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  • 1. NEWSLETTER ASSOCIATION OF PLASTIC SURGEONS OF INDIA – U.P.CHAPTER MAY, 2007 VOL 2/07EDITORIALHAIR LOSS AND ITS RESTORATION nails and the outer layer of our skin. Each strand of hair consists of three layers:H air loss, one of the most distressing aesthetic • Innermost core known as medulla found problem inflicting predominantly the males only in mature thick hair but also the females can occur due to • The middle layer or the cortex, the mainphysiological, psychological, genetic or a combination body of the hair which besides providingof all these reasons. People have been in search of the colour and texture; provides strengthprescriptions for hair loss restoration since the dawn to hairof civilization. The very first known hair loss • The outermost color less layer or cuticle,restoration formula was written in the Elbers Papyrus the main function of which is to protectsof ancient Egypt! the cortex.History The root of hair is enclosed within a hair follicle. TheThe history of hair restoration surgery dates back to hair follicle is a separate entity within the skin whichthe late 1930s with most of the initial work in the is formed and maintained through the interaction ofdirection of hair restoration surgery done in Japan, as dermal and epidermal components. Each hair folliclenoted by the distinguished hair transplant surgeon has an Outer Root Sheath (ORS) which is distinctDomnic Brandy. A Japanese dermatologist named from other epidermal components of the hair follicleOkuda performed the first true hair restoration surgery in being continuous with the epidermis. At the base ofby the use of small auto-grafts of hair bearing skin for the follicle, there is a pear shaped structure known asthe hair loss restoration of scalp, eyebrows and the dermal papilla (DP). DP is the precursor of a hairmustache areas in 1939. In 1943, Tamura published an follicle. DP cells interact with adult epidermis toarticle on the use of hair restoration surgery for the induce the development of new hair follicles throughreconstruction of the female pubic area in Japan. the process of division, elongation and differentiation.Fujita in Japan used a similar technique to bring about The dermal papilla is connected to the bloodthe hair loss restoration of scars, eyebrows, eyelash capillaries to derive nourishment for emergence ofdefects, and pubic areas in 1953. However, because of new hair.the Second World War, the contribution of Japanese The hair follicle together with the sebaceous glandsdermatologists and surgeons (which were in Japanese) and sheaths is a complete histological andthe development of hair transplant techniques was not physiological unit.recognized until many years later. Physiology of HairIn 1959, New York dermatologist Norman Orentreich Under normal circumstances hair growth in each hairreported that hair-bearing scalp (auto-grafts) could be follicle follows a well structured cycle. There are threesuccessfully transplanted from the back of the head to main phases of the hair growth cycle:the balding front and top. The success of these 1) Anagen - Growth Phasepioneering efforts of hair restoration surgeries led to 2) Catagen - Transitional phasethe conceptualization of the theory of donor 3) Telogen - Resting Phasedominance and opened the gates for a new discipline Anagan: It is the growth phase during which the hairSurgical Hair Restoration’ in the Western world. is actively growing. The growth phase for scalp hair isAnatomy of Hair about 2-6 years, and of total hair about 85% hair are inA normal adult has about 5 million hairs out of which this phase at any given time.1, 00, 000 are present on the scalp. Hair provides a Catagen: After the Anagen phase, the hairs enter into aprotective covering to the skin and helps in heat Catagen phase which lasts about 30 to 60 days. Duringtrapping. A hair is basically composed of a structural this phase the dermal papilla condenses and cells ofprotein called keratin which is also a constituent of our
  • 2. the follicle stop growing. During this phase a follicle worldwide.shrinks to about 1/6 its normal length. Minoxidil is thought to have a direct mitogenic effectTelogen: At this phase the dermal papilla becomes on epidermal cells, as has been observed both in vitroisolated in the dermal area and the hair still lies in the in vivo. Though the mechanism of its action forfollicle but can be easily pulled out by combing or causing cell proliferation is not very clear, minoxidil isbrushing. This is the normal hair loss. And if the old thought to prevent intracellular calcium entry.fiber has not already fallen out, it is pushed out by the Calcium normally enhances epidermal growth factorsnew hair fiber growing underneath. This phase lasts to inhibit hair growth, and Minoxidil by gettingfor about 2 to 3 weeks and of the total number of converted to minoxidil sulfate acts as a potassiumhairs, around 10-15% is in this phase at any given channel agonist and enhances potassium iontime. permeability to prevent calcium ions from enteringBiology of Hair Loss into cells.The dermal papilla is the most important structure in a It brings about an increase in density which is mostlyhair follicle which is responsible for hair-growth as caused by conversion of miniaturized hairs intowell as hair loss. The dermal papilla contains receptors terminal hairs rather than a stimulated de novo re-for male hormones called as androgens. Androgens growth. The hair loss becomes stabilized afterplay a major role in regulating hair-growth. Males continued use of drug, which takes about a year’s timehave more androgenic receptors in their follicles as for the medical hair restoration treatment to show itscompared to females and it is the metabolism of complete results.androgens which is main cause of hair loss both in Hair loss restoration treatment with 0.05%men and women. betamethasone dipropionate and 5% topical minoxidilThe metabolism of androgen involves an enzyme are found to be superior to minoxidil alone.called 5 alpha reductase which combines with the 1 ml (25 drops) of minoxidil solution must be usedhormone (testosterone) to form the DHT (Dihydro- twice daily, every day in order to be effective. Thetestosterone). DHT is a natural metabolite of our body. drops must be applied directly onto a dry scalp andProper nutrition is critical for the maintenance of the then slightly spread with the fingers. Topicalhair. When DHT gets into the hair follicles and roots minoxidil is very well tolerated and adverse effects are(dermal papilla), it prevents necessary proteins, mainly dermatologic. The most frequent adverse effectvitamins and minerals from providing nourishment is an irritant contact dermatitis.needed to sustain life in the hairs of those follicles. Facial hypertrichosis is seen in 3 to 5% of women butConsequently, hair follicles are reproduced at a much never seen in men. It affects mostly the forehead andslower rate. This shortens their growing stage (anagen sides of the face. This Hypertrichosis is absolutelyphase) and or lengthens their resting stage (telogen reversible; it disappears after the discontinuation ofphase) of the follicle. DHT also causes hair follicle to the drug. Though minnoxidil does not have any effectshrink and get progressively smaller and finer. This on blood pressure, it should be used with caution inprocess is known as miniaturization and causes the patient with cardiovascular diseases. It is alsohair to ultimately fall. DHT is responsible for 95% of contraindicated in pregnant and nursing mothers.hair loss. The drug finasteride was earlier used as treatment forSome individuals both men and women are genetically prostate enlargement, and can be used for the Medicalpre-disposed to produce more DHT than the normal hair loss restoration in MPHL. Finasteride dependsindividuals. DHT also creates a wax-like substance upon its specific action as an inhibitor of type II 5α-around the hair roots. It is this accumulation of DHT reductase, the intracellular enzyme that converts maleinside the hair follicles and roots which is one of the hormone androgen into DHT (Dihydro Testosterone).primary causes of male and female pattern hair loss. Its action results in significant decrease in serum andBlocking the synthesis of DHT at molecular level tissue DHT levels in even in concentration as low asforms the basis for the medical treatment of MPHL 0.2mg. Finasteride is able to stabilize hair loss in 80%(male pattern hair loss) and FPHL (female pattern hair of patient with Vertex hair loss and in 70% of patientsloss). with frontal hair loss. Most of these patients are ableMedical Hair Restoration: to grow more hair or retain the ones they have and itsMinoxidil and Finasteride are two drugs which have effect is more pronounced in crown area than in thebeen used with reasonable degree of success in front. The hair that grow after the medical hairpatients with hair loss. Minoxidil was used earlier as restoration treatments are better in texture and arean oral antihypertensive drug, but after its thicker, more like the terminal hair.hypertrichosis (excessive body hair) effects were Sexual dysfunction (decreased sex drive, erectilenoticed, a topical solution of the drug was tested for its dysfunction, and decreased semen volume) arehair growing potential. Minoxidil was then approved observed in about 3.8% of cases. But these side-as medical hair restoration treatment drug for men by effects subside within few months of Medical hairthe US Food and Drug Administration (FDA) in 1988 restoration treatments or disappear within a week’sas a 2% solution, followed by 5% solution in 1997. time as soon as the treatment is stopped.For women, the 2% solution was approved in 1991. Surgical Hair RestorationThough 5% solution is not approved for women, it is Surgical hair restoration as a process has progressivelyused as a medical hair restoration treatment by many evolved to give its patients more aesthetically pleasing 2
  • 3. results. It has given higher satisfaction rates for people through faulty design of the hair line with nowho made a well-informed decision to go for the consideration for the direction of the hair growth.surgical hair restoration. The principle of Surgical The micro-grafts and mini-grafts and follicular unitsHair Restoration is that if the hair follicles are used for hair transplant repair have lower metabolicharvested from the "permanent zone" of the scalp and requirements due to their small size and are able toare transplanted into to the balding areas, they retain grow in areas of fibrosis and burn scars and over skinthe hair characteristics of the donor area to dominate grafts and flaps, including split-thickness skin grafts.over the character of hair follicles in the recipient The survival rate and the hair growth of these(bald area), which are otherwise programmed for the follicular units are excellent. The hair transplant repairgreatest amount of hair loss. with follicular unit grafts can often be performed in aThe 3-4mm (millimeter) round plug grafts used in the single mega-session using 1000-1500 units.initial years of hair restoration surgery, were thought Subsequent small-sessions may occasionally beto be optimal size grafts in terms of density (hairs per required to make for a more aesthetically natural looksquare mm) and also in terms of blood flow and increase hair density.(nourishment) to the tissues of the graft. These circular The showing of scars, patches and unnatural hair lines12 to 20 hair-grafts (also known as quarter grafts) are the most detectable deformities that result fromprovided a high density to the recipient (balding) area un-planned, additional surgical hair restorationinitially. But they were difficult to maintain because of procedures.problems in re-establishing the blood flow to them, Other Hair Restoration Surgeries:especially toward the center of the grafts. Eventually, Scalp flaps: This technique involves the moving ofthe hair follicles in the very center of the graft would tissue from one area of the scalp to another, a pedicledoften die to give an appearance of a hole without hair flap from the hair bearing temple is moved forward toin the middle. As the graft healed and the scar the bald frontal hairline.contracted, it gave a very typical look to the bald Scalp reduction: A technique where baldness isscalp, which came to known as dolls hair or tooth reduced by excising a segment of bald scalp skin.brush appearance. Even otherwise, the unnatural hair Both of the above mentioned techniques can be usedlines and unnatural direction of the hair growth gave a with or without scalp tissue expansion but arevery obvious look to the people who had undergone successful only in certain selected patients with thehair restoration surgery. ideal hair and scalp characteristics, who were of theBut innovations in hair transplant surgery soon optimal age, and were highly motivated. But problemsovercame these initial problems by using smaller size of stretching (stretch-back) and pulling of the scalpmini-and micro-grafts. However, all the recent and due scalp reduction in some of the patients, ormost developed hair restoration techniques are based visibility of the scars due to scalp flap surgicalon follicular hair transplant which is the state-of-art techniques in many of the patients, led to the neartechnique that has helped surgeons to perform superior abandonment of these techniqueshair restoration and give their patients more natural Besides scalp baldness surgical hair restoration has(undetectable) and esthetically pleasing results. None great potential for hair loss restoration in facial andof these grafts consist of more than 4 hair follicles, scalp reconstruction cases. It is of help to regain hairsingle hair follicles being used in the frontal hair line lost as a result of post-surgical scarring, toin 3 to 4 rows followed by rows of double hair follicle camouflage scars from flap procedures or scalpand the larger ones are interspersed in the vertex. It reductions, to restore scalp and facial hair lost as resultrequires a great deal of future planning with due of burns or traumatic injuries, in congenital causes,consideration for the patients hair density, hair such as complete bilateral cleft lips (no mustache haircharacteristics (colour, curl, caliber), age, degree and in the pro-labium) and triangular alopecia, eyebrowtype of hair loss, previous procedures, potential for and beard irregularity, or to remove congenital nevi or"shock loss" (telogen effluvium), and of course, the arteriovenous malformations and to restore hair lostbudget. after oncologic resections (resection of melanoma andThe natural hair line is of utmost importance for the other skin malignancies). Surgical hair restoration islook of a person and always has indistinct and variable of immense significance to mankind not only becauseexistence. A truly natural hair line is never an abrupt, of its cosmetic and aesthetic values, but also due to theextremely dense, or regular. A natural hair line should positive outcomes that hair restoration surgery has onconsist of a very thin line of single hairs to serve as a the general and psychological well-being of the"transition zone" between the hairless forehead and person.the hair-covered scalp. The transplanted hair follicles Whatever the motive, the decision to undertake hairmay be distributed slightly unevenly to mimic a restoration surgery should be an educated one beforenatural hair line, but not so unevenly as to look any desperate patient becomes an easy game for theabnormal. Making a hair line look natural requires a unscrupulous and amateur hair restoration surgeonsurgeon with considerable experience and aesthetic playing on fears and panic of his patients foreye. Hair transplantation is not just a surgical immediate financial gain. This can lead to wastedprocedure, it is also and art form. An unnatural hair money and at worst, cosmetically tragic consequencesline may be the result of using larger sized grafts or for the patient. One must always remember that for a patient agreeing to the hair restoration surgery without 3
  • 4. being adequately informed, it is like a long story, providing a focus in artery disease and stroke research.which slowly unfolds with unpredictable moments of In recent years the Institute’s clinical research hassurprises, joys or sorrows! attracted a significant amount of national andVIEWS international media attention, including the face replantation of a 28-year-old woman whose skull had been “de-gloved”. The recent growing of beating heart tissue in the laboratory was announced in June to worldWHAT IS RECENT IN BOBIM acclaim. Significant though they are, these are just two examples that demonstrate the highly advancedThe Bernard OBrien Institute of Microsurgery expertise, and dedication of our current and past(BOBIM) has led the way in clinical and experimental scientists and surgeons at the Institute.research over the past 30 years. The Institute has made One of the most exciting current projects involvesstriking advances in the delicate craft of replantation inducing the body to regenerate a part that is missing -surgery and the transfer by microsurgical techniques of Organogenesis. Injecting natural growth proteins willbody parts and tissue to reconstruct people maimed by eventually enable people to grow a breast, ear, joint,trauma, cancer, burns and congenital deformity nose, finger or bone. This exciting new breakthroughIn addition to pioneering techniques in reconstructive involves the creation of new tissue growth in amicrosurgery, the Institute carries out internationally chamber within the body. Outstanding success inrecognized scientific research in the fields of Tissue growing three dimensional structures, such as breastEngineering and Vascular Biology. They also carry out tissue, with their own mature, well established bloodstudies on wound healing, nerve regeneration, supply has recently been developed at the Institute.inflammation, pain, the effects of trauma on tissue, and issue Engineering could well mean the end of organmore recently, prostate cancer. The training offered at transplants, and the sometimes painful reliance onthe BOBIM has an international reputation for organ donors, with surgeons predicting that they willexcellence. The Institute is the worlds largest centre be able to grow organs such as liver and pancreasfor microsurgery training. Research Fellows from within 10 years. This breakthrough has not previouslyoverseas and Australia form the backbone of our been achieved by other researchers who are limited totraining program. Since 1970, more than 200 surgeons two dimensional constructions, such as skin, made infrom over 30 countries including India have been the laboratory. BOBIMs Tissue Engineeringtrained in the principles of reconstructive microsurgery breakthrough hinges on the creation "in vivo", in anat BOBIM and have been involved in ground breaking animal, of new organs which have their own intrinsicresearch projects. blood supply and which can be transplanted to otherThe Institute has developed from a small, sites of the body. In the first application of this newpredominantly clinical, training centre to a major technology we envisage that silicone/saline implantsacademic research oriented institute, affiliated with the will be replaced with the safer alternative of fat tissueUniversity of Melbourne. Currently with more than 60 produced by the patients own body. The personalstaff, including doctorate and PhD students and benefits alone will have the advantage of increasing theoverseas Fellows, the major focus of the Institute has self-confidence of many women devastated by diseaseshifted towards scientific research in a number of fields or cancer of the breast.that serve to compliment surgical and clinical The technology of Organogenesis involves creating anactivities. These fields extend from tissue in vivo microenvironment and neo-vasculature that canreconstruction and repair, to respiratory research, grow with and service newly forming tissue isvascular biology, pancreas regeneration and currently lacking thus precluding the possibility ofcytoprotection pharmacology. In the last five years, engineering complex three-dimensional organs. Theresearch has focused on tissue reconstruction and Institute has taken an original in vivo approach torepair. The Tissue Engineering Group, headed by address the issue of how to generate a suitable in vivoAssociate Professor Rik Thompson, encompasses the “bioreactor” for growing new tissue, by developing aresearch areas of adipose and tissues, and model in which a functional vascular network with itsorganogenesis including heart, own supportive extracellular matrix is spontaneouslypancreas, liver, thymus and pituitary. The Institute is generated on a functional fistulous (AV) loop. Thisnow finding ways to prefabricate structures like ears, loop is placed inside a semi-sealed polycarbonatenoses or joints in one part of the body and transfer chamber of defined size and shape, with a smallthem to the appropriate place once they have grown. . opening for entry and exit of the vessels. When assembled on the femoral vessels in the groin of rats,The Institute also does much work with cancer. the new densely vascular tissue grows progressivelyBecause cancer growth depends upon new blood vessel out in a radial fashion from the loop. To test if thisformation, researchers can apply their knowledge of unusually angiogenic environment would support thehow this process works to inhibit new vessel formation growth of specific new tissue, the researchers areand thus halt cancer growth. The Cytoprotection exploring the outcome of adding tissue explants;Pharmacology Group, under the direction of Professor including pancreas, skeletal muscle, adipose tissue,Greg Dusting, who joined the Institute in 2005, is liver and kidney to the chamber-AV loop constructs.boosting the Tissue Engineering Program and 4
  • 5. The Institute also has a strong background in nerve Williams & Wilkins, the major publishing house forregeneration. It could be that the nerves and muscles of plastic surgery," comments Dr. Mutaz B. Habal,people recovering from work injuries, lawn mower cuts Editor-in-Chief of the Advances in Plastic Surgeryor glass laceration will recover two or three times series. "It also appears for the first time in an electronicbetter than with current methods. format, which will allow these important articles to be(Source: BOBIM’s Annual Report of Year 2006) viewed by every practicing plastic surgeon."CHANGING TREND OF BROWLIFT The 25th anniversary edition of Advances in Plastic Surgery presents 14 papers covering what is new and upcoming in the field. The lead article draws attentionHigh, perfectly-arched eyebrows are no longer the to an important but often-neglected aspect of breastaesthetic ideal, according to research showing low- reduction surgery (reduction mammaplasty):lying brows hold more appeal for young people. A new preserving normal sensation of the nipple. Untilsurvey by German scientists has found a shift in brow recently, plastic surgeons focused on aesthetic issuestrends, with arches that sit high and peak in the middle such as breast shape, at the expense of the uniquenow out of favour. Instead, those that curve lower over sensitivity of the nipple and areola. The authors reviewthe eye and peak one-third from the outside are deemed some relatively simple modifications of surgicalmore attractive, so this is what women are requesting, technique that can preserve the "sexually importantthey say. erogenous sensation of the breast…while improvingBut Australian plastic surgeons argue that this shape body image and, with it, sensuality."has been the ideal all along. Researchers at the German Several articles in the new Advances describe newUniversity of Regensburg and Johns Hopkins refinements to improve on the results of commonUniversity in the US showed pictures of women with plastic surgery procedures. One study describes a newdifferent shaped brows to 350 people of all ages. technique using computed tomography (CT) scans to"Young people up to 29 years of age judge arched "map" the blood supply to skin flaps used for breasteyebrows to be unattractive and prefer the lower reconstruction after mastectomy. Other reportspositioned eyebrow with a maximum in the lateral highlight the importance of identifying "perforator"third," they wrote in the journal Aesthetic Plastic blood vessels, helping to ensure a healthy blood supplySurgery. "This form has become more prevalent over for skin and muscle flaps used in reconstructivethe past several years and can currently be described as procedures. Another study presents a new approach tothe new ideal." The researchers urged plastic surgeons dealing with the difficult surgical problem of treatingto stop lifting the arches too high on the back of their non-healing wounds of the lower leg.results. "Current concepts of brow lift indications need The special issue also reports on the development of ato be reconsidered," they wrote. "The eyebrows are "center of excellence" in one of the fastest-growingfrequently placed too high, with the eyebrow arch in areas of plastic surgery: body contouring after massivethe middle, frequently leaving the patients with an weight loss in patients who have undergone weight-unnatural astonished expression." loss surgery (bariatric surgery). The authors advocateBut Sydney-based plastic surgeon Dr Steve Merten an integrated, multidisciplinary approach to thesesaid the definition of an attractive eyebrow has always complex cases, combining plastic surgery expertisebeen low-lying with the peak on the outside. "The with nutritional and psychological counseling and othertextbooks have never suggested an arch in the middle," services.said Dr Merten, spokesman for the Australian Society Other new developments reported in the 2007for Plastic Surgeons. "The problem was not the Advances in Plastic Surgery include:definition but that the lifting techniques we used tended • the use of automated facial image analysis techniqueto be more vertical and more towards the middle, to evaluating the effects of "Botox" treatment inwhich wasnt ideal." patients with facial nerve disorders. • A "partial mastectomy" approach to breast cancer surgery, which may offer special advantages for women with larger breasts.ANNIVERSARY ISSUE OF ‘ADVANCES IN • A new spray technique for applying cultured skinPLASTIC SURGERY’ graft cells in patients with facial burns of the face. • A new approach to the difficult problem of reconstruction after surgery for skin cancers on theThe January issue of Annals of Plastic Surgery is a nose.special issue comprising the latest stage in the "Speaking on behalf of the editorial board, we areevolution of a recurring title that since 1982 has enthusiastic and happy to see the progress we haveintroduced many major developments that have made in getting the Advances series in a continuumtransformed the science and practice of plastic and with the other publications in the field," adds Dr.reconstructive surgery: the Advances in Plastic Habal. "We expect to continue the tradition ofSurgery series. excellence and innovation presented by Advances in"In its new format as a special issue in the Annals of Plastic Surgery over the past 25 years.”Plastic Surgery, the Advances series joins Lippincott 5
  • 6. She also is one of very few researchers looking into matrixes for spinal cord damage, such as the kind that actor Christopher Reeves suffered years ago and fromNEW HORIZONS OF NERVE REPAIR which he is not recovered. She is collaborating with John McDonald, M.D., Ph.D., assistant professor of neurobiology at the Washington University School ofA biomedical engineer has tripped up proteins in Medicine. McDonald already has treated spinal cordnerve regeneration system with a novel delivery injuries in rats with embryonic stem cells; thesystem for peripheral nerve regeneration that could problem is that most of the stem cells died afterhave implications for successful stem cell delivery transplantation. Sakiyama-Elbert is hopeful that herand spinal cord repair. matrix/tube delivery system will allow 50 to 75Shelly Sakiyama-Elbert, Ph.D., assistant professor of percent survival of the stem cells by providing a morebiomedical engineering at Washington University in hospitable environment for the cells immediatelySt. Louis, has designed a system that employs a nerve after transplantation.guide tube filled with a gel containing growth factor The overall goal of this direction of her research is toproteins that stimulate nerve regeneration. Also part apply novel bioengineering technology to allowof the package are strategically placed sugars and controlled release of growth factors from scaffoldspeptides for binding in the gel matrix. The system has that facilitate the regeneration of adult spinal cordpromoted peripheral nerve regeneration in axons through and beyond spinal cord lesions. Thepreliminary rat studies. scaffolds are drug-delivery systems consisting ofThe clinical Gold Standard for peripheral nerve protein matrices containing growth factors that areregeneration involves taking a nerve from a donor released in a sustained manner during tissuesite on the injured persons body and sewing the regeneration. Adding embryonic stem cells duringdonor nerve in between the two ends of the injured polymerization, a process where small molecules arenerve. Though the nerve is dead, it provides a combined together to form larger ones, can furtherpathway that can guide the regeneration of the modify the scaffolds. The embryonic stem cells caninjured nerve. This is problematic because it creates repopulate the injured spinal cord and serve as aan injury to be addressed at the donor site, and there source of nerve growth factors during regeneration.is a limit to the amount of donor tissue you can usefrom a patient. Furthermore, there is no guaranteethat the donated nerve will come to life in a new site.Another alternative is the use of cadaver nerves, WHO IS THE MOST BEAUTIFUL OF ALL?which runs a risk of rejection.Sakiyama-Elbert, working with famed plasticsurgeon Susan Mackinnon, M.D., Syd. M. and Robert Two Australian scientists have invented computerH. Shoenberg Professor of Surgery of the software that distinguishes a beautiful face from a lessWashington University Medical School, with attractive one. Their invention uses facialsponsorship from Whitaker Foundation, places measurements, related to ratios and images of models,exogenous sticky material capable of binding growth actors and some 200 women from around the world.factors throughout the gel, causing the growth factor After a photograph of a womans face is put into theproteins to remain in the gel for months because they program, it returns a beauty rating of between one andkeep tripping over the sticky material. These binding 10.sites can be tuned according to how fast the drug University of Technology Sydney computer scientistsneeds to be released for successful regeneration. Hatice Gunes and Massimo Piccardi believe theTimed release is a key component of her system, software could be used in fields such as cosmeticbecause a real limitation is having the proteins surgery. "Potential applications exist in thediffuse out in a day or two, which is the case with entertainment industry, cosmetic industry, virtualmany currently used systems. media and plastic surgery," they explain in theAnother approach to peripheral nerve regeneration International Journal of Human-Computer Studies.that Sakiyama-Elbert is testing involves creating her Their preference is for the medical profession to use itown protein consisting of a growth factor, and two under supervised conditions to avoid situations wheredifferent domains, a cross-linking site and a substrate vulnerable people could harm their self-image. Drfor an enzyme that cleaves the growth factor at just Piccardi said his and Ms Gunes work grew out ofthe time a regenerating nerve cell would be migrating efforts to make computers more people-friendly bythrough the matrix. This cell-activated drug delivery enhancing their ability to recognise faces and moods.system is also incorporated into a gel and delivered To develop their system, they divided the face intofrom a nerve guide tube, and its a great example of a measurements such as the distance between the top ofnew area known as biologically responsible the face and the chin and between the eyes. Theymaterials. assembled 215 images of women of different ages,Stem cells for spinal cord repair levels of attractiveness and ethnic backgrounds, including photographs of Claudia Schiffer (pictured), 6
  • 7. Kate Moss and Catherine Zeta-Jones. The images were Mrs. Swarna Arora of Mumbai gave an overview of theshown to a mixed gender, multi-racial panel of 50 various modalities of treating facial scars. Dr. Naheedvolunteers who gave each face a rating of between one Ahmed of Multan had two presentations, one onand 10. reconstruction of upper auricular defects usingThey found while participants sometimes varied composite pedicle conchal skin and cartilage flap, andgreatly in the ratings they gave, overall there was one on dorsal nasal flap for alar reconstruction. Drsignificant agreement over what was an attractive face. Mumtaz Ali of Peshawar presented his experience ofNext they analysed the facial measurements of the Alloplastic Cranioplasty using Methyl methycrylate inwomen in the test images as well as the ratios between 8 patients and Dr. Asif Shah of Peshawar deliberatedthe measurements. on litigations, errors and experiences in PlasticBy looking for correlations, they were able to Surgery.determine the features common in beautiful women, The session on Clefts and Craniofacial Surgery saw Dr.and develop software that combined this with facial- Mohammad Anwar of Multan sharing his experiencesanalysis technology. The software has been fine-tuned of working in several Craniofacial Surgery Units in theover several years. When shown an image, the software U.S.A. Dr. S. Bhattacharya of Lucknow discussed theis capable of predicting what a panel of humans would treatment of Alveolar and Anterior Palatal Clefts,give the face plus or minus 1.5 marks. Further dwelling essentially on the rationale, timing anddevelopment should reduce the margin of error. technique of alveolar bone grafting and the invaluable input of the Orthodontists. Prof. Syed Adnan Ail ShahDr Piccardi said one use might be for plastic surgery deliberated on the protocol of management ofpatients who were unsure whether modifications Temporo-mandibular joint Ankylosis in his Unit insuggested by their doctor would improve their Lahore, laying emphasis on the use of Costochondralattractiveness. While the software has been developed graft to add a growth centre to the growing mandible.only to assess women, it could be adapted to rate men. Dr. Sajjad Ali Khan f Peshawar discussed the role ofDr Piccardi said one danger of the software was that it maxillary osteotomy in mid face defects and Dr.could fall into the hands of adolescents or others Naheed Ahmed deliberated on Cleft Lip Nose andsensitive about their looks and harm their self- image. corrective rhinoplasty. Dr. Gulam Quadir Fayyaz of Lahore, who runs a very successful Smile Train programme talked about repair of wide palatal clefts. Dr Samira Ajmal of Peshawar reviewed 300 cases of maxillofacial trauma and discussed the managementNEWS protocol practiced in her Unit and Dr. S. Bhattacharya of Lucknow deliberated upon Orbital Fractures, stressing for a multidisciplinary approach to them, their presentations, investigations, indications for surgery, surgical corrections, complications and pitfalls.JOINT CONFERENCE OF PAPS and PSSH The Aesthetic Surgery session saw Dr. Syed Haroon A. Shah of Dublin, Ireland presenting his tricks and tipsThe 12th Annual Joint Meeting of Pakistan Association on Face Lift surgery, and rightly cautioning theof Plastic Surgeons and Pakistan Society of Surgery of audience that though the cosmetic improvementthe Hand was held in Khyber Medical College in achieved is temporary, the consequences ofPeshawar from February 1 to 4, 2007. The pre complications are permanent. Dr. Fakhr Al khairy ofconference workshops were arranged in 3 sessions. Dr. Karachi and the present President of PAPS reviewedWaseem Saeed of Leeds, U.K performed cadaver 500 cases of Aesthetic Rhinoplasty and opined that fordissections to demonstrate the exploration and augmentation and tip plasty an infra-cartilaginousmanagement of Brachial Plexus Injuries. Dr. incision, for reduction rhinoplasty an inter-Obaidullah conducted a workshop on Hypospadias and cartilaginous incision and for Secondary and Cleft Lipin Plastic Surgery OT in Hyatabad Medical Complex Nose deformities an Open Rhinoplasty works best inDr. Mughese Amin and Dr. S. Asif Shah demonstrated his hands. Dr. Sabeen Masroor of Karachi discussingthe techniques and intricacies of Hair Transplant Large volume liposuction i.e. more than 5 liters ofSurgery. aspirate in a single procedure, concluded after treating 33 patients in whom an average of 8.9 lit wereThe session on Head & Neck Reconstructions started removed in an average procedure time of 4 hours, thatwith a Keynote lecture on the ‘Role of Plastic Surgery the procedure was safe with low morbidity. Dr.in the treatment of Head & Neck tumours’ delivered by Humayun Mohammud of Islamabad evaluated theCol. Mamoon Rashid of CMH Rawalpindi. Dr. S. safety of Liposuction in local anaesthesia in 50Bhattacharya of Lucknow discussed the anatomy of the patients. He used micro-canulas and thought thatTemporo-parietal flap and presented a plethora of its though it took him longer to accomplish the task butclinical applications. Dr. Tahir Masood deliberated on his results were better by this technique. Dr. Al khairythe use of local flaps for eyelid and periorbital also presented his experience of combiningreconstruction after ablative cancer surgery and Dr. Liposuction with Abdominoplasty. 7
  • 8. The last session had papers on limb and trunkThe session on Hand Surgery started with the State of reconstruction as well as urogenital reconstructions.The Art Lectures on Management of Brachial Plexus Mr. Waseem Saeed showed the use of LatissimusInjury and Management of Cerebral Palsy and other Dorsi for reconstructing the anterior chest wall defectSpastic Conditions delivered by Dr. Waseem Saeed of in Poland Syndrome. Dr. M.M. Bashir of LahoreSt. James University Hospital, Leeds, U.K. A very evaluated free tissue transfer as a reconstructive tool inthought provoking lecture evolution of management managing massive leg and foot defects and Dr. Farrukhprotocol for post burn flexion contractures of hand was of Lahore chose the medial perforator flap for softdelivered by Dr. Obaidullah, in which he emphasized tissue coverage around knee. Dr. T.A. Rizvi’show in order to get god results the treating surgeon has experience of managing fibromatosis and Dr.to be the physiotherapist, the occupation therapist and Ehtasham ul Haq’s dissection of the anatomy ofthe psychologist, if these back up supports are not reverse ALT flap and its application in a Post Burnavailable, as in most of the developing world. Dr. T.A. Contracture of knee were very interesting.Rizvi of CMH Rawalpindi presented his experience of Commenting on Free Flaps in trouble Dr. Saad urreplanting hand and distal forearm in 15 children in the Rehman of Rawalpindi opined that promptlast 8 years and Dr. Shahab Ghani of Karachi showed reexploration, more than once if required andthe versatility of a mini external fixator in hand thrombolytic therapy go a long way n helping theseinjuries. Mr. Waseem Saeed demonstrated the use of flaps. The conference ended with a lecture on SingleGracilis for achieving elbow flexion following free stage repair of Hypospadias by Dr. S. Bhattacharya infunctional muscle transfer and Dr. Kamran Khaid which he felt that to achieve the 4 goals of widening ofreviewed 8 patients of Median and Ulnar nerve injury meatus, correction of penile curvature, restoration ofin forearm, who underwent Burkhalter operation for the missing portion of the urethra and achieving normalOpponensplasty, and thought that this procedure cosmetic appearance of the external genitalia, the 3should be done along with the nerve repair. Discussing basic modalities of one stage repair remain Meatalthe use of Metacarpal artery flap in hand trauma, Dr. Advancement (MAGPI), Urethral extension techniquesMohammad Asim of Lahore showed a wide variety of (Hodgson Toksu, Mathieu) and Urethral Replacementboth orthograde and retrograde flap designs and their Techniques (Asopa, Duckett)successful applications. Lectures on Spaghetti wrist byDr. Kashif Abbas of Karachi, Giant cell tumours of theHand by Dr. M. Ibrahim of Islamabad and Tuberculous 2nd INTERNATIONAL TUTORIALS INinfections of the hand by Dr. Shahab Ghani were AESTHETIC PLASTIC SURGERYfollowed by a very interesting account ofExtravascation injuries in the hand in patients onChemotherapy by Dr. Samina of CMH Rawalpindi in The 2nd INTERNATIONAL TUTORIALS INwhich she concluded that immediate referral and AESTHETIC PLASTIC SURGERY was held atimmediate initiation of conservative therapy (saline Bombay Hospital Institute of Medical Sciences,irrigation of affected tissue by David Gault’s Mumbai from January 10 – 14, 2007 and was atechnique) can help conserve hand functions best, resounding success. The entire event was conductedfailing which flap coverage after excision becomes flawlessly. In the self-assessment report all themandatory. Dr. Y. Sajjad of Lahore showed the Delegates have confirmed that this is one of the best-versatility of Latissimus Dorsi in addressing the organized meetings with most co-operative andproblems of soft tissue effects of the upper limb. educative Faculty with no apparent technical fault in the registration, scientific program or the social events.A symposium on Joshi’s External Stabilizing System This surely was the best possible teaching mode(JESS) was organized by the Mumbai group. Prof. available in the current setup in this sub continent inSwarna Arora introduced Prof B.B. Joshi and his the field of Aesthetic Surgery.monumental work in Hand Surgery, Dr. Sandhya An Internationally renowned faculty drawn from sevenKaushik demonstrated the instruments and showed different continents was responsible for making it ahow a basic frame is constructed, and Dr. Ram memorable event in the Nation’s Plastic SurgeryPrabhoo, an imminent Orthopaedic and Hand Surgeon calendar. They included Dr. Thomas Biggs, Dr. Bruceshowed the versatility of the fixator system in dealing Cunningham, Dr. Brian Kinney and Dr. Satish Vyaswith the skeletal trauma of the hand. Dr. Rajesh Rohira from the U.S, Dr. Jose Guerrerosantos of Mexico, Dr.and Dr. Prabhoo then went on to talk about Shubailat Ghaith of Jordan, Dr. Michele Zocchi ofmanagement of acute injuries in both upper and lower Italy, Dr. P. Kontoes of Greece, Dr. Luiz Tiledo oflimbs using the JESS as well as Distraction techniques U.A.E, Dr. Alfred Berger, Dr. Wolfgang Funk and Dr.in deformity correction in both congenital and post Albercht Kraose Bergmann of Germany, Dr. Edwintraumatic deformities using the same system. Prof. Turkof of Austria and Dr. Abdul Reda Lari of Kuwait.Arora showed how JESS could be used in the They were ably augmented by a very strong Nationalmanagement of Post Burn Contractures and Miss Mala faculty comprising of well known aesthetic surgeonsShukla concluded with rehabilitation using low cost like Dr. Ashok Gupta, Dr. Suresh Gupta, Dr. K.splints and pressure garments. Ramchandran, Dr. Manoj Khanna, Dr. Lokesh Kumar, Dr. Nitin Mokal, Dr. Satish Arolkar, Dr. B.M. Daver, 8
  • 9. Dr. Neeta Patel, Dr. Kuldeep Singh, Dr. Manoj Johar aspect of the specialty, improved the understanding ofand Prof. A.K. Singh. The faculty rendered their fullest the subject and skill, helpful in improving patient carecooperation and participated in instructional courses, and request for similar course in future once everyworkshops, panel discussions, plenary lectures and live year.surgery demonstrations. The most influential presentation in the wholeTopics discussed in the tutorial included Facial conference was Prof. Biggs’ “Why I am here”. For aContouring & Rejuvenation, Face / Neck Lift, change, it did not concern plastic surgery; the subjectRhinoplasty, and Blepharoplasty. Interactive Sessions was India. It was meticulously prepared and beautifullyon Laser had discourse on Laser Resurfacing, IPL Skin presented. No doubt that the thoroughness was partlyRejuvenation, Pigmented lesions and Laser for Hair due to its source of statistics – CIA, of all things! HisDepilation. Breast aesthetic surgery was discussed in keen power of observation was striking. He hadgreat details - Vertical breast reduction and mastopexy, noticed, photographed and presented things weand Breast augmentations were the main issues. A very generally tend to overlook – like ordinary peopleinteresting session on Hot Topics and sessions on Lipo- talking incessantly on cell phones, even while riding asculpturing / Body Contouring, Botox and Soft tissue horse cart. His realization of a new younger Indiafillers were most appreciated. waking up to a bright future was indeed very touching.OPERATING SESSION: A galaxy of National and The immense love that he has for our country shone allInternational faculty demonstrated various surgical through his masterly talk.procedures. These procedures were demonstrated live A total of 176 delegates and 30 Faculty attended thethrough CCTV with two-way communication and were International Tutorials.moderated by a team at the Operation Theatre as well AESTHETIC SURGERY WORKSHOPthe Auditorium: These were Breast Augmentation,SAL / Body Sculpturing, Endoscopic Brow andForehead Lift, Face Lift and Facial Rejuvenation, An Aesthetic Surgery Workshop was organized by theBlepharoplasty / Facial Rejuvenation, and Rhinoplasty. Post Graduate Department of Plastic Surgery, KingAll the four Operating Rooms were names honoring George’s Medical University, Lucknow on Februarythe Gold Sponsors i.e. The Mentor Theater, the Euromi 19 and 20, 2007. Attended by over 50 delegates, theTheater, The Storz Theater and Ethicon Theater workshop showcased two surgeries – Rhinoplasty andrespectively. There were six Anesthesiologists and Hair Transplantation. Prof. Ian t. Jackson of the U.S.equal number of Anesthesia technician to support the delivered the prestigious Prof. R.N. Sharma Memorialentire surgical demonstrations. Each of the operating Oration and later demonstrated a Cleft Lip Noseroom had a moderator and two-way audio correction and an aesthetic rhinoplasty. Prof. B.M.communications with the auditorium and the images Daver discussed difficult rhinoplasties and Dr. Manojwere shown on two large screens with PIP. Khanna discussed in details the history, the technique,Live demonstration of office procedures like soft tissue the researches and the future of Hair Transplantationfillers / IPL procedures was also conducted very surgery. He then went on to demonstrate the surgery insmoothly on January 14, 2007. It was remarkable to a patient in whom he and his team transplanted 1200note that every single faculty was absolutely at home at follicular units in the frontal region to create a newthe operation theater and had full praise for all the frontal hairline and a frontal tuft. Prof. A.K. Singhnursing staff and operation theater technicians. Even conducted an augmentation rhinoplasty using a bonethe Implants, Dermabond Tissue Adhesive, Radio- graft. A small and truly interested audience was keptfrequency Surgical Unit, soft tissue fillers etc. were abreast of the happenings in O.T live through CCTVhandled and prepared very professionally and with two-way communication.efficiently, without making it appear that they arelooking at them for the first time.The Tutorial was endorsed by the Medical Council ofIndia, the Maharashtra State University of HealthSciences and the Indian Association of AestheticPlastic Surgeons. The Association of Plastic Surgeonsof India had endorsed the International Tutorials asadvanced teaching course, under the auspices of “DR. ACROSS SEVENC. R. SUNDERARAJEN NATIONAL UPDATE INPLASTIC SURGERY”All the lectures / operative demonstration were of very SEAShigh standard. The Certificates of attendance weretraded in exchange of the completed Medical Council CHANGE YOUR FACE ONLINEof India Evaluation Forms. By summing up in theEvaluation forms submitted by about 200 attendingdelegates / faculty most of the lectures had scored Roads to innovation are sometimes surprising. As aneither an average of very good (grade-4) or excellent example, a researcher at the University of Torontoscore (grade-5). This evaluation established the fact (UT) used facial-recognition software developed by histhat this course was very useful as it had covered all professor several years ago and adapted it for plastic 9
  • 10. surgeons and their patients. In "Look, ma, no scalpel," Sources: Terrence Belford, The Globe and Mail,the Globe and Mail describes how this new softwareallows you to see very quickly how you would looklike with different facial features. This is not the first STEM CELLS FOR BIGGER BREASTSapplication that can simulate the results of plasticsurgery, but this one is entirely automated. AndModiface -- the name of this AI-based software -- can Get ready for this – scientists in Japan claim to berecognize a face in a single second and updates its own able to increase the size of womens breasts usingalgorithms automatically as it gains more experience. fat and stem cells. They basically take fat fromThe researchers think this software also could be used abdomen or thigh, enrich it with stems cells, andby law enforcement personnel and consumers, so a then inject it into the breast. These stem cells act ascommercial version might be available one day. "master" cells, which are capable of making new fatThis software is based on previous work done at the cells. Interesting.UTs Artificial Perception Laboratory headed by Theyre hoping that this method will result in aProfessor Parham Aarabi. Alireza Rabi adapted softer, more natural-looking alternative to theAarabis facial-recognition software for plastic artificial implants used today that are filled with saltsurgeons. water or silicone. Mr. Yoshimura, a surgeon at theThe goal was a software program that would use an Tokyo University Medical School, injected over 40actual photo to show a person, realistically and in patients, and he believed the stem cell and fatadvance, what he or she would look like after having combination, which can increase a womans cup sizecosmetic surgery. Such a system could put an end to by two sizes, was a success, with no seriousdisappointed patients and also help surgeons refine complications. This month, German authoritiestheir craft, Mr. Rabi says. approved the process, which means that theYou can try Modiface yourself. You just have to procedure is now legal throughout Europe,upload an image of yourself and merge it with the including Britain. The FDA is much slower than itsfacial features of Brad Pitt or Hillary Rodham Clinton European counterparts. Of course, there are criticsfor example. Here is how Modiface works. "The first who think this procedure is a bad idea, and shouldthing the system does is recognize the face and specific be approached with extreme caution. Its possiblefeatures," explains Dr. Parham Aarabi of the University that the fat injected into the breast might just lookof Toronto. "Once that is done, it is a matter of lumpy, and that the stem cells wont be able to growpointing and clicking on the prompts." The user to a regular implants size. Obviously more researchchooses from a menu that includes hair, eyes, lips or needs to be done. So for women who are unhappywhole face. Click here to try ModiFace for yourself. with their small size, it seems there are other peopleBut how the system learns? who are thinking about them and there are newerDr. Aarabi says the system actually learns from each things for them in the horizon!attempt at reconstructing a face, slowly gaining theability to correct its own errors (such as putting eyes inthe wrong place) and refining its processes. Every threeto four weeks the researchers fine tune the system toremove glitches caused by users who might, for COSMETIC SURGERY LOTTERYexample, submit a photo of a dog instead of a person."Essentially the software amends and updates its ownalgorithms automatically as it gains more experience,"Dr. Aarabi says London-based Europa International is running what isAn interesting aspect of this project is how it was thought to be the worlds first lottery for cosmeticdeveloped in four separate stages. surgery. For the price of a 1.50 pound ($2.90) textThe first step was to create algorithms that achieved message or phone call, winners of the monthly drawfacial recognition at blazing speed; the second was to will receive 6,000 pounds toward the cost of thecreate software that would work well in high-traffic surgery of their choice. John Babbage, the co-founderareas such as an Internet site. Both those goals have of Europa International, said it is not much differentbeen met, Dr. Aarabi says. Step three is to have plastic from reality television shows that offer cosmeticsurgeons work with the beta version and provide surgery to contestants.written feedback. The final stage will be to create a But British plastic surgeons described Europacommercial product. Internationals cosmetic surgery superdraw as anFor more information, you can read Face Fusion: An unscrupulous marketing gimmick and warned patientsAutomatic Method For Virtual Plastic Surgery, which they could be putting themselves at risk. "I am appalledwas published in the Proceedings of the 2006 at this new scheme but unfortunately not surprised,"International Conference on Information Fusion said Douglas McGeorge, president of the British(Fusion06), Florence, Italy, July 2006 (PDF format, 6 Association of Aesthetic Plastic Surgeons (BAAPS).pages). "Cosmetic surgery can have a major impact on peoplesAnd after reading this paper, have fun mixing your face lives and make them feel very good about themselves.with the one of Paris Hilton or George Clooney. 10
  • 11. But it has to be thought out and the limitations and limb from the reptiles mouth. The male crocodilecomplications of any procedure have to be considered severed Chang Po-yus forearm at the Shaoshan Zoo inbefore rushing in," he opined. The association is the southern city of Kaohsiung when the veterinarianconcerned about what it sees as the hype-filled process tried to retrieve a tranquiliser dart from the reptilesinvolved in the lottery and the lack of counseling. The hide so he could give it medication, zoo officials said.winner of the draw will be randomly selected and meet The forearm was reattached following seven hours ofdirectors of the company before being flown to Prague surgery.for the surgery.Some clinics have offered gift vouchers for cosmeticsurgery but McGeorge said this is the first lottery hehas heard of. Europa, which was founded 11 years ago,is the marketing arm for cosmetic surgery clinics inPrague. The company has arranged surgery andaccommodation for thousands of clients, and about 90percent of its clients are British.Babbage dismissed criticism of the lottery, tellingReuters the winner will be dealt with in the same wayas any other client. Each participant entering the lotteryfills in a medical questionnaire The Liberty Times newspaper said Chang failed to notice that the crocodile was not fully anaesthetisedNIP’n’TUCK LOANS OFFER IN LEBANON when he stuck his arm through an iron rail to medicate it. As Chang was rushed to the hospital, a zoo worker shot two bullets at the crocodiles neck to retrieve theA Lebanese bank is giving out loans for cosmetic forearm, Chen Po-tsun, a zoo official, said.procedures in this notoriously image-conscious "The crocodile was unharmed as we didnt find anyMediterranean country. First National Banks website bullet holes on its hide," Chen said. "It probably wasdubs the "plastic surgery loans" as a way to "have the shocked and opened its mouth to let go of the limb."life youve always wanted". Customers can borrow The 17-year-old reptile is one of a pair of Nile$1,000-$5,000 (£500-£2,500) for surgery for two years, crocodiles kept by the zoo. Known as a man-eateras long as they are employed and under 64 years of because of its voracious nature, the crocodile is listedage. "Statistical studies showed that there is a huge as an endangered species, and is rapidly disappearingincrease in this sphere," marketing manager George from its native African habitat.Nasr said."This opens horizons," he said and the bank hasreceived more than 200 calls a day about the loan sinceit was launched with a TV and poster campaign lastweek. "We like to look our best... There are peoplewho see this loan as their life raft," Mr. Nasr said.Local media say the tense political climate and fears ofanother devastating war with Israel have not curbed FORTHCOMINGLebanons infamous urge for cosmetic enhancement,with demand increasing up to 20% since 2006. "People EVENTSare not going out anymore so they are staying homelooking in the mirror," industry representative Dr CONFERENCES IN 2007 & 2008Nabih Sader told the Daily Star newspaper. The mostpopular procedures are nose jobs - which cost afraction of what most people pay in Europe or the US - Apr 29 - May 4, 2007followed by liposuction and botox. There is usually a 3rd ASIA PACIFIC CONGRESS ONsharp increase in breast augmentation surgery in the CRANIOFACIAL SURGERY & DISTRACTIONspring, as women prepare for the summer season spent Venue: Maldiveson Lebanons beaches. Email: smbalaji@eth.net URL: www.distraction2007.comNOW THAT’S A JAW POPPING REPLANT May 17-20, 2007 ORAL CANCER: A GLOBAL CHALLENGE - FIRST WORLD CONGRESS OF THESurgeons reattached a Taiwanese veterinarians INTERNATIONAL ACADEMY OF ORALforearm on April 11, 2007 after a 200-kilogram Nile ONCOLOGYcrocodile chomped it off and colleagues recovered the 11
  • 12. Venue: RAI Conference Centre, Amsterdam, the 14th INTERNATIONAL CONGRESS OF IPRASNetherlands Venue: Berlin Congress Centre, Alexanderstra ße 11,Organizers: The International Academy of Oral 10178 Berlin GERMANYOncology with administrative support from Elsevier Website: www.ipras2007berlin.compublisher of Oral Oncology.Email: jm.seabrook@elsevier.comURL: www.iaoo2007.com July 14 & 15, 2007 Plastic Surgery Accreditation course on Maxillo- facial and Orthognathic SurgeryMay 25 - 27, 2007 Venue: Department of Plastic Surgery, StanleyLASER EUROPE 2007 Medical College, Chennai 600001Venue: Divani Caravel Hotel, 2 Vas, Alexandrou Course Convener: Prof. T. C. Chandran, Prof &Avenue, 161 21 Athens, Greece Head, Department of Plastic Surgery, Stanley MedicalOrganizers: Euro Medi Com, 29 Bld de la Republique College & Hospital, Chennai 60000192250 La Garenne – Colombes, FRANCE Contact: Prof. T. C. Chandran, No 4, H 56 A,Tel: +33 1 56 837800 Parvathy Street, Kalakshetra Colony, Besant Nagar,Fax: +33 1 56 837805 Chennai 6000090Email: emc@euromedicom.com Phone: 044-24900731, 98410 15851 Email: drteecee@yahoo.comJune 4 – 6, 2007 August 4, 2007INTERBURNS - International meeting on Burn Care HAND SURGERY WORKSHOP – FLEXORVenue: Burns Centre, Dow University of Health TENDON REPAIRSciences, Karachi, PAKISTAN. Venue: Aga Khan University, Karachi, PAKISTANContact: Dr. Shariq Ali FRCS, Head of Burn Centre, Organizers: Pakistan Orthopedic Association (HandDUHS & EBC Course Director Surgery Forum)Email: alishariq@yahoo.co.uk Contact: Dr. Haroon ur Rashid, Dept. of Surgery, Aga Khan University , Karachi, PAKISTAN Phone : 92 21 486 4760, 92 (0) 300 230 3171June 24 – 26, 2007 Fax: 92 21 493 4294W.S.R.M. 2007 – IV Congress of the World Society Email: haroon.rashid@aku.eduof Reconstructive Microsurgery poasouth@hotmail.comVenue: Athens Hilton Hotel, Athens, GREECE.Contact: Dr. Peter Neligan, Seceretary General,W.S.R.M. 2007. OR SVORONOS TRAVEL 5,Apollonos str. 10557 Athens, GREECE August 24 -26, 2007Tel: +30 210 3244932 31st Annual Conference of Indian Society of SurgeryFax: +30 210 3250660 of the Hand (ISSH CON – 2007)Email: centraloffice@wsrm.net Venue: Kodai International Hotel, Kodaikanal,p.neligan@utoronto.ca Tamilnadu, INDIAwww.wsrm2007.com Contact: Dr T. Chandra Prakasam, Dept. of Orthopaedics & Traumatology, Govt. Rajaji Hospital, Madurai 625020, Tamilnadu, INDIA.June 20 - 23, 2007 Tel: 91-452 2532535, Extn.298 / 098421100998th EUROPEAN CRANIOFACIAL CONGRESS Fax: 91 452 4394547Venue: Bilbao, SPAIN Email: cphand@yahoo.comContact: MaCarma Prado Website: www.issh.orgEmail: pradoma@gmail.com September 2 - 5, 2007 6th Asian Pacific Cleft Lip & Palate CongressJuly 6 – 8, 2007 Venue: Hotel Marriott Resort, Panjim, Goa, INDIAMaster Course on Less Invasive Methods in Contact: Dr. Sanjeev N. DeshpandeAesthetic Surgery and Cosmetology Tel: 91-22 28368358 / 26170708 / 9821055760Venue: Tbilisi, Georgia Email: snd2007@rediffmail.comContact: 1/1 Kandelaki, Str. Tbilisi, 0160 Georgia Website: www.apcp2007.comPhone and Fax: (+995) 32 384579, (+995) 95 542020Email: info@aptos.geURL: www.aptos.ge September 8 & 9, 2007 INTERNATIONAL CONFERENCE ON FEMALE GENITAL RECONSTRUCTIONJune 26 - 30, 2007 12
  • 13. Contact: Dr. Vishwa Prakash Tel: 92 21 4541317/4541390, 0300 8248258Tel: 91- 9810175220 Email: drshahabghani@hotmail.comEmail: vpagarwal@gmail.comSeptember 29 & 30, 2007NATIONAL CME / WORKSHOP ONSECONDARY CLEFT LIP NASAL DEFORMITYAND PROFILE PLASTYVenue: Kanchi Kamakoti Child Trust Hospital,Chennai and Sri Ramachandra Medical College & RI,Chennai, INDIAContact: Dr. Mrs. Matangi Ramakrishnan and Dr.Jyotsna Murthy, Sri Ramachandra Medical College &RI, Porur, Chennai 600 116Tel: 91- 44-24765614, 09641039820Email: Kmr_mathangi@hotmail.comsrmc.chennai@smiletrainasia.orgWebsite: www.srmc.eduNovember 24 & 25, 2007MBC INSTRUCTIONAL COURSE ON BURNS(Mediterranean Council for Burns and Fire Disasters)Venue: Sterling Hospital, Ahmedabad, INDIAContact: Dr. B. Atiyeh and Dr. P.K. BilwaniTel: (079) 7556665, (079) 7556665, 9824047717Email: aata@terra.net.lbbilwanipk@satyam.net.in SECRETARIAT January 10 – 13, 2008 Department of Plastic & Reconstr. Surgery3rd INTERNATIONAL TUTORIALS INAESTHETIC SURGERY Institute of Medical Sciences, B.H.U.Venue: Bombay Hospital Institute of VARANASI, INDIAMedical Sciences, G.T. Hospital andGrant Medical College, Mumbai, INDIAContact: Dr. Ashok Gupta, Suite #16,Laud Mansion, 2nd floor, 21 M. KarveRoad, Mumbai 400 004, INDIA.Email: aesthakg@vsnl.comneetapatel@hotmail.com EDITORIAL OFFICEJanuary 17 - 19, 2008 Dr. Surajit BhattacharyaNABICON 2008 Capital Diagnostics, Mini Plaza, M2 Gole MarketVenue: SNTI Jamshedpur Mahanagar, LUCKNOW 226006, INDIAContact: Dr. R. Bharat, Burn Care Unit, Tata Main Tel: 91 522 2384881 / +94150 81668Hospital, Jamshedpur 83100 Fax: 91 522 2380550Tel: 91 657 2433519, 2141165, 6500608 / Email surajitb@sancharnet.in09934320311Email: vbharat@satyam.net.in URL: www up-apsi.com www.lucknowplasticsurgery.comFebruary 6 – 10, 200813th Annual Conference of Pakistan Association ofPlastic Surgeons and Pakistan Society of Surgery ofthe Hand.Venue: Liaquat National Hospital & Medical College,KarachiContact: Dr. Shahab Ghani 13