile cancer presenting with fungating, cutaneous tumour deposits received palliative surgical resections for abdominal and inguinal disease. A VRAM flap was used in all cases to achieve tissue coverage.

Attitudes to face transplantation: results of a public engagement exercise at the Royal Society Summer Science Exhibition.

Hettiaratchy and Butler (Lancet 2002;360:5-6) framed face transplantation as the next logical step on the reconstructive ladder for severe facial injury, in particular, pan-facial burns. The procedure formed the basis for a Royal College of Surgeons of England working party report. Ethical, surgical, and psychological issues were identified as research priorities before face transplantation is attempted in the United Kingdom.

Forehead flap method for total nasal reconstruction.

One of the very first recorded methods developed over the ages to correct the mutilating deformity of rhinectomy was the forehead flap. While many other techniques have also been devised, this surgical method has stood the test of time better than any other. Further refined during the 20th century, it has now become the gold standard for obtaining the best results in nasal reconstruction.

Facial atrophy in HIV-related fat redistribution syndrome: a plastic surgical perspective on treatment options and a look to the future.

Approximately 50% of patients on highly active antiretroviral therapy (HAART) develop lipodystrophy with central and visceral fat accumulation and/or facial and limb atrophy. Although the exact mechanisms of this are not fully understood, the facial atrophy encountered is secondary to atrophy of the subcutaneous fat, and not the deeper fat pads, as has been suggested. More recently, the above features in combination with hyperlipidaemia and insulin resistance have been described and are referred to as HIV-related fat redistribution syndrome.

Variations in clinical audit collection: a survey of plastic surgery units across the British Isles.

Introduction: Clinical audit is a requirement of good medical and surgical practice and is central to the UK Government's plans to modernise the NHS.

Materials And Methods: A survey was conducted to assess clinical audit data collection and collation within plastic surgery departments across the UK. The survey identified a variety of different data collection and collation methods, with extensive differences between plastic surgery departments.

Severe gynecomastia in an African boy with perinatally acquired human immunodeficiency virus infection receiving highly active antiretroviral therapy.

Highly active antiretroviral therapy (HAART) slows the progression of human immunodeficiency virus (HIV) disease and lowers mortality and morbidity in children. Coincident with these advances, an increasing number of side effects are being reported. We describe an adolescent boy with perinatally acquired HIV infection who developed significant bilateral breast enlargement as a result of HAART.

Smoking and wound healing problems in reduction mammaplasty: is the introduction of urine nicotine testing justified?

We sought to prove a significant relationship between cigarette smoking and wound healing problems in reduction mammaplasty patients, to show the effect of stopping smoking before the procedure, and to justify the implementation of urine nicotine testing preoperatively. One hundred and seventy-three consecutive patients aged 16 to 67 years underwent bilateral reduction mammaplasty in our institution over 26 months. Patients were advised to stop smoking at least 4 weeks prior to surgery.