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14th Issue October 2013

The e-magazine for 37.000 Plastic Surgeons

105 National - Regional Societies

ISSN: 2241-1275

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CONTENTS • President’s Message . . . . . . . . . . . . . . . . . . . . . . . . . . 5 • General Secretary’s Message . . . . . . . . . . . . . . . . . . 7 • IPRAS Management office Report . . . . . . . . . . . . . 9 • Obituary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


• Senior Ambassador . . . . . . . . . . . . . . . . . . . . . . . .


• Pioneer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


• Rising Star . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


• 11th IQUAM Congress and Consensus Conference . . . . . . . . . . . . . . . . . .


• IPRAS Laser Academy . . . . . . . . . . . . . . . . . . . . .


• IPRAS Academy for Aesthetic Surgery Training . . . . . . . . . . . . . . . . . . . . . . . . . .


• IPRAS-Trainees Association . . . . . . . . . . . . . . . .


• ISPRES Section . . . . . . . . . . . . . . . . . . . . . . . . . . .


• PIP News. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


• Surveys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


• Educational Programs . . . . . . . . . . . . . . . . . . . . . .




PRS Award





• National Associations’ & Plastic surgery organizations’ News . . . . . . . . . . . . . . . . . . . . . . . .


• Historical Accounts . . . . . . . . . . . . . . . . . . . . . . . .


• Books Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


• National & co-opted societies future events . . . .


• IPRAS Website . . . . . . . . . . . . . . . . . . . . . . . . . . .


• Industry news . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


• IPRAS past General Secretaries . . . . . . . . . . . . .



BAPRAS Congress Report



Germany Society Report

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Board of Directors President Marita Eisenmann-Klein - Germany General Secretary Nelson Piccolo - Brazil Treasurer Bruce Cunningham - USA Deputy General Secretary Yi Lin Cao - China Deputy General Secretary Brian Kinney - USA Deputy General Secretary Ahmed Noureldin - Egypt Deputy General Secretary Andreas Yiacoumettis - Greece Parliamentarian Norbert Pallua - Germany Executive Director Zacharias Kaplanidis - Greece

Dear colleagues, “ brings us closer as citizens of the world, brings a better understandling between peoples and brings to us a sense of purpose” says our newly appointed Chairman of the Disaster Relief Committee, Bryan Gamble, plastic surgeon and recently retired General of the US Army, about humanitarian work. On a global scale of values humanity and solidarity rank high, everywhere in the world. And people who donate their time and expertise to help fellow men and women are highly respected. Prof. Marita Eisemann-Klein No wonder, that many individuals and groups decide to travel to President of IPRAS the scenes of disasters or to third world countries in the intention to help without adequate planning or being part of a competent network. The Red Cross, other NGOs and government institutions, but also local plastic surgery societies can give us a lot of examples of negative effects and outcomes of these actions! The most common mistakes are: - to work without accreditation: even the best training in the world does not entitle you to work without permission, neither in disaster areas nor in teaching courses for aesthetic surgery! - not to ask local authorities/medical associations, whether your specialty is needed there. - to perform operations, which you might have been trained for, but which you have not performed for a long time, - even the procedures, which are part of your daily life, can be difficult under circumstances in which your resources are very limited! - to use techniques or devices which usually require long-term follow up by experienced plastic surgeons. Thank God, these are exceptions! We have all reasons to be very proud of our well established humanitarian groups, -all of them work within well established networks. Just one example: as representatives of IPRAS WomenforWomen we are supposed to meet the Vice President of India in November in order to discuss how we can make our existing cooperation even more efficient. “A life is not important except in the impact it has to other lives” says Jackie Robinson. Our cover photo this time shows the photo of Neha and her grandmother, one day after the operation that we performed during an IPRAS WomenforWomen mission in India, photographed by the artist Christopher Thomas. He allowed us to print Christmas Cards with this photo, - they will be sold to finance our next mssion and will be available shortly. Neha’s pre-operative photo was on the cover of our 12th issue. The other photo on our cover this time shows the Nemaste-Statue, created by artist Ashley Bennett-Stoddard, who also created our beautiful pendants, - ideal Christmas gifts, too. Another supporter is Rainhard Fendrich, songwriter and performer, a legend in Austria and Germany. He donated the income of a concert to IPRAS WomenforWomen. Christopher and his curator Ira, Ashley, Rainhard and so many more people out there with a big heart, - there are many ways to create an impact to the lives of others, - we all should have in mind how blessed we are for the chances to create this impact, - every single one of us. Please read Bryan Gamble’s statements and think about what your impact could be! Cordially yours

Marita Eisenmann-Klein IPRAS President

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• To promote the art and science of plastic surgery • To further plastic surgery education and research • To protect the safety of the patient and the profession of Plastic, Reconstructive and Aesthetic Surgery • To relieve as far as it is possible the world from human violence or natural calamities through its humanitarian bodies • To encourage friendship among plastic surgeons and physicians of all countries


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Dr. Nelson Piccolo IPRAS General Secretary

As we come back from another National Plastic Surgery Society Meeting, which was attended by people from all continents, we continue to realize that Plastic Surgery is an ever evolving Science. Coincidentally, key note lecturers will also undoubtedly demonstrate this evolution within their practices, whatever their fields of interest may be. I think that this is a marvelous fact! At the end of my third decade in practice, I am still learning – as I believe we all are. Learning from our mentors, teachers, colleagues, exponent leaders of the specialty and from the younger generation. New thoughts and new ideas are almost daily findings. The way translational research has grown in the recent years has modified our practices through a most welcome “reality check”. We see and search for its benefits everyday in our practice. It is no secret that it requires a vast amount of knowledge to practice State of the Art Plastic Surgery. This has become even vaster as we have also learned to survey our

patients through questionnaires about our (their) results and about many other thoughts, yielding a much more widespread awareness that they, as are we, are whole human beings. Information and knowledge are also continuously exchanged. The advent of e-publications, as well as cybernetic access to hard copy published material, has pulled down any and all walls which could possibly hinder this exchange. We, as Plastic Surgeons must endeavor to provide sequential communication in how we practice Plastic Surgery and about our acquired knowledge into easy access information through meetings and teaching, through writing, through designated publications, and through any other form which is or may become available. There must be a conscientious and concerted effort toward this objective. In my opinion, after taking care of our patients, this has become our main mission. These are also the times within the Plastic Surgery Specialty when Plastic Surgeons must remain united within another most noble, single goal: the upholding of the bastions which support Plastic Surgery on the various different aspects and ways we practice, teach and research around the world. The good news is: this is the right place - IPRAS is 105 countries strong !!! Every single member of these National Societies share these achievements since these same achievements are the daily actions of these Plastic Surgeons in all 105 IPRAS countries. Every one, every day, everywhere !!!

Prof. Mimis Cohen, Chair of the IPRAS Scientific Advisory Board, Dr. Nelson Piccolo, IPRAS General Secretary at the IPRAS booth during the ASPS congress, October 2013, San Diego

Dr. Nelson Piccolo IPRAS General Secretary

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July 2013 – September 2013 In September 2013, after the short summer pause, IPRAS participated in the important congress of the Balkan Association of Plastic, Reconstructive and Aesthetic Surgery, from September 5thto 7th, which attracted 163 participants from approximately 30 countries, and took place in the beautiful city of Budva in Montenegro. The congress was honored by the participation of the local Minister of Health, Prof. Miodrag Radunović, and the Budva Mayor, Mr. Lazar Radjenovic, who indeed sponsored the opening cocktails. IPRAS supported this congress, not only by offering its auspices, but also with a subsidy of approximately 7000 €, which had been accounted for and approved in the official budget of the Confederation for 2013. The newly founded Montenegrin Association of Plastic Surgery, which became an official member of IPRAS during the IPRAS World Congress in Chile, through their President, Dr. Miodrag Djurović and their General Secretary, Dr. Aleksandra Božović – Čelebić, proved to be marvelous hosts to the approximately 200 participants of the congress. We would like to thank them for their excellent collaboration, not only during the congress, but also during all the months prior to the congress, when we all worked together to achieve this successful result. We would also like to give our gratitude to all the faculty members and especially: Sabri Acartürk (Turkey), Alija Agincic (Bosnia and Herzegovina), Katarina Andjelkov (Serbia), Juarez Avelar (Brazil), Srdan Babovic (USA), Ali Barutçu (Turkey), Pavel Brychta (Czech Republic), Aleksandra Božović – Čelebić (Montenegro), Patricio Centurion (Peru), Sonja Cerovac (UK), Márcio Crisóstomo (Brazil), Strahil Efremov (Bulgaria), Marita Eisenmann-Klein (Germany), Dimitri Evstatiev (Bulgaria), Alexandru Georgescu (Romania),

PROMOITALIA Booth during the BAPRAS congress

Ashok Gupta (India), Yoshiaki Hosaka (Japan), Janek Januszkiewicz (New Zealand), Dana Jianu (Romania), Yves-Gerard Illouz (France), Olivera Kosovac (Serbia), Gorana Kuka (Serbia), Goran Lazović (Serbia), Kostas Manos (Greece), Marko Milosavljević (Serbia), Saša Mišeljić (Serbia), Luis Montellano (Brazil), Toma Mugea (Romania), Igor Niechajev (Sweden), Carlos Parreira (Portugal), Paolo Persichetti (Italy), Nebojša Rajačić (Kuwait), Radmilo Rončević (Serbia), Katharina Russe-Wilflingseder (Austria), Marcos Paulo Sforza (Brazil), Nina Šijan (Serbia), Mihail Skerlev (Bulgaria), Violeta Skorobać Asanin (Serbia), Igor Smiljanić (Serbia), Milan Stojičić (Serbia), Albin Stritar (Slovenia), Ali Teoman Tellioglu (Turkey), Zoran Terzić (Montenegro), Branislav Trifunovic (Serbia), Kurt Vinzenz (Austria), Theodore Voukidis (Greece), Andreas Yiacoumettis (Greece), Renato Zaccheddu (Italy), Mario Zambelli (Croatia), Rado Žic (Croatia). After the end of the BAPRAS congress, on Sunday September 8th, the first IPRAS Academy for Aesthetic Surgery Training The art of the face took place with NO registration fee. Approximately 50 participants took place and enjoyed presentations by the following esteemed speakers: Sforza M. (Brazil), Andjelkov K. (Serbia), Yoshiaki H. (Japan), Voukidis T. (Greece), Niechajev I. (Sweden), Colic M. (Serbia), Avelar J. (Brazil), Jianu D. (Romania), Gupta A. (India), Eisenmann-Klein M. (Germany), Russe-Wilflingseder K. (Austria) We thank them for their valuable contribution to the IPRAS educational cause and we promise that we will continue this important mission of plastic surgery.

VOE booth during the BAPRAS congress

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Opening ceremony

Moreover, we would like to send our very special thanks and our congratulations to the President of the congress and the Balkan Association of Plastic, Reconstructive and Aesthetic Surgery, Prof. Miodrag Colic. For almost an entire year, he worked very hard for the success of the congress; he travelled to a large number of Balkan countries to promote the congress with all his powers; he collaborated with the scientific and organizing committee and he accomplished the 8th Congress of the Balkan Association to be the most multitudinous ever. Furthermore, at the General Coffee Break

Assembly, it was decided that the next BAPRAS Congress would return to Greece after almost 17 years. Dr. Kostas Manos, from Thessaloniki, was elected next Congress President and we wish him every success in his task. Following the success of the 8th BAPRAS Congress, it is certain that Budva is definitely going to remain a beautiful memory for many years, for both the organization of the event and for the wonderful city itself.

The Mayor of Budva Mr. Lazar Rađenović and the Minister of Health of Montenegro Prof. Dr. Miodrag Radunović during the opening ceremony


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From October 11th to 15th, IPRAS travelled to San Diego, USA, in order to take part in the annual Plastic Surgery Meeting by the American Society of Plastic Surgeons. As in previous years, the IPRAS booth was located in the Exhibition area, and the congress was attended by the IPRAS President, Prof. Marita

AAPRAS congress in Armenia, Conference Hall

LipoSales Booth during the BAPRAS congress

Eisenmann-Klein, the IPRAS General Secretary, Prof. Nelson Piccolo, the IPRAS Treasurer, Prof. Bruce Cunningham, our Deputy General Secretary, Dr. Brian Kinney, the IPRAS Commercial Director, Mr. Gerasimos Kouloumpis, and the Assistant Executive Director, Mrs. Maria Petsa.

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Once again, the congress of the largest National Society of IPRAS was a success. The participation of the ASPS members and the industry was overwhelming. The IPRAS President, the General Secretary and the other IPRAS Board of Directors members had the opportunity to participate in various ASPS institutional meetings and to discuss the evolution of Plastic Surgery around the world.

The Assistant Executive Director, Mrs. Maria Petsa, and the Commercial Director, Mr. Gerasimos Kouloumpis had the opportunity to welcome many participants to the IPRAS booth, and discuss the future goals of IPRAS. The same happened with a large number of exhibitors and the whole industry, who have offered their support over the years to Plastic Surgery, and who were very interested to hear of future IPRAS

Prof. Greg Evans, totally successful during his term as the President of the ASPS, delivered the presidency to Robert X. Murphy, Jr., and therefore we would like to send our congratulations to Dr. Evans and our warmest wishes for a very successful term to the new President, Robert X. Murphy, Jr. Our President Prof. Marita Eisenmann-Klein, together with Dr. Roger Khouri, Dr. Eufemiano Cardoso, Dr. Brian C. Cooley, Daniel Kacher, Eva Gombos, Dr. Thomas G. Baker were honored with the “Best Cosmetic Paper� award from the PRS Journal for the paper with the topic: Brava and Autologous Fat

MENTOR booth during ASPS meeting

TULIP booth during ASPS meeting

CANFIELD booth during ASPS meeting

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Mr. Gerasimos Kouloumpis, IPRAS Commercial Director, Mrs. Maria Petsa, IPRAS Assistant Executive Director, Mrs. Jennifer Kelley, HYPERGUIDE representative and Director Educational Development of Vindico, Prof. Mimis Cohen, IPRAS Chairman of the Scientific Advisory Board.

initiatives and large International congresses, such as the 2015 IPRAS World Congress in Vienna. Finally, from October 24th to 26th, IPRAS participated in the National Congress of the Armenian Association of Plastic, Reconstructive and Aesthetic Surgery, in Yerevan. IPRAS supported this event, by sponsoring the registration fee of 35 residents in Plastic Surgery. Participants from approximately 10 countries attended this very important event, whom we would like to especially congratulate for their fine work and to thank: the President of the Congress, Dr. Gagik Stamboltsyan; the President of the Armenian Association and Chairman of the Scientific Committee, Dr. Armen Hovhannisyan;

Prof. Rod J. Rohrich, Editor-in-chief of PRS journal, Prof. Marita Eisenmann-Klein, Dr. Roger Khouri during their award at ASPS meeting in San Diego.

and the members of the Scientific Committee, Dr. Gevorg Yaghjyan and Dr. Mimis Cohen. Our gratitude also goes to the very important professionals of the International Faculty and more precisely to: Rox Anderson (USA); Stephan Ariyan (USA); Charlotte Ariyan (USA); William Futrell (USA); Ramon Llull (Spain); Othon Papadopoulos (Greece); John Persing (USA); Kirill Pshenisnov (Russia); Igor Reshetov (Russia); Ricardo Rodriguez (USA); Kurt Vinzenz (Austria). A more analytical review of the Congress in Yerevan shall be provided to you in our next edition of the IPRAS Journal. Thank you for your attention. IPRAS Management Office

Participants of the AAPRAS 2013 congress in Armenia in front of the Matenadaran Museum


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18th World Congress of IPRAS

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Harold E. Kleinert, M.D. FACS October 7, 1921 – September 26, 2013

Harold Kleinert was born in 1921 on a homestead ranch in Sunburst, MT, USA only 10 miles from the Canadian border. He attended Northern Montana College and graduated from the University of Michigan in 1943. He completed his medical degree from Temple University School of Medicine in Philadelphia in 1946. His postgraduate training was completed at Grace Hospital in Detroit, Michigan. Dr. Kleinert came to the University of Louisville - School of Medicine in 1953 and founded the Hand Clinic for the comprehensive care of hand patients. Dr. Kleinert quickly became distinguished as a pioneer in the field of hand, upper extremity and microsurgery. In 1960 he established the Christine M. Kleinert Institute (CMKI) in Hand Surgery at the University of Louisville; which has now trained over 1300 physicians from over 50 countries. In 1962, Dr. Kleinert and fellow Morton Kasdan performed and documented the first revascularization of a partial digital amputation. In 1963, Dr. Joseph Kutz joined practice with Dr. Kleinert and created The “Kleinert Kutz Hand Center”. Dr. Kleinert was also an inventor of many currently used hand surgical instruments (Kleinert-Kutz elevator, tendon grasper and ronguer), the double operating microscope and an innovator of regional anesthesia and a pioneer of the two-bed operating room which is still used today. Dr. Kleinert was a Clinical Professor of Surgery Emeritus at the University of Louisville and at Indiana University-Purdue University. He served as President of the American Society for Surgery of the Hand in 1976 as well as the Louisville Surgical Society. He was the recipient of the Scientific Achievement Award from the American Medical Association in 1980 for significant contributions to the field of medical science.

Dr. Kleinert was appointed a National Consultant in Hand Surgery to the Surgeon General, United States Air Force in 1973. He was certified by the American Board of Surgery and was a Fellow of the American College of Surgeons. He wrote more than 200 articles and book chapters during his career. Dr. Kleinert was a kind, mild and gentle person, as well as an excellent technical surgeon and diagnostician. He is remembered as a down to earth person who never raised his voice, spoke softly and was open minded and comical. When asked why he went across the country to Philadelphia for his medical education, he would laugh and tell a story of what his mentor told him “Kleinert, you need a lot of polishin’; you need to go as far east as you can”. When he would interview fellowship candidates, he would tell them to set in his seat and ask “If you were to come here, what would you teach us?” His staff and peers only half jokingly said he was able to "lay on hands" because of the remarkable results his patients attained. His bedside manor inspired his students, he took time to discuss his patients' lives and how they needed their hands to make a living. He cared for patients regardless of their ability to pay, often accepting a homemade dessert, knitted scarf, or antique trinket in payment. In addition to his surgical practice, Dr. Kleinert reclaimed his agricultural roots with his livestock, abundant garden and collection of antique orphaned cars and tractors on his Southern Indiana farm. Left to treasure his memory besides his patients, colleagues and friends are his wife, 6 children, 14 grandchildren and 12 great-grandchildren. Dr. Haaris Mir and Dr. Zubin Panthaki

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Prof. Dr. med. Alfred Berger

What is your educational and training background review? I was born on the 31st of July, 1934 in Graz, Austria. In 1959 I graduated as a Medical Doctor from the University of Graz. I trained between 1959 and 1963 in Graz as a General Surgeon in Trauma Surgery. In 1966 I became specialized in General Surgery. I worked at the First Surgical Clinic in Vienna University for the period from 1963 to 1981. From 1967 to 1981 I was in the Department of Plastic and Reconstructive Surgery, where I worked with the University Professor, Dr. H. Millesi, in the 1st Surgery Clinic, at the University of Vienna. For the period between 1971 and 1972 I worked at Shriners Burns Institute and General Surgery Service in Massachusetts General Hospital of Harvard Medical School in Boston. In 1973 I was honoured with the title Venia legend in Plastic Surgery and became a Dozent at the University of Vienna. In 1978 I became Assistant University Professor for Plastic and Hand Surgery and served as Chief of the Burn Unit. From 1981 to 2000 I was Ordinary University Professor and Director of the Department for Plastic, Reconstructive and Hand Surgery at the Burn Center of Hannover Medical School, in Germany. In 1997 I became a Member of the Ethics Committee Medizinische Hochschule Hannover. In 2000 I was a Visiting Prof. for Plastic and Hand Surgery at the INI, in Hannover.

I am a member of multiple international Societies: Member of EXCO of IPRAS / IPRAF, Honorary President of IPRAS Congress Berlin 2007, Hon. Member of UEMS / EBOPRAS, Hon. Member of Hungarian Hand Society, Hon. Member of Columbian Society of Plastic and Aesthetic Surgery, Honorary Member of VDPRÄC. I have published 572 Articles in Journals, 22 Book Articles and I am the author of 5 Books. My preferred topic titles are: Endoscopic techniques in Plastic Surgery, Microsurgery techniques in Burn Surgery, Abdominoplastic, Peripherial Nerve Surgery. Did you ever consider a different career? Yes. I had once considered both Thoracic and Cardiac Surgery. If yes, what other options were you considering and what made you ultimately decide? Well, the influence of my teacher Millesi, was a major factor, as well as my time in Boston at the Harvard Medical School, and my interest in microsurgery and flap surgery, as well as design. Did you have desperate moments during your professional life? I would not say that I really had any particularly desperate moments during my professional life. Mistakes you could have avoided? I don’t remember any major mistakes, really. Issue 14

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Is there something you regret not having pursued? One thing I could say I regret not pursuing would probably be to conduct further investigations into contracting the artificial nerve graft. So far, what were the highlights of your career?A.B.: The best parts of my career were probably my time in Boston, Microsurgery and the friendship with B. O’Brien, M. Godina, R. K. Khouri, G. Lundborg, A. Swanson, J. F. Burke, G. I. Taylor, I.D. Iannovich and many more national and international colleagues. As for my various memberships in different organizations, you may refer to my resumé. Thirty-three of my scholars are in leading positions – six of them are international (China, Chile, Saudi Arabia, Bangladesh and India) and nine of them are in university positions as professors. What are your goals for the next few years?A.B.: My goals for now include book writing, maintaining contact with various plastic surgeons, and my scholars, and in general enjoying the life with my wife, our 3 children and 4 grandchildren.

in general surgery, and then look for a good teacher in plastic surgery, and a hospital, which is able to treat all major problems of our specialty. Try to be always a good doctor, and not a salesman, and also to be open-minded for all the new techniques in plastic surgery.

Would you encourage any family members to pursue the same career? Yes, definitely!

CONTACT INFORMATION: Home address: Trahütten 37, 8530 Deutschlandsberg, AUSTRIA

What message do you have for our residents/young plastic surgeons? I would suggest that they should start with a good training

Hospital address: INI–Hannover, Rudolf-Pichlmayr-Str.4, 30625 Hannover, GERMANY


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What do you like to do in your free time; hobbies/ sports? I personally enjoy reading, attending the theatre, listening to classical music and going to concerts, and also hunting. What is you favorite book? Favorite music? I would have to say that my favourite book is the Bible, and I love all forms of classical music What would you like to share with our readers? Again: Don’t follow the modern way of selling everything and teach the patient to find the right decision. Don’t forget this; in plastic and aesthetic surgery the most important part is between the patient and the doctor.


Bryan Gamble, MD, MS, FACS,

Brigadier General (retired) US Army, Diplomate American Board of Plastic Surgery, Chairman IPRAS Disaster Relief Task Force

Eisenmann-Klein: We are so happy that you agreed to chair our Disaster Relief Task Force, Bryan! Welcome! You just retired from the US Army as a Brigadier General, - sounds like the most astounding careerfor a plastic surgeon. How did this happen? What was first, - the army or medical school? Dr. Eisenmann-Klein, thank you for this opportunity to serve IPRAS and our specialty. The military and uniformed services in the United States use scholarships to help medical students fund their education. So, first I was accepted to medical school and soon after accepted into the scholarship program. In return, the military, the Army in my case, would get a 4 year commitment in return for funding the 4 years of school. Did you ever consider a different career? No, I had wanted to become a Plastic Surgeon since I was 12 years old. That was when my mother was diagnosed and treated for breast cancer. Is there something you regret not having pursued? No. I have been very fortunate to have a great depth and breadth of opportunities and experiences in my clinical and military career. I guess that if there were one thing, it would be not being able to bring my wife with me to the many wonderful places I have been fortunate enough to visit.

So far, what were the highlights of your career? First, to have an opportunity to care for the military members and their families, and to help develop a system of health to meet their needs, wherever they might be and whenever they need. Second, it has been to contribute to the military’s global trauma care system, with quality and safety metrics that have superior outcomes and survival compared to years past. Next, the opportunities to work with Ministries and nongovernmental organizations to help develop and bring improved healthcare to those less fortunate. Medical engagement and diplomacy helps to strengthen our global community, as well as our specialty. Lastly, that as my children have grown, they too have embraced service to others as a path to take. At least 2 have pursued medicine as a career, and the other 2 are looking to law. I’m very proud of them. What are your goals for the next few years? My main goal is to gain a position in medical educational leadership. I believe that it is critical for those that follow us in surgery and medicine have the tools needed to benefit their patients and maximize the patients’ outcomes. This requires, I believe, an understanding of more than the science, but knowledge of the business, legislative influences, and regulatory structures impact on healthcare delivery. In that way, they might be a master Issue 14

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of the science, but also a strong influence to shape the best possible outcomes for their patients. I also look forward to looking for opportunities to bring our ability to care as Plastic Surgeons to those in need, where ever it might be around the globe. As I mentioned earlier, it brings us closer as citizens of the world, brings a better understanding between peoples and brings to us a sense of purpose. Would you encourage your son to pursue the same career? As I mentioned before, 2 of my sons are in medicine; one in medical school now, and the other as a surgical intern. While I would be honored if they chose Plastic Surgery as a specialty, they will be the best judge of that when the time comes. What message do you have for our residents/young plastic surgeons?


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Three things; Always place the patient first, be their advocate, and don’t forget to listen. Next, Question things; let the curiosity within drive you to solve things unsolved, create new answers to old problems, and be open to new ideas from all. Never accept that it has always been done that way. Lastly, don’t forget that what is old in Plastic Surgery still works. Learn and keep those options in your surgical tool kit. You will find as I have what was ‘old’ is ‘new’ once again. What do you like to do in your free time; hobbies/ sports? Cycling, gardening, traveling and watching the sun rise. Also include a recent picture, complete address, hospital affiliation etc. 707 Fitzhugh Way, Alexandria, VA 22314 Clinical Professor of Surgery, Uniformed Services University of Health Sciences, Bethesda, MD Fort Belvoir Community Hospital, Fort Belvoir, VA


Dr. Toni Zhong, M.D., M.H.S, FRCS(C)

Dr. Zhong please give us a review of your educational and training background. I am a graduate of the Plastic Surgery Residency Training Program at the University of Western Ontario in London, Ontario, Canada and became a Fellow of the Royal College of Physicians and Surgeons of Canada in 2007. Following the completion of my residency, I was awarded the prestigious Zeiss Canada Microsurgery Scholarship to pursue a year-long Microvascular and Reconstructive Surgery Fellowship at Memorial Sloan Kettering Cancer Center in New York City under the directorship of Dr. Peter Cordeiro. After completing the clinical fellowship, I enrolled into the Masters of Health Sciences Program in the field of Clinical Epidemiology from the Harvard School of Public Health. I successfully obtained my Masters of Health Sciences degree in 2011. I was recruited to join the Division of Plastic and Reconstructive at the University of Toronto in November 2008. I am currently an Assistant Professor, as well as both the Fellowship Director for the Breast Reconstruction and Aesthetic Fellowship Program, and the Fellowship Director for the entire Division of Plastic and Reconstructive Surgery at the University of Toronto. Did you ever consider a different career? I considered many different career paths before deciding to take the plunge into plastic surgery. During the first two years of medical school, I was interested in medical oncology, pediatrics, and obstetrics/gynecology. I loved all aspects of medicine that involved acquiring new

knowledge about the human body, learning to perform new procedures, and being an entrusted member of a medical team to look after patients. If yes, what other options were you considering and what made you ultimately decide? It was not until I had my rotation in plastic surgery as a third year medical student that I discovered the wonders of being a plastic surgeon. I still recall the first day that I spent “shadowing” a plastic surgeon in his operating theatre. During the span of only several hours, he performed operations to reconstruct a woman’s breast, repaired the nerves and tendons in a young boy’s fingers, and excised a giant congenital nevus on the back of a baby and reconstructed the massive defect using a large rotational flap overlying several tissue expanders. From that day on, I knew that a career in plastic surgery would be the single most fulfilling choice that I could make in my professional life. Did you have desperate moments during your professional life? We all have moments when stresses in our professional lives seem so daunting that we become momentarily paralyzed. However, it is what we choose to do during these critical moments that ultimately define who we are in the face of great challenges. I have learned that it is best to maintain a calm exterior, even if it is a mere façade; to not act or speak rashly as words and actions cannot be reversed or forgotten, and to have the confidence in yourself to do the right thing, whatever it may be. Issue 14

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So far, what were the highlights of your career? There have been so many highlights. Since I am an academic plastic surgeon, I spend about 40% of my time conducting clinical research. Naturally, a highlight of my academic career was when I was awarded the prestigious Career Development Award from the American Society of Clinical Oncologists. Another career highlight was when I was awarded the operating grant from the Canadian Breast Cancer Foundation to support the MCCAT (MultiCenter Canadian Acellular Dermal Matrix Trial) which aims to evaluate the efficacy of one-stage acellular dermal matrix assisted implant reconstruction compared to the traditional two-stage tissue expander/implant method of breast reconstruction. The third career highlight was my recent appointment as the provincial clinical lead to develop standardized breast reconstruction guidelines for breast cancer patients in Ontario to reduce the disparity in the delivery of breast reconstruction care. What are your goals for the next few years? My most significant goal for the next few years is to complete the recruitment for MCCAT trial and analyze the results from this landmark trial. Since the two-stage tissue expander/implant reconstruction is the most frequently employed method of postmastectomy breast reconstruction and commonly regarded as the goldstandard method of implant reconstruction, the MCCAT has the potential to provide rigorous evidence to promote reconstructive practice shift toward a novel one-stage method of breast reconstruction supported by patient reported outcomes. Would you encourage any family members to pursue the same career? Absolutely. The rewards of being a plastic and reconstructive surgeon have been immense for me. I cannot think of another profession whose history is embedded with more creativity, innovation, and diversity. On a personal level, each day at work, I am stimulated intellectually by a new clinical or research question, and challenged technically to provide a solution to a difficult reconstructive problem. What message do you have for our residents/young plastic surgeons? I think that it is easy to get lost in the daily rigors of a busy surgical residency or practice, or feel burdened by the enormous clinical and administrative burden and lose sight of love for our profession. It is precisely during these times, that we must remind ourselves that we are


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in the extremely privileged position of being entrusted to operate on another person’s body, and that this privilege comes with enormous responsibilities. Describe us your experience with IPRAS Women For Women. I am a member of IPRAS Women For Women, a volunteer organization of female plastic surgeons who provide reconstructive surgery to women living in lowand middle-income countries. My first experience with the Women For Women Surgical Humanitarian Mission was in the Chilmari district of Bangladesh on April 23rd, 2011. I led the surgical team with Dr. Constance NeuhannLorenz (Former President of Women For Women, Munich, Germany). The other members of the international team consisted of a junior plastic surgeon, Dr. Michelle Locke, a breast reconstruction fellow from Auckland, New Zealand who was completing her fellowship training at the University of Toronto under my supervision at the time, two anesthesiologists, and an OR scrub nurse. For five consecutive days, from April 24th to April 28th, 2011 our team performed approximately 61 procedures in 32 patients. Many of these patients had multiple sites of burn injuries. The ages of the patients ranged from 2 to 70, and the most commonly performed procedure was burn contracture release and reconstruction using a full thickness skin graft. What do you like to do in your free time; hobbies/ sports? I have a 19-month old baby at home who occupies all of my spare time, he is both my hobby and my passion.

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Dear Colleagues, Lasers, light and energy based devices have numerous applications in plastic and aesthetic surgery and are greatly enlarging our treatment options. These technologies are rapidly developing and their future is very promising! In order to face the rising application of lasers in plastic surgery we founded the IPRAS Laser Academy. Members of this body will be able to participate at meetings and workshops, where well-known professors reveal their expert knowledge. The aim of the IPRAS Laser Academy is to provide an academic forum for its members, to exchange experience and share knowledge about recent developments in order to avoid preventable complications. We are very happy to cordially invite you to submit your interest in the IPRAS Laser Academy! All IPRAS members are able to submit their application to become a member of the IPRAS Laser Academy. Members will receive information concerning scientific meetings and educational workshops on laser, light and energy based devices, techniques and developments first of all IPRAS members. Please find our membership form below. Make sure that your membership to your national association is up to date as only IPRAS members are allowed to join. Membership is free of charge. We are very much looking forward to meeting you in the near future! Cordially yours, Katharina Russe-Wilflingseder Coordinator of the IPRAS Laser Academy

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Application of Interest Family Name: .......



IPRAS national society/association or regional association Country member: ...................

Hospital/Private Practice: City:



Address: . . . . . Telephone: Fax:





My interest/ experience in laser applications: ...................



Please send the application at or fax it at 0030 210 664 5176 I hereby declare that the above mentioned details are true and correct

Full Name and Signature:


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IPRAS ACADEMY FOR AESTHETIC SURGERY TRAINING To the IPRAS National Societies Dear colleagues, During the congress in Chile we announced the founding of the IPRAS Academy for Aes-thetic Surgery Training. We now want to share with you the list of confirmed IPRAS Academy Training Professors, which can be found on the IPRAS Website. Please let us know whether your Society would be interested to hold in your country an: IPRAS Academy Training Course/Workshop in Aesthetic Surgery There will be different options: you may want to undertake the organization of the course yourself or opt for turning the organization of this activity over to IPRAS and its partner Zita, our professional congress organizer. Zita is willing to carry the financial risk of such a course so that your Society will not have to deal with potential losses. In any case neither we nor Zita do expect a profit from these courses: these courses shall enable your trainees to gain experience in aesthetic surgery at very low expenses. Your Society may define the topics of these courses and we shall propose the appropri-ate training professors for your topics. You may suggest names from your side and IPRAS will check the availability of the dates that you may choose. Local speakers are welcome but their names and their presentations must be approved by IPRAS. Please have in mind that a collision of dates with big congresses should be avoided, though you may like to have it organized during your National Congress, in which case the financial issues will be incorporated in the general management of your Congress. We would be highly appreciative if you could provide us with the name of a member of your distinguished Society, who would be willing to serve as the coordinator of your na-tional courses of the IPRAS Academy of Aesthetic Surgery Training. The general guidelines and rules are included in this letter (please click here). Please let us know if you have any queries. We look forward to cooperating with you in this new service for the IPRAS national soci-eties. With best personal regards The IPRAS Board of Directors

Marita Eisenmann-Klein President

Bruce Cunningham Treasurer

Nelson Piccolo General Secretary

Norbert Pallua Parliamentarian

Ahmed Noreldin Deputy General Secretary

Brian Kinney Deputy General Secretary

Andreas Yiacoumettis Deputy General Secretary

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Marking the first anniversary of IPRAS-TA Shady A. Rehim MB ChB., MSc. MRCS. General Secretary IPRAS-TA Dear friends & colleagues, It is my great pleasure to take this opportunity to share with you IPRAS-TA‘s achievements over the past year, and update you on forthcoming IPRAS-TA plans and activities. Indeed this a very exciting time for all plastic surgery residents & trainees around the world, as next month IPRAS-TA will be marking its first anniversary. It is hard to believe that one year has already passed since IPRAS-TA was officially announced at the 1st IPRAS-TA meeting that was held in Athens on the 1st of November 2012. However, there isn’t a better way to celebrate this special moment, than participating in our next scientific event, the 2ndIPRAS-TA meeting that will take place in conjunction with the annual conference of the association of plastic surgeons of India (APSICON) in Mumbai between the 24th to the 27th of November 2013. Please join us at this incredible meeting. We are looking forward to hear your presentations and invaluable scientific contributions. Through an array of activities IPRAS-TA managed to establish itself as the premier International plastic surgery trainees association, representing plastic surgery residents from over 105 countries. There is no doubt that now we have a young, vibrant and progressive association. This has been accomplished through the collaborative efforts of trainees from different countries and training programs that have worked diligently to turn this dream into reality. Over a relatively short period of time, IPRAS-TA has managed to reach most of its goals, yet there are a lot more to be accomplished. Our website is currently up and running and includes an ample amount of information regarding IPRAS-TA structure, bylaws and activities that can be accessed through this link: residents-trainees. The website is also a great educational resource. Whether you are preparing to take an exam or would like to earn CME credits you can subscribe to the online education platform ‘Plastic Surgery Hyperguide’ to keep up-to-date with the most recent trends in plastic surgery. IPRAS-TA also provides you with the opportunity to find out and participate in hands on skills courses and workshops that are organized by distinguished faculty and take place during IPRAS-TA meetings and also 32

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throughout the year. Please visit the IPRAS-TA website to learn more. We are a small specialty, but unifying under the umbrella of IPRAS-TA amplifies our voices and allows plastic surgery trainees to have a significant impact on the future and development of their specialty. For this reason, IPRAS-TA took the initiative by surveying plastic surgery trainees around the world to present their collective views on a number of pertinent issues that trainees face throughout their training. The IPRAS-TA questionnaire can be found on our website and it only takes 10-15 minutes to complete. If you haven’t already completed our survey we urge you to do so. Building on our past achievements, together we can continue to make a difference. In keeping with our vision that aims to create bridges and foster communication among international plastic surgery trainees, IPRAS-TA created an interactive discussion forum on facebook (http://www.facebook. com/groups/359872790755106/?fref=ts). Currently there are more than 250 active members in this dynamic group that truly represents plastic surgeons from different cultures and backgrounds. Trainees are welcomed to post their questions and comments you will find plenty of help and advice from the group. Whether you are looking for educational opportunities or would like to keep track with the on-goings of the international plastic surgery community, the IPRAS-TA facebook group is a great resource of information. As a group we are constantly open to new ideas and innovations that can better serve our positive energy and true anticipation for what the future holds for our specialty. Please take this opportunity and join our facebook page. In IPRAS-TA, we recognize that the standards of plastic surgery training among member countries can be quite heterogeneous. We also realize the frustrations and difficulties that plastic surgery residents & trainees go through during their training period. The preliminary results of the survey conducted by IPRAS-TA highlighted aesthetic surgery as one the areas of concern among the majority of plastic surgery trainees. However, this is just one example. Additionally, the limited resources and lack

Members of the temporary elected IPRAS-TA ExCo. (Left to right: Ondrej Mestak, Giorgio Giatsidis, Hans Marius Solli-Nilson, Ziyad Alharbi, Sarah Lorenz, Antonis Kritharis, Angelos Karatzias, Nandita Melati Putri, Željka Roje. Two members Shady Abdel Rehim and Ben Khoda missing in this picture)

of opportunities especially in the developing countries may put further pressure on the trainees. IPRAS-TA therefore attempts to close this gap by promoting educational and networking opportunities within the international plastic surgery community that can actually make a difference. Last year IPRAS launched its Academy of aesthetic surgery that is run by experts in that ďŹ eld. In the foreseeable future, IPRAS-TA is planning to establish exchange programs and short-term travel fellowships platform that can improve the practical skills and enrich the training experience of plastic surgery residents, but more importantly trainees will be able to bring back their acquired knowledge and skills back to their home countries. From a personal perspective, the great works of eminent surgeons notably the likes of Daniel Marchac, Ivo Pitanguay and Ian Taylor among many others have always inspired me. I was honored to meet with these pioneers in

person and make lifelong friends with many other plastic surgeons through IPRAS and IPRAS-TA conferences. As a graduate from a developing country myself, I also consider myself lucky to have had the opportunity to work in prestigious plastic surgery units in Europe, and through meeting with distinguished professors and establishing networks via IPRAS and IPRAS-TA, I was able to further supplement my training experience by joining a reputable international research fellowship program in the United States. I look forward and hope that IPRAS-TA continues to inspire as many young plastic surgeons as possible around the world. IPRAS-TA was created by plastic surgery trainees to serve trainees, so your participation will keep us going. Finally, and on the behalf of IPRAS-TA executive committee, I would like to thank all of you who made this year a truly enjoyable experience for IPRAS-TA.

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The Role of Autologous Fat Grafting in Secondary Microsurgical Breast Reconstruction P. Niclas Broer, MD1, Katie E. Weichman, MD1, Neil Tanna, MD MBA1, Stelios C. Wilson, BS, Anna Allan, MD2, Jamie P. Levine, MD1, Christina Ahn, MD1, Mihye Choi, MD1, Nolan S. Karp, MD1, Robert. Allen, MD1 1. New York University Institute of Reconstructive Plastic Surgery New York, NY 2. Gonville and Caius College University of Cambridge Cambridge, UK



Autologous breast reconstruction offers higher rates of patient satisfaction, but not all patients are ideal candidates, often due to inadequate volume of donor sites. While autologous fat grafting is frequently used to augment volume and contour abnormalities in implant-based breast reconstruction, its clear utility in microsurgical breast reconstruction has yet to be defined. Here, we examined patients undergoing autologous microsurgical breast reconstruction with and without the adjunct of autologous fat grafting to clearly define utility and indications for use.

Fat grafting is most commonly used in those breasts with rib harvest, DIEP flap reconstructions, and those with acute postoperative complications. It should be considered a powerful adjunct to improve aesthetic outcomes in volume deficient autologous breast reconstructions and additionally optimize contour in volume-adequate breast reconstructions.

Methods: A retrospective review of all patients undergoing autologous breast reconstruction with microvascular free flaps at a single institution between November 2007 and October 2011 was conducted. Patients were divided into two groups: those requiring postoperative fat grafting and those not requiring fat grafting. Patient demographics, indications for surgery, history of radiation therapy, patient BMI, mastectomy specimen weight, need for rib resection, flap weight, and complications were analyzed in comparison.

Results: 228 patients underwent 374 microvascular free flaps for breast reconstruction. One-hundred (26.7.%) reconstructed breasts underwent postoperative fat grafting, with an average of 1.12 operative sessions. Fat was most commonly injected into the medial and superior medial poles of the breast, and the average volume injected was 147.8mL per breast (22-564mL). The average ratio of fat injected to initial flap weight was 0.59 (0.07-1.39). Patients undergoing fat grafting were more likely to have had DIEP and PAP flaps as compared to MS TRAM. Patients additionally were more likely to have a prophylactic indication 58% (n=58) versus 42%(n=117) (p=0.0087), rib resection 68% (n=68) versus 54%(n=148) p< 0.0153), and acute postoperative complications requiring operative intervention 7% (n=7) versus 2.1% (n=8) p <0.0480). Additionally, patients undergoing autologous fat grafting had smaller BMI, mastectomy weight, and flap weight. 34

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Clinical Question: Therapeutic Level of Evidence: Level III CATEGORY: Fat grafting to the breast Weichman KE, Broer PN, Tanna N, Wilson SC, Allan A, Levine JP, Ahn C, Choi M, Karp NS, Allen R. Source: Institute of Reconstructive Plastic Surgery, New York University, New York, NY 10016, USA. The role of autologous fat grafting in secondary microsurgical breast reconstruction. Ann Plast Surg. 2013 Jul;71(1):24-30. doi: 10.1097/ SAP.0b013e3182920ad0. ( Katie Weichman, MD, P. Niclas Broer, MD1 , Neil Tanna, MD MBA1, Neil Tanna, MD MBA1, Anna Allan, MD2, Jamie P. Levine, MD1 , Christina Ahn, MD1, Mihye Choi, MD1 does not have any financial disclosures, Nolan S. Karp, MD1, Robert. Allen, MD1,does not have any financial disclosures

Purpose: To evaluate indications and utility of fat grafting to the breast in cases of autologous reconstruction. Corresponding Author: P. Niclas Broer, MD New York University Medical Center Institute of Reconstructive Plastic Surgery 560 First Avenue THC-169 New York, NY 10016 Klinikum Bogenhausen Munich Section for Plastic Surgery Englschalkingerstr. 77 81925 Munich Germany

International Society of Plastic Regenerative Surgery (ISPRES)

Application For Membership Family Name: …………………………………………………

Name: ………………………………………………… IPRAS national society/association or regional association Country member: ………………………………………………… Board Certification in: …………………………………………………

Membership(s): ……………………………………………………………………………………………………… ……………………………………………………………………………………………………… ………………………………………………………………………………………………………

Hospital/Private Practice












My involvement / experience with fat research /application or other regenerative factors: ……………………………………………………………………………………………………… ……………………………………………………………………………………………………… ………………………………………………………………………………………………………

Please send the application at or fax it at 0030 210 664 5176

I attach a recent Curriculum Vita (one page) I Hereby Declare that the above mentioned details are true and correct Full Name and Signature:

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PIP: French plastic surgeons analyze the scientific data collection and publish their recommendations SOFCPRE and SOFCEP, two plastic surgery expert societies, are committed since the beginning of the PIP survey: - to deliver information to patients - to allow surgeons to guide their patients through developed therapeutic strategy regularly reviewed and updated - to advise the authorities on the medical level - to advocate for a strengthening of control procedures by getting actively involved in the development of a surveillance unit. Both Expert Societies have commissioned a survey of their members between January and April 2013, to evaluate the policy of explants, the adverse effects and the statistics of aesthetic choices for the replacement of these implants. (Table) Number of surgeons who responded Patients who received implants by these surgeons

210 10485

210 plastic surgeons, all members of at least one of the two societies, responded to the survey SOFCPRE SOFCEP. This questionnaire was developed and tested in advance by the ACPO (Association of Plastic Surgeons of the West). These 210 French surgeons had initially inserted PIP implants in 10,485 patients. In 2010, there were an estimated 30,000 women in France with PIP silicone gel implants. We can therefore, consider that the sample is large enough and that the survey is sufďŹ ciently representative. One should know that in addition to the aesthetic and reconstructive surgery of the breast, breast imaging, and oncoplastic surgery, plastic surgery covers a huge area : burns surgery, cranio - maxillofacial surgery, general plastic surgery and oncology, pediatric surgery, and ďŹ nally hand surgery and microsurgery. Therefore, not all plastic surgeons perform breast surgery and the number of respondents to this survey is consistent. 38

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Finally, not all French patients have had implants or explants by French plastic surgeons, since some patients were operated abroad or by doctors of other specialties. (Table) Explantations in % relative to implantations Total explantations practiced


Explantations whose primary implanter is a participant of this survey


Explantations whose primary implanter is a colleague of another specialty



In April 2013, the respondents had explanted in total 7210 patients: 5669 patients were initially treated by them 1541 + patients were initially treated by a colleague of another specialty. As for the 10,485 patients implanted, these surgeons had explanted 7210 patients, and by extrapolating these results, it is expected that nearly 70 % of the patients initially operated by French doctors, have had their PIP implants removed to date. This is a very respectable ďŹ gure. (Table) In % regarding explants Intact implants including shell:



Complications of reoperation



Following the 7210 explants performed: - 5433 patients had intact implants (including shell) i.e 75 % of explants. - 137 patients suffered from surgical complications

requiring reoperation (hematoma, infection,...) i.e. 1.90% of the patients operated These figures are reassuring and show the validity of the explantation policy implemented by the authorities since December 2011. Over time, the percentage of failures will increase mechanically with duration as for any breast implant. One should know that it is much easier and faster to remove intact rather than broken prosthetic implants, which reduces the risks of the procedure and the consequences for patients. The SOFCPRE SOFCEP therefore, encourage patients to be checked regularly and to organize the removal of PIP implants. (Table) Type of reoperation practiced during explantation in % compared to explantation interventions

Type of interventions practiced during reoperation for explantation

Patients who wished to benefit from an increase in volume or mastopexy



Patients who did not replace their implants



Implantation of saline –filled implants



Replacement of PIP implants by autologous fat



No implant replacement, saline implants, autologous fat implants



Of the 7210 patients explanted by the survey respondents - 2247 patients wanted to benefit from an increase in volume or mastopexy ( breast lift or breast re-shaping) in addition to the explantation, i.e. 31.17% - 259 patients had their implants removed without replacement i.e. 3.59% - 48 patients did replace their PIP implants with saline -filled implants i.e. 0.67 % saline - 83 patients did replace their PIP implant with autologous fat i.e. 1.15%. If one adds the patients who had no wish to replace their implants to those who replaced them with saline implants

and to those who chose autologous fat, the total reaches 390 patients. The survey permits to evaluate at 5.41 % the patients with PIP implants, who have not replaced their implants with silicone gel implants. This figure must be most likely rounded to 6 % because it lacks the patients who chose hydrogel implants (not mentioned as a survey option). These figures show that patients were anxious to preserve their physical appearance, even though the state did not take care of the replacement implants for patients who had not established them in primary reconstruction. They also show that there is not a crisis of confidence in the medical silicone gel. Patients as well as surgeons are well aware that the checks were never this severe and the manufacturers this vigilant. (Table) In % with regards to implantation Patients having a break and refusing explantation Patients who never showed up





The surgeons who responded identified 22 patients with confirmed rupture, which refused explantation, i.e. 0.21 % ( a little over 2 per thousand). The SOFCPRE SOFCEP remind that should there be a rupture, a lymph node or oozing of a prosthesis, explantation should be planned quickly due to the proinflammatory nature of the PIP gel, because it was not manufactured in accordance with the standards in force. Out of the 10,485 patients who were initially treated, the surgeons were not able to locate approximately 1416 patients, i.e. 14% (due to change of address etc). The SOFCPRE and SOFCEP stress that in all cases, particularly if they note abnormal symptoms, patients who are carriers of PIP implants, should consult their surgeon to specifically consider their monitoring, a possible change of prostheses even in the absence of signs of prosthesis deterioration, or to follow the most appropriate procedure. For patients who do not know if they have prostheses of the actual brand PIP, it is essential that they should be contacted by their surgeon or the clinic, for the complete references of their prostheses (brand, serial number, lot...). Thus, they should contact their surgeon regarding this issue. This also applies to patients operated abroad, because we know that the company PIP exported a large part of its production.

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These last ďŹ gures highlight the need forcommunication to encourage patients who have not contacted their doctors, in order to be informed and treated.

Finally on cancer risk The SOFCPRE and SOFCEP remind that there is no connection of any kind, to be established between the use of PIP implants and the prevalence of cancer risk, " a total of 64 cases of breast adenocarcinoma was reported to MSNA (ANSM) (eg AFSSAPS) at the end of December 2012, in women with silicone gel PIP implants. There have not been reported any new cases of anaplastic large cell lymphoma in women with silicone gel PIP implants since November 2011. According to the advice of the National Cancer Institute (INCA) and experts from the European Commission, reported tumors are not related to the characteristics of PIP implants "(PIP Information Point - ANSM 11/04/2013) In practice, each year, 47,000 new cases of breast cancer


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are currently diagnosed in France. One French woman in ten will face this disease during her lifetime. Statistically, it is therefore also expected, that women with PIP implants will develop the same rates of breast cancer as the general population, i.e. one in ten women. Many studies of the same direction performed on thousands of patients, have shown that the rate of breast cancer in patients with prostheses was not higher than in the rest of the population. On the contrary, several studies on thousands of patients have shown, that the risk of breast cancer was reported to be slightly lower in this population than in the rest of the general population. The extended follow-up of the population of patients who underwent implantation of PIP prostheses, should give comparable results. Ref A. Meunier*, H. Tristan, R. Sinna, E. Delay Breast Implants and Breast Cancer Journal for Aesthetic Plastic Surgery 50 (2005) 595-604


Local perforator flaps in lower leg reconstruction Georgescu Alexandru, M.D., PhD; Matei Ileana, M.D., PhD; Capotă Irina, M.D., PhD University of Medicine IuliuHațieganu Clinic of Plastic Surgery and Reconstructive Microsurgery ClujNapoca, ROMANIA

Introduction Perforator flaps represent the latest surgical discovery in soft tissue defect coverage all over the body. These flaps were initially used as free microsurgical transfers, but it was proven that they could also be successfully performed as local and regional flaps (1-6) We will try to demonstrate that the propeller perforator flaps can be used with great results in covering selected cases of soft tissue and composite defects in the lower limb.

Material and method We performed perforator flaps based on perforators emerging from the peroneal, anterior and posterior tibial arteries in 117 cases with complex tissue defects in lower leg.


Eighty-six flaps were used as propeller flaps, and 31 were advanced or rotated between 30º and 90º. The donor area was directly closed in 28 cases, in 15 cases skin grafted, and in 74 cases skin grafted and direct sutured. The main steps in harvesting such a flap are: a. exploratory incision; b. microsurgical dissection in the attempt to find the perforator; c. final design of the flap; d. rotation or advancement of the flap into the defect.

Results In 93 cases the flaps were completely viable (Fig. 1). In 21 cases we encountered a superficial flap necrosis, solved with secondary skin grafting, and 3 flaps were completely lost, needing another surgical procedure to solve the case.




Figure 1: Heel carcinoma in a patient with arteriopaty. a. preoperative aspect, b. defect after excision, c. the flap is harvested based on a perforator from the peroneal artery, d. postoperative aspect at 6 months

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Discussions In recent years, the free perforator flaps started to be extensively used in covering soft tissue defects all over the body. To avoid some of the drawbacks in using free perforator flaps (i.e. longer anesthesia and operative time, distant donor site, necessity of a microsurgical team with good microsurgical skills), a lot of surgeons started to use the perforator flaps as local flaps, and as microsurgical non-microvascular flaps (1). The use of local/regional perforator flaps in the lower leg was stimulated due to the recent advances in the vascular anatomy, which demonstrated the presence of a high number of perforators emerging from the anterior and posterior tibial arteries, and from the peroneal artery (3, 5, 6). In most of the cases, the local/regional perforator flaps are used as propeller flaps. The Advisory Panel of the First Tokyo Meeting on Perforator and Propeller Flaps in 2009 defined those flaps as skin islands with two paddles which can be of the same dimensions, or with a larger and a smaller one, the demarcation limit between them being the perforator vessel, and which have to rotate around the perforator vessel for at least 90 to 180 degrees (4). One of the main advantages of these flaps is the possibility of their use also in patients with diabetes and/or atherosclerosis, probably due the rich collateral circulation developed in those cases (5). A very important drawback is represented by the venous congestion, which is relatively frequent for these flaps. But, even this one progresses to necrosis, this one is only superficial and can be solved only by using a free split thickness skin graft. This is a big advantage if compared to a free flap, because in this case, if you lose the flap you lose everything. To conclude,the local/regional perforator flaps have gained in popularity in the last years, due to their main


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advantages: 1. the source artery and underlying muscle and fascia are spare, 2. there is a very good blood supply, as a muscle/musculocutaneous, but also reduced donorsite morbidity,as a skin flap, 3. the surgeon is able to replace like with like, 4. the donor-site is in the same area, 5. there is the possibility of completely or partially primarily closure; 6. the process is less demanding from technical point of view, because they are microsurgical procedures, but without microvascular sutures, 7. there is a shorter operating time.

References 1. Al.V.Georgescu, I.Matei, F.Ardelean, et al. Microsurgical nonmicrovascular flaps in forearm and hand reconstruction, Microsurgery, 27: 384-394, 2007 2. I.Matei, Al.Georgescu, B.Chiroiu, et al.Harvesting of forearm perforator flaps based on intraoperative vascular exploration: clinical experiences and literature review. Microsurgery 2008; 28: 321-30 3. 43. Saint-Cyr M, Wong C, Schaverien M, et al. Perforasome theory: Vascular anatomy and clinical implications. Plast ReconstrSurg 2009;124:1529-44 4. Pignatti M, Ogawa R, Hallock GG, Mateev M, Georgescu AlV, Balakrishnan G, Ono S, Cubison TCS, D’Arpa S, Koshima I, Hyakusoku H. The “Tokyo Consensus on Propeller Flaps. PlastReconstrSurg 2011, 127: 716-22 5. Georgescu Al., Matei I., Capota I. The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases. Diabetic Foot & Ankle 2012, 3: 18978 - v3i0.18978 6. Georgescu Al.V. Propeller perforator flaps in distal lower leg: Evolution and clinical applications. Arch. Plast. Surg. 2012 (39/2) 94-105

Microtia - Reconstruction of the Ear Juarez M. Avelar, Brazil


Congenital abnormality of the ear is a major group of deformities of the auricles. The treatment is carried out through reconstruction of the ear, which is an arduous procedure and is performed in two surgical stages. Due to several deformities a meticulous surgical evaluation is mandatory before operation, which requires adequate analysis of all anatomical disturbances of the auricle and neighboring regions as well.


Ever since the beginning of my work I have been very much concerned about the classification of the ear. Nowadays my classification of congenital anomalies presents 5 groups: 1. anotia; 2. agenesis of the auricle; 3. severe microtia; 4. moderate eutopic microtia; 5 moderate ectopic microtia. This classification is very useful for the selection of the appropriate technique. Patients with anotia do not present congenital ear cartilage or lobule; with agenesis they present absence of the ear but the auditory meatus and tragus are present; severe microtia presents lobule in abnormal position and rudimentary ear cartilage which is not used for reconstruction; moderate eutopic microtia presents lobule, external ear canal, and extended ear cartilage with conchal cavity which is all used during reconstruction in normal position of the future auricle; moderate ectopic microtia present the same anatomical structures of the moderate eutopic microtia, but all the anatomical structures are lower than on the other side. Congenital anomaly 1. Anotia 2. Agenesis of the auricle 3. Severe microtia 4. Moderate eutopic microtia 5. Moderate ectopic microtia

Methods and Materials

During 40 years of practice I have performed 695 ear reconstructions on congenital deformities on 595 patients. In all kinds of abnormalities the operation is performed under general anesthesia in two stages reconstruction. It is mandatory to create two anatomical elements: 1. a new auricular framework; 2. cutaneous covering for the new ear. Those anatomical structures require excellent conditions since blood supply is quite poor all around. Any deficiency of the arterial circulation both elements (new cartilage skeleton and cutaneous covering) may present some necrosis. Therefore, reconstruction of the auricle is a constant effort to maintain alive those anatomical structures. On the first operation the ninth rib cartilage is removed in order to sculpture the new auricular framework by excavation which is introduced subcutaneously through a tunnel created on the mastoid area. In severe microtia the lobule is created by rotation back and downward to determine the lower segment of the ear. The remnant cartilage of the congenital abnormality must be removed in order to create the new conchal cavity. On patients with anotia it is necessary to create the new lobule on the same body of the new auricular framework. On the other hands patients classified as moderate microtia (eutopic and ectopic) all remnant congenital cartilage

tissue is useful during reconstruction, but it is much smaller than of a normal auricle. Therefore it is necessary to create a new auricular skeleton excavated on rib cartilage. The second surgical stage of reconstruction is performed six months after the first one by cutaneous incisions following the posterior border of the new auricle. Afterwards the new ear is lifted by dissection bellow the fascial flap which covers the all posterior aspect of the auricle. Following the operation full-thickness skin graft is removed from the posterior wall of the opposite auricle in order to cover the raw area on the mastoid region and posterior side of the reconstructed ear as well.


The reconstructed ears present well balance with the opposite side which give to patient a well being. Although the operation is a reconstructive procedure, the final result is an aesthetic one. All anatomical details of the reconstructed ear depends basically how the surgeon excavates the new auricular skeleton during the first stage. Conclusion: Total reconstruction of the auricle is an effective procedure to reinstate the harmony of the face, giving to the patient an improvement in his personal well-being.


1 Avelar JM (1979) Microtia – simplified technique for total reconstruction of the auricle in one single stage. In: Fonseca Ely (ed) Transactions of the seventh International Congress of Plastic and Reconstructive Surgery. Cartgraf, Rio de Janeiro, p 353. 2 Avelar JM (2013) Microtia. In Ear Reconstruction (Avelar JM), published by Springer, p. 65-77.



a. During first stage of reconstruction on a patient with severe microtia on right side. A scissor is performing cutaneous undermining on the area of the future helix and antehelix. The skin of the future conchal cavity is not dissected. b. photo during the second surgical stage showing the new ear is already lifted and skin graft is done on the posterior aspect of the reconstructed ear. c. a male patient with severe microtia on right side. d. same patient 18 years after total reconstruction of the ear.



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The Examination Board, Accreditation and Educational Committee of the EBOPRAS N. Pallua, M.D., Ph.D. Vice President of the EBOPRAS B.-S. Kim, M.D.

The European Board of Plastic Reconstructive and Aesthetic Surgery (EBOPRAS)was established in 1991 and represents an official branch of the European Union of Medical Specialists (UEMS). Funded by national plastic surgical associations or societies, the organization is divided into two sub-committees, the “Accreditation & Residency Review Committee” and the “Educational Committee” and the Examination Board.

Accreditation & Residency Review Committee The “Accreditation & Residency Review Committee” is an organisation which is responsible for improving the quality of residency training programs in Europe. Furthermore, the Sub-Committee supports the harmonization and uncomplicated cooperation between different European countries and their respective departments. Reaching a high standard of expertise within Europe is one of the fundamental goals and the Accreditation & Residency Review Committee helps European plastic surgeons to join the EBOPRAS program easily. To this end, delegates of the EBOPRAS have so far visited and accredited departments of several European countries. Currently, plastic and reconstructive surgery departments from the United Kingdom, Ireland, Germany, Netherlands, Denmark, Finland, Switzerland, Austria, Spain, Portugal, Italy, Croatia, Hungary and Romania are registered as EBOPRAS accredited training centres. The accreditation visitations are not only scheduled to assess quality standards of the applying units but they also represent a way to build up a relationship with prospective accredited centers. Sharing experience and promoting exchanges between residents as well as specialists are important aspects of the accreditation process.

An official accreditation visit can be arranged via request to the Committee. Visitation forms which must be filled out by the applying department and the respective hospital can be found on the webpage (http://www. The application form includes questions about the range of surgeries, available infrastructure and specialties, employed staff or training activities. The application form will be critically reviewed by the Committee and compared to the on-site investigations conducted by a delegation. The quality of the clinical and research facilities, training and surgical spectrum and many more aspects are assessed and awarded with marks. The delegation will come to a conclusion regarding the strengths and weaknesses of the department, and finally will discuss the overall results and accept or deny the accreditation request.

Educational Committee The “Educational Committee” as the second SubCommittee of the EBOPRAS is responsible for the distribution and actualization of the Syllabus, the Logbook, other professional policy related issues and the organization of the “EBOPRAS Plastic Surgery Course”. Due to an enormous increase of the number of candidates for the “European Board of Examination in Plastic Surgery”, the Examination Board, formerly part of the Educational Committee, was established recently. To reach harmonized plastic surgical standards and a hallmark within Europe, the European Board of Examination in Plastic Surgery is organized regularly throughout the year. Since the first examination was administered in 1994, numerous plastic surgeons have Issue 14

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successfully passed the European Board Examination. A list of all “Fellows of EBOPRAS (FEBOPRAS)”can be found on the website. Importantly, the aforementioned examination cannot be equated with a work permit of all UEMS countries since these rights are exclusively owned by the national authorities. However, a number of European countries such as Switzerland, the Netherlands or France have accepted the European Board Examination either partially or completely over the years. Generally, the examination consists of two steps, a multiple choice question component, and an oral examination component. The multiple choice question part is offered twice a year. Registered plastic surgery specialists from any country or trainees of UEMS accredited countries are eligible to participate. Candidates must complete 120 questions in English within a timeframe of three hours. The questions try to avoid national features and rather focus on widely applicable theoretical and clinical concepts. Only candidates who have reached the pass mark of 66% are allowed to advance to the oral examination. In case of failure, candidates can repeat the first step with no limit set on the number of attempts. The second step of the examination is an oral test. Candidates must have passed the MCQ examination within the last three years, must not have failed the oral exam more than four times since passing the first step and be either a registered plastic surgical specialist from any country or a trainee of a UEMS country with a minimum of four years of specialty training. The oral test includes questions assigned to eight categories


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(congenital abnormalities, trauma, burns, hand surgery, tumors, reconstruction, aesthetic and breast) according to the Syllabus. The examiners will show clinical pictures and test the candidate’s ability to apply plastic surgical knowledge to each category. To grant a high standard of objectivity, the examiners have to undergo a professional coaching in advance. Furthermore, the candidates are tested by two groups of examiners which eventually cover the aforementioned eight categories. The main language of the test is English, although assistance in French, German, Italian or Spanish is available on request. Once the candidates have successfully mastered the oral examination, they will receive a certificate and be enlisted as an official Fellow of EBOPRAS. Candidates who have failed can repeat the oral examination up to four times as long as they have passed the first step within the last 3 years. Otherwise, the first step must be retaken. In order to apply for the European Board Examination in Plastic Surgery, candidates must fill in a form found on the website ( php), complete additional forms sent by email and pay the examination fee. The dates and fees are announced on the EBOPRAS website. Finally, the Educational Committee organizes the annual European Course in Plastic Surgery. It provides the opportunity to meet colleagues, strengthen co-operations and extend plastic and reconstructive surgical knowledge through numerous lectures held by internationally renowned specialists. This year’s course will be held in Thessaloniki from November 5th-7th, 2013.

Medical Educational Systems for South African Plastic Surgery Trainees & Specialist Dr Eva Anna Siolo, MD (Warsaw), MBChB (Natal), FCS Plast (SA) Nelson R Mandela School Medicine, University Of Kwa Zulu Natal

South Africa is ranked as a medium human development country by United Nations and healthier African countries. The public health sector is allocated about 4% of GDP through unconditional grants,from the national treasury. There are three bodies regulating & aiding training programs & accreditation systems in South Africa. The Health Professions Council Of South Africa (HPCSA)is responsible for matters relating to the education, training & manner of practice related to the profession this is regulated by the minister of health. The South African Medical Research Council (MRC)is an institution which objectives are to promote the improvement of the health and the quality of life of the population of South Africa through research, development and technology transfer. The third body is the Colleges Of South Africa(CMSA) which is the custodian of the quality of medical care in South Africa. It is unique in the world disciplines of medicine & dentistry. The specialist qualifications obtained through the CMSA are known as “Fellowships”. These are recognized by the Health Professions Council of South Africa as acceptable for specialist registration. For those medical and dental practitioners who do not wish to specialize the CMSA offers higher diploma and diploma qualifications which are registration by the HPCSA as additional qualifications there is also an additional qualification for those who obtain a certificate in one of the subspecialties. The primary role of CMSA is fostering postgraduate education in medical field. The major function is then provision of higher qualifications through examination and accreditation of specialized training as evidence of achievement of acceptable standards of professional competence in various disciplines registered with HPCSA recognized by sister colleges & similar institutions. The process of CMSA examination is responsibility of examinations and credentials committee. The constituent colleges are closely involved in this. Indeed, CMSA examinations could not be conducted without individual college support, which includes: • provision of a list of suitable examiners; • supervision of satisfactory standard of examination; • consideration of changes in the syllabus and conduct of examinations; • advice on accreditation of specialized training in posts which are not in treating hospitals. The CMSA is an approved and acknowledged CPD accreditor for HPCSA and members in good standing enjoy a free accreditation service upon submission of completed special forms. The continuing professional

development activities of the CMSA fall within the remit of the educational committee. Reflecting above on plastic surgery specialists training & leading post graduate accreditation the main body is College of Plastic Surgeons of South Africa which coordinate and implement educational programmes in collaboration with educational committee of CMSA. Recently specialist training is undergoing major transformation from pattern shared by the British College of Medicine to updated, modernized & truly objective teaching programs & examinations.

Training & Programmes Training programs are unified among the 8 teaching centres in the country. To successfully enter & complete fellowship of the College of Plastic Surgeons candidates must fulfill specific requirements: • Primary examination (FCS(SA) primary 2MCQpapers with no oral examination), which can be attempted after successful completion of Basic Surgical Skills course prior to applying for examination; • Intermediate (FCS (SA) IntermediateMCQ papers) which finalize 12 months of surgical training in approved posts. That period of time must include 6 months of General Surgery and 3 months of ICU also ATLS course is required at the time of applying for FCS (SA) intermediate examination; • Final examination - (FC PlastSurg (SA)-2 written papers with clinical and/or oral and/or practical). That exam can be attempted after 36 months in a numbered registrar training post in accredited institution after submission of portfolio. Recently "CRITICAL"(which stands for Certified Record of In-Service Training Including Continuous Assessment & Learning ) portfolio has been specified. It is a professional resource document structured in a flexible format which allows trainees to plan and meet the objectives of the specialty training program through documented process of work experience, learning & reflection. For the trainee, the objectives of the portfolio are to: 1. To stimulate students to think consciously and objectively about their own training. (This is known as reflective learning). 2. To document the scope and depth of the candidate’s training experiences. 3. To provide a record of the trainee’s progress and personal development as training proceeds. 4. To provide an objective basis for discussion with the candidate’s supervisors about work performance, Issue 14

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objectives, and immediate and future educational needs. 5. To provide documented evidence for the CMSA of the quality and intensity of the training the trainee has undergone. It is expected that candidates formally meet with their supervisor several times each year. At this meeting, supervisors will review the candidate’s progress and should use entries in the portfolio as a basis for discussion. This allows a structuring of the supervision process. By referring to and discussing specific areas of learning and experiences, the supervisor is able to provide informed feedback and constructive advice with regard to problems and deficiencies. In this way the portfolio allows a structuring of the supervision process. Ideally, the portfolio should be made available to the supervisor before the meeting. The CMSA requires evidence that learning has taken place as part of a structured programme. The portfolio is an important piece of evidence for this.The portfolio is not just a logbook of signed procedures undertaken or witnessed. It should contain the candidate’s written reflections and systematic documentation of his/her learning experience. It includes opportunities for candidates to reflect, to explore, to form opinions, and to identify the strengths and weaknesses in their own abilities and knowledge. It provides the facility for trainees to follow their own progress; not only through the training programme, but also towards the learning goals they have set for themselves. In this way the portfolio provides an opportunity to record and document the subjective aspects of training.

Accreditation: Accreditation of centres to provide training posts is regulated by the HPCSA. Graduates of accredited programmes are eligible for registration with HPCSA which is a legal requirement to practice the profession in South Africa. Accreditation status is valid for 5 years. It is a complex process based on institutional self-review & continuous development underpinned by the honesty & integrity of all concerned. The Health Professions Act Board’s regulations, criteria and standards identify basic elements that must exist in all accredited education programmes eg: 1. Trainee related issues: admission & recruitment objectives, composition of the students body in terms of numbers, race, sex etc 2. Staff related issues: staff profile according to qualification, race, gender, equity, exposure & capacity, workload in, staff development opportunities & number of consultants to trainee’s ratio curriculum. 3. Curriculum complying with CMSA guidance for fellowship exams 4. Resources for training like operating budge, physical space, adequacy of access to computers & internet, library facilities. Recently a component of compulsory masters of 48

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medicine (MMRD) research dissertations has been introduced as a requirement for specialist registration. That put teaching universities under pressure to formulate MMEd programmes with adequate & qualified supervision. Enabling inline modules has been developed to facilitate the easier execution of above requirement. There has been a significant decline in the number of medical publications over last 15 years due to decline in research funds so resent initiative of MRC is to revitalize medical research in the country. The so called "Flagship Program" has been established to closely cooperate with Deans & Heads of The Medical Schools to initiate high impact research projects & provide funds for equipment, infrastructure & scientific. In 2013 MRC allocated about 60 mln Rand (proxy 6mln USD) to fund 15 grants & increase the amount every subsequent year by about 20% during this 3 year program. The training & accreditation standards in South Africa are undergoing major transformation over last few years which indicates a demand for better designed programs for higher medical education. That leads to the development of new accreditation systems, procedures & standards which been enlighten in this article. It's a long road, but hopefully it will have significant local impact & set standards for rest of Africa as well as worldwide.

References: 1. South African University Flagship Project-Request For Application (RFA) Dr Niresh Bhagwandin 2. HPCSA Guidelines For Evaluation And Accreditation Of Education & Training Institutions 3. CMSA Portfolio of Learning Fellowship Of Plastic Surgeons Of South Africa 4. Revitalizing the MRC, Current State of The Organization & Proposal For The Way Forward Prof Salim Abdool Karim EDUCATION & POSTGRADUATE ACCREDITATION SYSTEM IN SOUTH AFRICA HPCSA



Health Professions Council Of South Africa

Colleges Of Medicine South Africa

Medical Research Council








8th BAPRAS Congress in Budva, Montenegro Prof. Dr. Miodrag Colic President of the 8th BAPRAS Congress The figure of about 200 participants from 40 countries speaks for itself. This has really been the most successful BAPRAS ever. People from all over the planet came to Budva to attend the magnificent Congress organized by Prof. Dr. Miodrag Colić (President of the Congress) who was assisted by the newly-founded Montenegrin Plastic Surgery Association MontePRAS. The gathering was also attended by the President of the International Confederation for Plastic Reconstructive and Aesthetic Surgery, Prof. Dr. Marita Eisenmann-Klein who, together with Prof. Colić, the President of the European Society of Plastic, Reconstructive and Aesthetic Surgery, Prof. Andreas Yiacoumettis, the President of MontePRAS-a Prim. Dr. Miodrag Đurović and with much assistance from the Secretary to the Association Dr. Aleksandra Božović-Čelebić, and the Mayor of Budva Mr. Lazar Rađenović and the Minister of Health of Montenegro Prof. Dr. Miodrag Radunović, formally opened the Congress in the evening of September 5th. The lectures were presented for three full days, and the last day, the morning of September 8, was reserved for a special event, for the first time inaugurated at the Congress, i.e. IPRAS Academy of Aesthetic Surgery for doctors on specialization headed by Prof. Miodrag Colić and assisted by Dr. Voukidis from Greece and Prof. Avelar from Brazil. The lecturers were awarded the titles of IPRAS Professors and with that, a great idea was brought to life, i.e. that the doctors in their final year of plastic surgery are given access to a better insight into the principles of aesthetic surgery from the greatest experts on that field.

This time, the session was symbolically titled 'The Art of the Face' since all techniques were related to that part of the body. The first was Prof. Yoshiaki Hosaka from Japan, who introduced the majority of the face contouring techniques by osteotomies which are now called aesthetic surgery of the facial skeleton, who was followed by Dr Igor Niechajev from Stockholm who conducts similar surgery using artificial materials such as Medpor. Dr Katarina Anđelkov presented basic techniques for upper eyelid surgery with potential complications and methods of their management, while Dr Marcos Sforza explained the same on lower lids. Prof Colić lectured on face lifting using short incisions and fat tissue modeling, Dr. Theo Voukidis lectured on the implementation of STEM cells while Prof. Avelar spoke about ear reconstructions at which he is the best in the world. The next speakers were Dr. Dana Jianu from Romania who spoke about facial rejuvenation through regenerative surgery, Prof. Ashok Gupta from India who lectured about the techniques to be used for the periorbital area, around the eyes, Prof. Marita Eisenmann-Klein presented a study of the facial attractiveness, and Dr. Katharina Russe from Austria, the coordinator of the IPRAS Laser Academy spoke about the use of lasers in facial aesthetic surgery. After that, Dr. Saša Mišeljić and Dr. Nina Šijan from the “Hospital Colić”, and dr. Aleksanda Čelebić, Secretary to the Montenegrin Association, provided a practical demonstration on the use of Botox and Juviderm filler on the face, which unexpectedly attracted great interest. The Congress itself took place in the spirit of friendship

Opening ceremony. From the left: President of MontePRAS, Dr. Miodrag Đurović, President of the congress Miodrag Colić, Mayor of Budva Mr. Lazar Rađenović, Minister of Health of Montenegro Prof. Dr. Miodrag Radunović, IPRAS President, Prof. EisenmannKlein Marita, ESPRAS President and Deputy General Secretary of IPRAS Prof. Andreas Yiacoumettis, Secretary of MontePRAS Dr. Aleksandra Božović-Čelebić

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and cooperation of the Balkan nations who all participated in it in addition to the participants from more than thirty countries who were all satisfied with the quality of lectures, and choice of eminent lecturers. I would single out some of them such as Ives Gerard Illouz from Paris, the founder of liposuction who is also a legend of aesthetic surgery, then Luis Montellano from

Opening Ceremony

Brazil, one of the creators of the lower leg prosthesis and Markos Sforza from Brazil who gave a key lecture on the use of STEM cells in regenerative medicine, and many others. Janek Januszkiewicz from New Zealand spoke of breast reconstruction, and his colleague Rado Žic from Zagreb and Violeta Skorobać from Belgrade, Nebojša Rajačić from Kuwait and Miodrag Colić from

Belgrade talked about body contouring after great weight loss. Albin Stritar talked outstandingly about burns, Igor Smiljanić and Jelena Nikolić from Serbia spoke about perforator flaps and Goran Lazović in the capacity of the Vice President of the Congress took care of the general plastic surgery and rhinoplasty techniques along with his colleague Zambelli from Croatia. Sonja Cerovac from London was a chairperson of an exceptional session on hand surgery, as well as her colleague from Romania Dan Georgescu, while Dr. Radmilo Rončević was a doyen of craniofacial surgery. Hair transplant was covered by Dr. Gorana Kuka who spoke aboutrobot technology as well as her colleagues Marsio Crisostomo from Brazil and Mihail Skerlev from Bulgaria. The most numerous surgical team was from Turkey that was headed by Ali Barutçu and Sabri Acaturk as the founders of BAPRAS, which, this time, was the first by the number of participants. It is, of course, impossible to name all participants, who were more numerous that at any other BAPRAS congress in the past. Social spirit was very much appreciable through a rich program starting from the opening ceremony by the Mayor of Budva who also supported the ceremony financially, through the dinner for lecturers and the gala dinner for all participants to the tour of the vivid Boka Kotorska that went from Cetinje, Kotor to Sveti Stefan and the Skadar Lake. We would heartily like to thank our sponsors: X1 Medical Technologies (Cytori,Motive,Tulip), Polytech, Mentor, Allergan, MediexpertD.O.O., LipoSales, VOE, Proaesthetic, Promoitalia, Zimmer, Bioenergetic Labs

At the IPRAS booth. From the left: Dr. Kostas Manos, Greece, Dr. Toma Mugea, Romania, Prof. Andreas Yiacoumettis, Greece, Prof. Eisenmann-Klein Marita, Germany, Prof. Acaturk Sabri, Turkey, Turkey, Dimitre Evstatiev, Bulgaria, Prof. Alexandru V. Georgescu, Bulgaria, Dr. Agim Berisha, Kosovo, Dr. Miodrag Đurović, Montenegro


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Tulip Booth Journalists from the Press Conference

Mentor Booth

Prof. Andreas Yiacoumettis, Greece and Dr Goran Lazovic, Serbia during the Press Conference

Polytech Booth

ZIMMER booth

During the congress a successful press conference was organized with the participation of a large number of media representatives from several television channels, radio stations, magazines and newspapers. Prof.

Eisenmann-Klein talked about Fat Transplantation, Prof. Yiacoumettis analyzed the Malignant Skin Tumors, Prof. Lazovic provided information about the congress and BAPRAS purposes. Dr. Miodrag Ä?uroviÄ&#x2021; presented the Importance of Plastic Surgery in Traumatology. Journalists participated very actively with questions and the atmosphere was very lively. Plastic Surgery and BAPRAS congress were among the main themes on the media in Montenegro. I believe that the participants brought home a full suitcase of beautiful memories from Montenegro which this time was a very proud host. It was in any case an event to remember. The next congress, as it was decided on the last day by the General Assembly of the BAPRAS, will be held in two years on the Hippocrates island of Kos in the mutual Greek-Turkish organization with the visit to Bodrum on the nearby Turkish cost. The new President of the BAPRAS, Kostas Manos from Thessaloniki, will surely do his best to make that congress unforgettable because he has been in this organization as the Secretary General from its foundation in 1998. The spirit of the Balkan association continues with its life gaining strength as it goes and gathering around itself not only Balkan but also other eminent surgeons from all corners of the globe. Unity in the profession is the only reference. Issue 14

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Croatian Society of Plastic Reconstructive and Aesthetic Surgery

Croatian Medical Assembly

The last year activities of our Society. Zlatko Vlajcic, MD, PhD, Plastic Surgeon CSPRAS Secretary Croatian Society of Plastic Reconstructive and Aesthetic Surgery cofounded "FELLOWS IN SCIENCE“, the Regional Coordination of Plastic Surgery Societies of South-east Europe for the purpose of regional professional and scientific exchange of knowledge and experience. The Coordination consists of the four regional Societies in the fields of Plastic, Reconstructive and Aesthetic Surgery from Slovenia, Croatia, Bosnia-Herzegovina and Serbia and the founding meeting was held in University

R. Karabeg, M. Margariotni, M. Novakovic, U. Ahcan Founders of “Fellows in Science”

Hospital “Dubrava” in Zagreb, Croatia on the 27th of November 2010. The founders of the Coordination were Presidents of the regional National Societies: Prof. U.Ahcan from Ljubljana, Ass. Prof. M.Margaritoni from Dubrovnik, Ass.Prof. R.Karabeg from Sarajevo, and Prof. M. Novakovic from Belgrade. The members of the Steering Committee are the four founders plus Prof. R. Zic from Zagreb, Ass. Prof. N. Stepic from Belgrade, Ass. Prof. Z. Roje from Split, Prim. R. Milanovic and Prim. Z. Vlajcic from Zagreb. The Coordination “Fellows in Science” has just finished our first Congress held 18-21th of September 2013 in Ljubljana, Slovenia, with 180 participants and 25 international invited speakers. The President of the Congress was Prof. U. Ahcan, and will soon publish a final report. The next Congress of the “Fellows in Science” is planned for the 1st of November 2015 in Dubrovnik, 52

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Croatia, joined with the National Congress of the CSPRAS and appointed by ESPRAS. The organization of the further Congresses will be over a period of two years, always in conjunction with the National Congresses of the domestic Societies. The Coordination also organized the “Adriatic Club”, consisting of plastic surgeons from the same region, similar to the “Alpine Club” and the “Pyrenean Club”. The founders of the “Adriatic Club” were: U. Ahcan (Ljubljana), I. Ducic (Washington), M. Fabjan (Kranj), R. Karabeg (Sarajevo), M. Margaritoni (Dubrovnik), Z. Roje (Split), S. Stanec (Zagreb), Z. Stanec (Zagreb), Z. Veir (Zagreb), M. Zambelli (Rijeka), Z. Magaš (Bjelovar) R. Žic (Zagreb) and Z. Vlajčić (Zagreb). We also completed our first 5-day meeting, on the MSC Cruiser “Musica“ during the West Mediterranean Cruise (Venice-Athens), completely financed by the members, from 28/10 ‘til the 01/11/2012 with a lot of interesting topics like: peripheral nerve injuries in aesthetic plastic surgery, the court expertise in plastic surgery, the process of education and licence approval in plastic surgery, complications of different mammaplasty techniques, "fillers“ usage, abdominoplasty, breast implants, advertising in plastic surgery, professional insurance

Z. Vlajcic, M. Margaritoni, Z. Roje, U. Ahcan, M. Zambelli – “Adriatic Club-Dubrovnik”

Exchange program Danish Hand Society - CSPRAS, M. Steinbauer, H. Fisker - visiting University Hospital “Dubrava”, Zagreb, EBOPRAS Educational Center

Exchange program Danish Hand Society - CSPRAS, Z. Vlajcic, R. Selmani - visiting Gentofte Hospital, Copenhagen, Denmark

in plastic surgery etc. We also organized a lot of social activities for the members and accompanied persons. For the next meeting we are planning an East Mediterranean Cruise in two years. From 07 - 08th June 2013 we organized the “3rd Zagreb International Course in Breast Reconstruction” at the Department of Plastic, Reconstructive and Aesthetic

Surgery, University Hospital “Dubrava”, Zagreb, sponsored by Mentor, for participants mostly from Egypt. Previous meetings were organized at the same hospital for participants from India and Russia. We also organized two Symposia with interdisciplinary and international panels, based on whom we published this year Guidelines for Melanoma Therapy and Guidelines for Oncoplastic Surgery of the Breast. And finally, we have also continued the cooperation of the Danish Hand Society and CSPRAS (M.MargaritoniR.Gvozdenovic). The residents and young specialist exchange program started this year with invited two weeks visiting for plastic surgeons from Croatia (Z.Vlajcic-Zagreb, R.Selmani-Dubrovnik) to the Gentofte Hospital and Rigshospitalet in Copenhagen in June, and responsive visiting of two colleagues from Denmark (M.Steinbauer, H.Fisker) to the University Hospital “Dubrava“, Department of Plastic, Reconstructive and Aesthetic Surgery as EBOPRAS Educational Center.

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Experience met Curiosity: Annual Convention DGPRÄC & VDÄPC 2013 in Münster Hans Strömsdörfer

Berlin/Münster – “For Plastic Surgery, there is no need to fear the future. Thanks to flat hierarchies and a broad surgical spectrum it is attractive for young physicians”, Prof. Peter M. Vogt, President of the German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC), pointed out opening the congress. “Experience meets Curiosity” was the motto of the 44th Annual Convention of DGPRÄC and the 18th Annual Convention of the Association of German AestheticPlastic Surgeons (VDÄPC) in Münster. Numerous events enabled a cross-generation exchange from September 12 to 14, 2013. With more than 230 scientific lectures, 95 posters, eight workshops, nine lunch symposia, a handson class, and 33 scientific symposia, over 800 visitors learnt about the latest in Plastic Surgery. “Plastic Surgery is a vital part of the health system”, said Federal Health Minister Daniel Bahr who came to open the convention in Halle Münsterland Congress Center. “No matter if the patient visits you after accident, tumor or for aesthetic reasons – your job enables them to participate in society again.” In their program, Congress Presidents Dr. Albrecht Krause-Bergmann and Dr. Wolf D. Lüerßen emphasised the interdisciplinary aspect of Plastic Surgeons’ work. For instance, dermatologists, gynaecologists, urologists

and psychologists debated together at a panel discussion about “genital surgery”. Interdisciplinary sessions about “oncological reconstruction” and “oral and maxillofacial surgery” also enabled further exchange. Speakers from all over the world (e.g. United Kingdom, Canada, the US, Brazil) provided an insight into international Plastic Surgery research. Even Dr. Graeme Perks, President of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), Dr. R. D. Gregory Evans, President of the American Society of Plastic Surgeons (ASPS), and Dr. Charles N. Verheyden, President of the Plastic Surgery Foundation (PSF), came to Münster. “Complications” were also an issue in Münster. A session about the “development of multi-resistant bacteria in Burns ICUs“ dealt with the question about the effectiveness of antibiotics’ therapies. In an international session about complications in Aesthetic Plastic Surgery the participants discussed their problem management. Another session was about the future of stem cell and autologous fat transplantation.

Federal Health Minister Daniel Bahr opens the Plastic Surgeon convention.

Congress President Dr. Albrecht Krause-Bergmann congratulates new DGPRÄC President Prof. Dr. Jutta Liebau.


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New board The DGPRÄC general meeting elected Prof. Dr. Jutta Liebau (Düsseldorf) as the new President of the society. Prof. Dr. Hisham Fansa (Bielefeld) was elected new Vice President. Prof. Dr. Lukas Prantl (Regensburg) became Secretary, while Dr. Eva-Maria Baur (Murnau) continues as Treasurer.

Honorary Member Prof. Dr. Hans-Ulrich Steinau received this year’s DGPRÄC Honorary Membership. 1990 to 2012, he was head of the Clinic for Plastic Surgery and Burns Unit at BG University Hospital Bergmannsheil of Ruhr University Bochum. Prof. Steinau was President of the former “Society of Plastic Surgeons” (today DGPRÄC) from 2001 to 2003. In 2006/2007, his Presidency of the German Society of Surgery (DGCh) followed – as first Plastic Surgeon ever. There, he initiated the book “German Society of Surgery 1933-1945“, which analyses DGCh-Presidents of the Third Reich. Next to the vonLangenbeck-Prize and several scientific awards, he was honoured with the Cross of Merit on ribbon in 2011. Dieffenbach Medal and Höhler Pin DGPRÄC President Prof. Dr. Peter M. Vogt (right) awards Prof. Günter M. Lösch with the Dieffenbach medal.

Honorary Members in private: Prof. Dr. Hans-Ulrich Steinau (left) und Prof. Dr. Edgar Biemer at the buffet.

Prof. Dr. Günter Maria Lösch, founder member of the “Society of Plastic Surgeons” (today DGPRÄC), was awarded with the Dieffenbach medal in Münster. He gave the traditional Dieffenbach lecture about “The phases of life from a Plastic Surgeon’s view: cultural-historical thoughts”. 1974 to 1996, Prof. Lösch was Director of the Clinic and Policlinic for Plastic Surgery at Lübeck University Hospital. He was also a founding member of the “Association of the Scientific Medical Societies in Germany” (AWMF). Being “DGPRÄC Historian”, he established the “Ulrich-T.-Hinderer-Library” in Berlin in 2006/2007. Prof. Lösch has been DGPRÄC Honorary Member since 2008. DGPRÄC has awarded the Dieffenbach medal since 1989 in memory of Plastic Surgery pioneer Johann Friedrich Dieffenbach (17921847). VDÄPC honoured Prof. Dr. Wolfgang Mühlbauer with this year’s Höhler Pin. 1984 to 2003, he headed the Department of Plastic Surgery, Hand Surgery and Burns Unit at Bogenhausen Clinic in Munich. He founded the

“Association for promoting Burns Patient treatment“ in 1985, to support the work of the Bogenhausen Burns Unit. In 1989, he was founding member of the “European Association of Plastic Surgeons” (EURAPS), in 1995 founding member of VDÄPC. In 2005, Prof. Mühlbauer was honoured with the Cross of Merit on ribbon. He became DGPRÄC Honorary Member in 2007 and received the Dieffenbach Medal in 2008. Science Award and Scholarship Dr. Daniel Tilkorn (Krupp-Krankenhaus Essen) received 3000 Euro as the winner of this year’s DGPRÄC Science Award. His study “In vitro myoblast pre-conditioning enhances subsequent survival post in vivo implantation into a murine tissue engineering chamber“ is about the survival of stem cells in tissue engineering. Dr. Katrin Seidenstücker (Sana-Kliniken Düsseldorf) won the 2500 Euro Travel Scholarship donated by “Polytech Health & Aesthetics GmbH”.

Received the Höhler Pin of VDÄPC: Prof. Dr. Wolfgang Mühlbauer has a conversation with his “dinner partner” Katharina Olbrisch.

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best scientific poster (“Effects of TRAIL and TRD on apoptosis and proliferation in human rhabdomyosarcoma, leiomyosarcoma and epithelioid cell sarcoma”) was given to Carmen Karlisch (Gynaecological Hospital Witten) and her team.

Journalist Award

A strong team – the Congress Presidents Dr. Wolf D. Lüerßen (left) und Dr. Albrecht Krause-Bergmann.

Congress Prizes Mehran Dadras and his team (Clinic for Plastic, Aesthetic and Reconstructive Microsurgery / Hand Surgery at Ernst von Bergmann Hospital in Potsdam) received 1500 Euro for the lecture “Instant perineum and pelvis floor reconstruction with VRAM flaps after abdomino perineal rectum resection at rectum and anal cancer”. 1000 for the

All Abstracts can be found here: 56

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The 2013 „Journalist Award of German Plastic Surgeons“ went to Dr. Heike Le Ker und Dr. Dennis Ballwieser. The “Spiegel online” journalists received 2000 Euro for their article “Misadvised unter the knife“. There, they analyse a “beauty clinic test” and inform their readers about how to find a good doctor and which questions to ask. The Journalist Award exclusively goes to print media. Further training of the year DGPRÄC Associated Members elected the best Further Training Hospital of the year for the sixth time. In the category „more than four Assistants in Further Training“ the award went to Prof. Dr. Hans-Eberhard Schaller, Director of the Clinic of Hand, Plastic, Reconstructive and Burn Surgery at BG Hospital in Tübingen. The category “up to three Assistants in Further Training” was won by Dr. Peter Huber (Head of Department of Plastic Surgery, Aesthetic Surgery and Hand Surgery at Marienhospital in Schwerte).

All photos: DGPRÄC/Helge Schubert

                               

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      

        

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11th Annual Congress of the Northern Cyprus Society of Plastic, Reconstructive and Aesthetic Surgeons Report Huseyin Borman, MD, Prof. President Northern Cyprus Society of Plastic, Reconstructive and Aesthetic Surgeons The 11th Annual Congress of the Northern Cyprus Society of Plastic, Reconstructive and Aesthetic Surgeons was held in Girne, in the Northern Cyprus, from the 12th to the 15th of September, 2013. The participants enjoyed the Opening Cocktail Party that was organized at the Bellapais Ruins. There was a friendly atmosphere at the hillside.

The Opening Ceremony was initiated with the speeches of the President of the Congress, Dr. Emirali Hamiloglu, President of the Society, Prof. Huseyin Borman, Founder President, Prof. Ali Nihat Ulgen, President of IPRAS, Prof. Marita Eisenmann-Klein and Minister of Health of T.R.N.C., Dr. Ahmet Gulle. New developments were shared among the national and international colleagues. The scientific program included aesthetic surgery of the nose, eyelids, face, breast,


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abdominal wall and body contouring. Also, reconstructive surgery for congenital anomalies and traumatic defects was discussed. Studies on microsurgery were presented. In the special panel comprised of international guest speakers, the President of the IPRAS Board of Trustee, Prof. Guler Gursu gave the first presentation on International Relations in Plastic Surgery Societies; Prof. Marita Eisenmann-Klein presented her experiences of Breast Reconstruction using Fat Injections; Prof. Hiroshi Mizuno from Japan presented his studies on Stem-cells and their Clinical Applications; and Prof. Kurt Vinzenz from Austria shared his experiences in Restorative Surgery for Facial Aesthetics. The President of the Cyprus Society of PRAS, Dr. Christos Merezas, presented his methods of Breast Augmentation Mastopexy. Numerous panelists from Turkish Society of Plastic, Reconstructive and Aesthetic Surgery attended the congress and talked on a variety of subjects.

International Plastic Surgery Mission in Uzbekistan Murod M. Jafarov, MD, PhD Main pediatric plastic surgeon of Ministry of Health Uzbekistan President of Society of Plastic reconstructive and Aesthetic surgeons of Uzbekistan (SPRASU)

“Smile Train”, an NGO with an Indian team and Uzbek charitable organization as Fund "You Are Not Alone" with Society of Plastic reconstructive and Aesthetic surgeons of Uzbekistan (SPRASU) were offering plastic surgery operations to all children who need these surgeries. This mission was first in Uzbekistan where “Smile Train” joined. Before the mission, two people, Dr Ashish Sabharwal and Dr Nodir Alimov went in Urgench to select a hospital. The “Regional Children’s Hospital” in Urgench city was selected on the basis of designated surgeons and anesthetists with good standing and MCI registration. Mission was done from May 28 to June 6, 2013, in this mission was attended: from India - Dr. Ashish Sabharwal's, Dr. Raman Sethi, Dr. Pankaj Soni, Dr. Harish Ghildiyal, Dr. Rahul Chhajlani, Assistant of surgeons Ramanjit Singh and Baljit Kaur, nurses Sukhdev Singh

and Rajwinder Kaur; from Uzbekistan - Dr. Murod M. Jafarov, Dr. Mavlon T. Meliboev, Dr. Ikhtiyor Nizamov, Assistant of surgeons Jalol Mubarov and Temur Radjapov, nurse Umida Nadjmitdinova and a representative of the Uzbek Fund. The Uzbek Fund "You are not alone" covered all the costs of all participants associated with food and accommodation in one of nice hotel "Khorezm Palace." During the mission period 151 patients were viewed with different pathologies of the face, and after discussion 73 children were selected for surgery. Later, 12 operations were canceled due to anemia, bronchitis and diarrhea in the children. Within 4 days 61 operations were completed, and 3 took place under local anesthesia. Most patients were with cleft lip and palate, and there were some cases with secondary cleft lip nasal deformity. There were three operation

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tables in two operation rooms. The postoperative period was without complications. For two patients with wide alveolar fistula, tongue flaps were used. After 15 days they were recommended to make a visit to Tashkent for the cutting of the tongue flaps. For young doctors of Regional Children's Hospital of Urgench, master classes on major diseases were given, such as the cleft palate and lip from the Indian team. 5th June Indian surgeons for students Urgench branch of Tashkent Medical Academy made presentation by plastic surgery. The Urgench people were happy about this mission and kindly requested for this team to come again. On the last day of our visit we played soccer with local medical team from Hospital. It was a friendly game. After 10 days, the next International mission started in Tashkent with Korean plastic surgeons. This team was from Yonsei University College of Medicine (YUMC) and it was their 14th Annual mission to Tashkent. The Korean part was attended by Prof Kim Yong Oock, Prof. Chung Yoon Kyu, resident Yoon Taeho and scrub nurses Park Gi Jeong and Kim Song Yi. For the operation, they selected the Department of Plastic surgery of Tashkent Pediatric Medical Institute Clinic, which was same as over the last 14 years. There are


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three operation rooms with all facilities and equipment for surgery. Also, the anesthesiologist team (Dr. Mavlon Meliboev, Dr. Bakhtiyor Goziev, Dr. Otabek Fayziev and Dr. Ikhtiyor Nizamov) was one of best in the country, because this team had great international experience and a high level of skill. In the outpatient department 114 patients were checked, with cleft lip and palate, post-burn scar deformity, polydactyly and syndactyly, some vascular malformation and skin defects. Among the patients, 35 were selected for surgery. The mission was from the 16th June till 22nd June and operations on 33 patients took place, and two were cancelled, due to fever. There were three operation tables in two rooms. Post-operative time for patients was without any complications. Local doctors, as Nodir Alimov was one of active surgeons in this mission. The Uzbek team of this Department and the staff of the Plastic Surgery Department of YUMC have had a longterm cooperation in plastic surgery, and all Uzbek doctors passed training in Korean partner University. This kind of international mission helps to improve knowledge and surgical skills for young doctors. We are hoping that future members of SPRASU will become more active members in international missions.


The Austrian Society of Plastic, Aesthetic and Reconstructive Surgery Mrs. Eva Klausner Department of Biomedical Research WaehringerGuertel 18-20, A-1090 Vienna Ph.: ++43 (0)1-40400-5222, Fax: ++43 (0)1-40400-5229 E-mail: Web.: The Association was founded on November 9th, 1963, and the founding members were:R. Trauner (1stPresident), R. Ullik, W. Ehalt, O. Hofer, P. Wilflingseder, S. Wunderer, H. Kรถle, J. Glaninger, E. Winkler, L. Antoine, H.G. Bruck, W. Deutschmann, G. Freilinger, H. Millesi, H. Pierer, R. Strehli, M. Trauner, and F. Klementschitsch. In 1963 the 3rd Congress of the International Confederation of Plastic and Reconstructive Surgical Societies took place in Washington. The wish of Austria to be represented in and to become member of this confederation led to the foundation of the Austrian Society of Plastic Surgery. Until 1971 the Austrian Society of Plastic Surgery was part of the Austrian Society of Surgery, but with the implementation of a specialty for plastic surgery, the society became an independent but associated society in 1972, organizing its own Annual Meetings. In 1969 H. Millesi reported the first results of microsurgery on peripheral nerves. In 1972 the pioneers of the up and coming new field of microsurgery met at the first Symposium on Microsurgery of Peripheral Nerves

and Vessels in Vienna. This event laid the foundation for the Society of Reconstructive Microsurgery. Already at the 2nd Vienna Symposium on Microsurgery of Peripheral Nerves and Vessels the first results of free microvascular flaps were presented. Since then the success of microvascular surgery has basically changed the profession of plastic surgery. Therefore in 1976, H. Millesi and G. Freilinger established the first duty for replantation in Europe. In 1990, during a surgical separation of Siamese twins in Vienna, the Department of Plastic Surgery, Head H. Millesi, performed the first homologous muscle transplantation worldwide. In 1991 the Austrian Society of Plastic Surgery changed its name to the Austrian Society for Plastic, Aesthetic and Reconstructive Surgery under the then president J. Holle. Under his presidency breast reconstruction with a free abdominal flap, nowadays a state-of-the-art procedure, was established. An important milestone was set in Innsbruck in March 2000; H. Pizaand, R. Margreiter and their teams performed

51 Ann Meeting-Rupert Koller-Thomas Hintringer (Vice President)-Elisabeth Zanon (Board Member) -Matthias Rab (Congress President)-Walther Jungwirth (President).jpg

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IPRAS Journal


the first successful double-hand transplantation in Austria (the second worldwide) in a patient, who had lost both hands in a bomb attack. The Annual Meetings have always the aim to present and discuss an interesting selection of topics, such as the problem of the Dupuytren´s contracture, or the progress of the surgery of the plexus brachialis since 1960 (H. Millesi, 2007). During Th. Hintringer´s presidency (2011-2013) the Austrian Parliament passed a new law on aesthetic surgical interventions in 2012. Due to the Board´s and The Madagascar Team.jpg

Thomas Hintringer Vice President

Walther Jungwirth President

Th. Hintringer´s efforts, this law regulates the medical competency for aesthetic procedures.The Austrian Society for Plastic, Aesthetic and Reconstructive Surgery now has 161 Full and 33 Associated Members, and the Austrian Society for Plastic, Aesthetic and Reconstructive Surgery organizes advanced training courses for residents twice a year in proportion to the 4year training program. W. Jungwirth, president of the Society, actively supports a project in Bolivia, and up to now he and his friends have financed more than 50 cardiac operations for Bolivian children. For many years Th. Hintringer, former president, has supported a health-project in Mweka/

Dr. Helmuth Hoflehner Board Member 62

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Dr. Gerhard Pierer Board Member Issue 14

Kongo. Though transport of goods and any personal effort were very difficult because of the political situation in this region, a new hospital was built and commissioned in 2011, thus providing at least basic medical care. In 1995 J. Holle founded an organization for African children with Noma disease. There are many other members of the society engaged in humanitarian projects, such as S. Spendel in Kosovo, M. Deutinger in Jemen and Libya, and I. Plötzenender in Madagascar. All of them work on an honorary basis in local hospitals and perform mainly reconstructive surgical operations. The main upcoming event is the Annual Meeting 2014, hosted together with the German Society of Plastic, Reconstructive and Aesthetic Surgery and the German Society of Aesthetic-Plastic Surgeons. Furthermore, our Society patronizes several other smaller events, such as the 4th Symposium on Plastic Surgery in Bozen/South Tyrol, the 11th Plastic Residents´-Week in Salzburg, and the 5th Vienna Symposium on Surgery of Peripheral Nerves. The current Board of Directors consists of the following people: President: Dr. Walther Jungwirth; Vice-President: Prim.Dr. Thomas Hintringer; Secretary: Univ.Prof. Dr.Stephan Spendel; Treasurer: Univ.Prof.Dr.Lars-Peter Kamolz; as well as the Advisory Board: Univ. Prof. Dr. Gerhard Pierer; Prim. Dr. Boris Todoroff; Dr. Elisabeth Zanon; and Dr. Gabriel Djedovic.

Dr. Hildegunde Piza-Katzer

Dr. Stephan Spendel Secretary


Ear Reconstruction Avelar Juarez M., Brazil This book was published by Springer in 2013 with 191 pages and 610 colour photos including diagrams, tables, trans-operatory photos and clinical cases of several patients. Ear reconstruction is required with a variety of patients, especially those with congenital anomalies and associated deformities. In this book, a experienced practitioner in ear reconstruction explains the approaches that he has personally developed over the past 40 years in order to improve surgical results, and also presents important new concepts. The proposed techniques offer tailored solutions to specific problems and are applicable in settings including severe microtia, moderate microtia, anotia, traumatic amputation, and unsatisfactory prominent ear surgery. Complications during and after ear reconstruction are also discussed, with guidance on their treatment. Throughout the book, the aim of the author is to share the fruits of his extensive experience with fellow surgeons in an informative and practically oriented way. The clearly written text is accompanied by numerous helpful colour photographs.

Contents 1 Surgical Anatomy of the Ear and Neighboring Regions Juarez M. Avelar ...............� 1 2 Classification of Congenital Anomalies of the Ear and Associated Deformities Juarez M. Avelar .............� 15 3 Surgical Principles and Planning for Ear Reconstruction Juarez M. Avelar .............� 33 4 Modeling of the New Auricular Framework Juarez M. Avelar and Thiago M. Avelar............................................................................................ 45 5 Temporo-Parietal Fascial Flaps to Improve Ear Reconstruction Juarez M. Avelar .............� 55 6 Microtia Juarez M. Avelar .............� 65 7 Moderate Microtia Juarez M. Avelar .............� 79 8 Anotia Juarez M. Avelar .............� 91 9 The Upper Pole Juarez M. Avelar ..........� 101 10 Auricular Lobule Juarez M. Avelar ..........� 117 11 Acquired Deformities of the Auricle Juarez M. Avelar ..........� 129 12 Complications During and After Ear Reconstruction Juarez M. Avelar and Helio de Rezende Paolielo Jr. .............................................................. 151 13 Craniofacial Anomalies Associated with Microtia: Importance of Its Repair Before, During and After Ear Reconstruction Marcelo Paulo Vaccari-Mazzetti, Juarez M. Avelar, and Thiago M. Avelar .............. 163 Issue 14

IPRAS Journal


Review of

“A life that matters

transforming faces, renewing lives” Zubin J. Panthaki, MD, CM, FRCS(C), FACS Professor of Clinical Surgery Professor of Clinical Orthopedics University of Miami - Miller School of Medicine

Abstract Book review of "A life that matters-transforming faces, renewing lives" by Dr. Kenneth E Salyer, M.D. Published by Center Street publishing, a subsidiary of Hachette Book Group, New York, USA, June 2013. Softcover paperback with 339 pages. Illustrated with some black and white photographs.

Text body Book review of "A life that matterstransforming faces, renewing lives" by Dr. Kenneth E Salyer, M.D. Published by Center Street publishing, a subsidiary of Hachette Book Group, New York, USA, June 2013. Softcover paperback with 339 pages. Illustrated with some black and white photographs. Dr. Salyer is one of the pioneers in the field of craniofacial surgery. This book, "A Life that Matters" is an autobiographical account of some of the influences and impact Dr. Salyer and his work has had on craniofacial and cleft surgery around the world. It is an inspirational work and written in the form of a memoir. The book has 11 chapters with an introduction and an afterword by the author. It is written as an historical journey through the life of Dr. Salyer with key chapters devoted to special cases. Initial sections of the book deal with Dr. Salyer's motivation for becoming a craniofacial surgeon including his difficult upbringing and his sister's injury resulting in the need for facial surgery. Other key events that shaped his life and career included being in the trauma bay when President Kennedy came in to the Dallas hospital after his fatal gunshot wounds and witnessing the miraculous transformation of various cleft lip and palate surgeries. During the early years of craniofacial surgery Dr. Salyer had the fortunate opportunity to interact with some of 64

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the giants in the burgeoning field; Ian Jackson, Danielle Marchac, Paul Tessier, and Jack Mustarde all influenced his eventual career interests. Dr. Salyer had achieved what many would consider to be the pinnacle of his profession by the time he was 40. He was Professor and Chief at University of Texas, Southwestern and was happy with his career and family. He then falls on hard times: his marriage ends in divorce, he is fired from his academic position and he has to struggle to make ends meet and deal with depression. This book is inspirational for two reasons: 1. Because of the great craniofacial work and progress that is demonstrated in caring for the world's children, but also 2. Because of Dr. Salyer recovering from the depths of his depression and reestablishing himself and his career. Despite his termination from University of Texas - Southwestern, Dr. Salyer ends up reestablishing a practice in Dallas and becoming very successful once again. Then, slowly over the years, he establishes the World Craniofacial Foundation and raises money to do craniofacial surgery for underprivileged children throughout the world. Over the course of the next few years, the World Craniofacial Foundation performs miraculous and amazing surgeries for children in need. Several chapters in the book are devoted to case studies of challenging and inspirational outcomes from craniofacial surgery. The book ends on an inspirational note showing the meaning that Dr. Salyer has found in his life by performing good works and trying to raise awareness of children with craniofacial anomalies. This book is quick-paced and uplifting. I encourage anyone considering a career in craniofacial surgery or wanting to know more about one of the pioneers in the field to read this book.

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NATIONAL & CO-OPTED SOCIETIESâ&#x20AC;&#x2122; FUTURE EVENTS 05 - 07 November 2013

22nd European Course in Plastic Surgery Location: Thessaloniki, Greece - Venue: Porto Palace Telephone: (+30) 211-1001782 - E-mail: URL: 21 - 24 November 2013

15th International Course on Perforator Flaps Location: New York, USA - URL: 25-26 November 2013

39th Annual meeting of the Israel Society of Plastic & Aesthetic Surgery Venue: Hilton Tel-Aviv - E-Mail: 27 - 29 November 2013

Winter Scientific Meeting 2013 Location: Dublin, Ireland - Venue: The Convention Centre Dublin Telephone: 0207 831 5161 - E-mail: URL: 10 - 13 April 2014

11th IQUAM congress and consensus conference & 3rd International Meeting of the IPRAS-Trainees Association Location: Budapest, Hungary - Venue: Marriott Hotel Contact: Nikos Antonopoulos - Telephone: (+30) 211-1001782 E-mail: - URL: 06 - 11 July 2014

ESPRAS 2014 (European Society of Plastic, Reconstructive and Aesthetic Surgery) Location: Edinburgh, Scotland, UK - Venue: Edinburgh International Conference Center E-mail: - URL: 03 - 06 September 2014

LaserInnsbruck 2014 Location: Innsbruck, Austria - Venue: Congress Messe Innsbruck Contact: Mina Ploumpi - Telephone: (+30) 211-1001781 E-mail: - URL: 6 -8 November 2014

Forth Congress of the World Association for Plastic Surgeons of Chinese Descent in Hong Kong. Co-organizers include the Hong Kong Association of Cosmetic Surgery, the Departments of Surgery of the University of Hong Kong and the Chinese University of Hong Kong, and the College of Surgeons of Hong Kong. Venue: Hong Kong Academy of Medicine - Telephone: (852) 2155 8557 E-mail:

It is our great pleasure and honor to invite you, Mexico will host two major events of plastic surgery,“International Symposium of Breast Surgery and Rhinoplasty. In tribute to 100th anniversary of Dr. Mario González Ulloa” that will take place at Presidente Intercontinental Hotel from December 6 7, 2013, and 45 National Congress of AMCPER that will be held in Expobancomer from April 29th to May 03th both are dedicated to all plastic surgeons of the world. Mexico City is a fascinating capital that beguiles its visitors with endless options. One of the largest metropolitan areas in the world. Many of the most visited tourist attractions in Mexico City are concentrated in the historic center, including the Plaza de la Constitucion or Zocalo, the National Palace, Metropolitan Cathedral, Templo Mayor, Palace of Fine Arts and Alameda Park. A few blocks north of the Palace of Fine Arts, Plaza Garibaldi is one of the best places in Mexico City to hear live mariachi music. Chapultepec Park, the largest in Mexico City, is divided into three sections and home to several of capital’s top tourist attractions, including Chapultepec Castle, the Modern Art Museum and the National Museum of Anthropology. Keep in mind that, with a few exceptions, most museums and archaeological sites in Mexico City. You’ll also want to explore the neighborhoods of Zona Rosa, Roma, Condesa, Coyoacan and San Angel. Home to lovely parks, plazas, shops, markets, cafes and some of the top tourist attractions in Mexico City, these artsy neighborhoods are especially popular among visitors to the city and foreign residents. Nearby, in the trendy posh neighborhood of Polanco you’ll find some of Mexico City’s top nightspots and chic restaurants. Further south, the University City campus of Mexico’s National Autonomous University is known for its modern architecture and impressive murals that are the work of some of Mexico’s top artists. The University Cultural Center hosts a variety of events and performances. In the southern Xochimilco borough of Mexico City and north of the city at the Teotihuacán archaeological site. In Xochimilco you can hire a colorful trajinera (wooden boat) to tour the canals and gardens.

For further information please visit: International Symposium of Breast Surgery and Rhinoplasty. In tribute to 100th anniversary of Dr. Mario González Ulloa”

45 National Congress of AMCPER

José Luis Haddad Tame, MD President AMCPER

SAVE THE DATE 12th Quadrennial Meeting of the European Society of Plastic, Reconstructive and Aesthetic Surgery 6-11 July 2014 Edinburgh International Conference Centre

A European Voice for Plastic Surgery ������������������������� � Surgical Skills Masterclasses � Dedicate Nurses Programme � Non Surgical Aesthetic Workshop � Oral Abstract Sessions � Poster Sessions

For the latest information and further details on ���������������������������

Congress Secretariat: ESPRAS 2014 26-28 Hammersmith Grove, London W6 7HA +44 (0) 20 8748 8868

Hosted by

Leading international speakers including Demetrius Evriviades, UK Elizabeth Hall-Findlay, Canada Fu Chan Wei, Taiwan Gary Burget, USA Gino Rigotti, Italy Hans de Bruijn, Holland Henk Giele, UK John Thompson, Australia Laurent Lantieri, France Mike Klaassen, New Zealand Olivier Gerbault, France Peet van Deventer, South Africa Peter M. Vogt, Germany Rod Cooter, Australia Simon Kay, UK Vishy Mahedevan, UK Werner Audretsch, Germany

n it o n! a e r t s op i g w e R no is


17th ASEAN Congress of Plastic Surgery in conjunction with 11th International Confederation for Plastic, Reconstructive & Aesthetic Surgery – Asia Pacific Section Congress 2014 1– 4 AUGUST 2014 . SINGAPORE

Email: Tel: Fax: +65 6411 6641 +65 6496 5599


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JOIN YOUR COLLEAGUES The first website that gives you the opportunity to upload your scientific profile for free!!


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Take advantage of the opportunity to upload free and easy, your scientific profile at the IPRAS website. Gain the benefits of being under the IPRAS umbrella. Sign up on and follow the following steps: 1. Create an account by clicking “Member’s login” on the top right-hand corner and then select the “Create new account” tab. 2. Fill out your “Username”, “Email” and “Password”, as required. 3. Select the option “Doctor” and your country, under the section “If you are a doctor, complete the following”. 4. Once all account details have been added, click on “Create new account” button. Then you click on “EDIT” and then on “DOCTOR PROFILE”. This is the section where all the information of your scientific profile can be uploaded. You may complete the fields with the information that you prefer such us: Personal Picture, Hospital Position, Affiliation, Special Field of Interest, Contact Details, Memberships, Topics of Special Interest, Publications etc. At the “EDIT” section you may proceed to the appropriate corrections at your account such us to change your password or to update personal information. When you complete the aforementioned steps there will be one last step remaining for your details to be uploaded on the IPRAS website. The application

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must be approved by the National Association you are a member. The application will be sent at the Association of the country that you have declared, ensuring that only IPRAS members of good standing and high ethical principles are able to upload their personal details. As soon as your Association verifies you as a member, your profile will automatically be uploaded at the website’s, “Find a doctor” option in the “Members”section. It is also up to you to decide whether your profile will be classified as “private” or visible to all visitors of the IPRAS webpage. Our aim, besides facilitating communication among colleagues, expands to allowing patients to verify the good standing and high ethical principles of the doctors’ profiles hosted, allowing them to choose qualified IPRAS members for needed procedures. There are two new Sections at the IPRAS website. • IPRAS-TA section where you may find more information concerning the Trainees Association • Congress Registry section where you may find the all the plastic surgery related congresses. If you face any difficulties please do not hesitate to contact us at: Always at your disposal! IPRAS Management Office

INDUSTRY NEWS SECTION Patient 3D-Web Access booking: Patient 3D-Web Access & Patient 3D-Web Access & booking: Patient 3D-Web Access &&booking: booking: Patient 3D-Web Access & booking: Patients and Doctors want it! it! Patients and Doctors want it! Patients and Doctors want Patients and Doctors want it!

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real-time 3D simulator for breast augmentation: real-time 3D simulator for breast augmentation: SinceSince the the patient’s web-banner was launched,already already to-use to-useto-use real-time 3D simulator for breast augmentation: patient’s web-banner waslaunched, launched, Since the patient’s web-banner was already Since the patient’s web-banner was launched, already moremore thanpatient’s 3000 patients sent their photos to doctors Since the web-banner was launched, already Simple as no brainer: get simulations in just one click. 3000 patients senttheir theirtheir photos to doctors - Simple no brainer: get simulations just one more thanit.than 3000 patients sent photos to doctors more 3000 patients sent photos to the doctors - -Simple asfast: noas brainer: getchange simulations in time. just -as Simple no brainer: get in simulations inone justclick. one click. through Without any doctors receive more than than 3000 patients sent their photos to doctors Lighting make any in real through it. Without anyextra extraeffort, effort, doctors receive the Simple as no brainer: get simulations in just click. Lighting fast: make any change in real time. through it.the Without anyalready extra effort, doctors receive the -the through it. Without any extra effort, doctors receive Lighting fast: make any change in real time. Lighting fast: make any change in real time. 3D of patient done and their contact through any extra receive the - Accurate 3D it.ofWithout the patient alreadyeffort, donedoctors and their contact Accurate as make Swiss made: benefit from the3D ultimate 3D asfast: Swiss made: benefit fromin thereal ultimate - -Lighting any change time. 3D of3D the already done done and their their contact of patient theThat patient already contact - technology. Accurate as Swiss made:made: benefit from the 3D 3D - Accurate as Swiss benefit fromultimate the ultimate information. That easy! easy! 3D ofinformation. the patient already done and and their contact technology. Accurate as Swiss made: benefit from the ultimate 3D information. That easy! information. That easy! technology. technology. information. That easy! � � technology. An online survey was conductedamong among the who An online survey was conducted thepatients patients who �� � � � sent their 3D to doctors, with results proving the concept An online survey was conducted among the patients who who An online survey was conducted among the patients sent theirsurvey 3D to was doctors, with results proving the concept An online conducted among the patients who � � � of the Crisalix being one proving most �� sent their 3D to3D doctors, with results proving thethe concept sent their to web-banner doctors, with results the concept of the Crisalix web-banner being one ofof the most sent their 3D to doctors, with results proving the concept � � � important qualified lead providers inone the plastic surgery ofimportant the Crisalix web-banner beingin of most of thequalified Crisalix web-banner onethe of the most �� lead providers the plastic surgery of the Crisalix beingbeing one of the most � industry ever web-banner created: � � important qualified lead providers in the plastic surgery important qualified lead providers the plastic surgery industry ever created: �� important qualified lead providers in theinplastic surgery � � industry ever created: � industry ever created: - 70% patients booked a consultation with the doctor. �� industry everofcreated: � �� � - 70% of patients booked a consultation the doctor. - 22% of patients had finally surgery withwith the doctor. � � - -70% booked a consultation with doctor. - of 70% of patients booked a consultation with the doctor. 22% ofpatients patients had finally surgery with thethe doctor. � � - 70% of patients booked a consultation with the doctor. � �� ampatients looking forward to myfinally surgery and am the happy I gotdoctor. to see - 22%-“Iof had finally surgery with doctor. 22% of patients had surgery with the - 22%the of patients had finally surgery with the doctor. � � � 3D image that helped my mind at ease”. A.S. (USA). �� “I am looking forward to myset surgery and am happy I got to see

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To benefit Already doctors andinstalling clinics as Clinica conversion rates rates and more referrals. theirconsultations, website.reputed conversion and more referrals. consultations, simplysimply by installing the such web-banner on on by the web-banner conversion rates and more referrals. consultations, simply by Becker installing theRuth web-banner on fromIPRAS this offer, please and visit readers � Planas (Spain), Hilton (USA), Graf (Brazil), members have a special 10% their website. their website. their website. Cornette de Saint Cyr (France) and many more are and proceed to “sign up”. Use the following code in the discount on Crisalix annual subscriptions. 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Use the following code in the you by taking photos from home. 41f282e1d8 already enjoying the benefits of the new Code”Code” field: field: 1015 Lausanne already enjoying the benefits of theweb-banner. new web-banner. “Coupon “Coupon already enjoying the benefits of the new web-banner. Crisalix sets the banner up for the doctor in no time so “Coupon Code” field: Switzerland Crisalix 41f282e1d8 41f282e1d8 “The can patientimmediately sent us the photos through the do banner forwork a 3Dfor 41f282e1d8 patients click on it and the PSE-A Crisalix sets the banner up for the doctor in no time so Crisalix sets the upthe fordoctor thea consultation doctor nous, time so Crisalix consultation, andbanner in twobanner days she had with Crisalix Crisalix sets the upfrom foralready in no in time so you by taking their photos home. Crisalix 1015 Lausanne patients can immediately click on it and do the work for where she immediately decided to proceed with the surgery after seeing patients can immediately click on it and do the work for PSE-A PSE-A patients can immediately click on it and do the work for PSE-A the simulation results.” Piotr Sikorski, MD (Finland) you byyou taking their photos from home. by taking their photos from home. 1015Switzerland Lausanne 1015 Lausanne you taking theirusphotos from home. “Thebypatient sent the photos through the banner for a 3D 1015 Lausanne Switzerland Switzerland consultation, anddays in two shea 3D already a consultation “Only a few afterdays I placed bannerhad on my website for mywith newus, Switzerland “The patient sent us the photos through the banner for a 3D “The patient sentdecided us the photos through the banner for a 3D potential patients prepare their 3D from home, I had alreadyfor 1 patient where she immediately to proceed with the surgery after “The patient sent usto the photos through the banner aseeing 3D consultation, and in two days she already had a consultation with us, consultation, andaPiotr in two days was she already hadthea 3D consultation with us, who came up consultation, simulation, the simulation results.” Sikorski, MDpleased (Finland) consultation, and in for two days she already had awith consultation with us, where she immediately decided to proceed withMD the(UK) surgery after seeing where shebooked immediately decided toJames, proceed with the surgery after seeing and finally the surgery.” Matt where she immediately decided to proceed with the surgery after seeing the simulation results.” Piotr Sikorski, MD (Finland) the simulation results.” Piotr Sikorski, MD “Only a few days after I placed a 3D banner on(Finland) my website for my new the simulation results.” Piotr Sikorski, MD (Finland) potential patients to prepare their 3D from home, I had already 1 patient “Only few days after I placed a 3D banner on my website forsimulation, my for newmy new “Only a few days after I placed a 3D banner on my 3D website who a up for a consultation, pleased with the “Only acame few days after I placed a 3Dwas banner on my website for my new potential patients to prepare their 3D from home, I had already 1 patient potential patients to prepare their 3D from home, I had already 1 patient and finally booked surgery.” James, MDI (UK) potential patients to the prepare their Matt 3D from home, had already 1 patient who came for up a consultation, was pleased with the 3Dthe simulation, who up came for a consultation, was pleased with 3D simulation, who came up for a consultation, was pleased with the 3D simulation, and finally the surgery.” Matt James, MD (UK) andbooked finally booked the surgery.” Matt James, MD (UK) and finally booked the surgery.” Matt James, MD (UK)

Issue 14

IPRAS Journal




Tord Skoog (Sweden) 1955 - 1959

David N. Matthews (U.K.) 1959 - 1963

Thomas Ray Broadbent (USA) 1963 - 1967

William M. Manchester (N. Zealand) 1967 - 1971

John Watson (U.K.) 1971 - 1975

Roger Mouly (France) 1975 - 1983

Jean-Paul BossĂŠ (Canada) 1983 - 1992

Ulrich T. Hinderer (Spain) 1992 - 1999

James G. Hoehn (USA) 1999 - 2006

Marita Eisemann-Klein (Germany) 2006 - present

IPRAS Journal

Issue 14

International Confederation for Plastic Reconstuctive and Aesthetic Surgery IPRAS BENEFITS FOR INDIVIDUAL MEMBERS AND NATIONAL ASSOCIATIONS • Immediate information about safety warnings on devices, drugs and procedures • Information regarding the proper use of all materials, substances and techniques related to Plastic, Reconstructive and Aesthetic Surgery through IQUAM (the International Committee of Quality Assurance and Medical Devices in Plastic Surgery) General Consensus statement, with an update every 2 years • Free electronic receipt of the IPRAS JOURNAL • Information regarding harmonization of training • Information regarding accreditation of Plastic Surgery Units • Promotion of Patient Safety and Quality Management (in cooperation with WHO) • Protection of the Specialty and Promotion of its image world-wide • Promotion of Individual Members of National Associations by uploading their scientific profile on the IPRAS website • Exchange of ideas, views, thoughts and proposals through the IPRAS website and its FORUM section • Certificate for Individual Members to display their IPRAS Membership • Right to participate in all events organized by National Societies and IPRAS • Strengthening ties of professional cooperation and friendship with colleagues beyond national borders all over the world • Information regarding the developments of plastic surgery worldwide • Association support for educational and research purposes • Association legal & ethical advice according to international law and practices and assistance with crisis management • Promotion of local or regional news and Historical Accounts of IPRAS National Associations through the Journal • Information, promotion and reports of local or regional events, organized by other National Societies and IPRAS, through the official IPRAS management office

Issue 14

IPRAS Journal


14th Issue October 2013

IPRAS Journal Management Editor: Honorary Editor-in-Chief: Editorial board:

GS Print: E-mail: Post Editing: Photographer: IPRAS Management Office ZITA CONGRESS SA 1st km Peanias Markopoulou Ave P.O BOX 155, 190 02 Peania Attica, Greece Tel: (+30) 211 100 1770-1, Fax: (+30) 210 664 2216 URL: • E-mail: Executive Director: Zacharias Kaplanidis E-mail: Assistant Executive Director: Maria Petsa E-mail: Accounting Director: George Panagiotou E-mail: Commercial Director: Gerasimos Kouloumpis E-mail: Marketing Director: Labrini Nikolopoulou E-mail :

Next issue: January 2014

IPRAS Ricardo Baroudi, MD Marita Eisenmann-Klein, MD Nelson Piccolo, MD Andreas Yiacoumettis, MD Mimis Cohen, MD Chris Khoo, MD Zacharias Kaplanidis, Economist Diastasi William Greenall Julian Klein

DISCLAIMER: IPRAS journal is published by IPRAS. IPRAS and IPRAS Management Office, its staff, editors authors and contributors do not recommend, endorse or make any representation about the efficacy, appropriateness or suitability of any specific tests, products, procedures, treatments, services, opinions, health care providers or other information that may be contained on or available through this journal. The information provided on the IPRAS JOURNAL is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on this journal is for general information purposes only. IPRAS, IPRAS Management Office and its staff, editors, contributors and authors ARE NOT RESPONSIBLE NOR LIABLE FOR ANY ADVICE, COURSE OF TREATMENT, DIAGNOSIS OR ANY OTHER INFORMATION, SERVICES OR PRODUCTS THAT YOU OBTAIN THROUGH THIS JOURNAL. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY SEEKING MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE READ ON OR ACCESSED THROUGH THIS JOURNAL. While every effort has been made to ensure accuracy, neither the publisher, IPRAS, IPRAS Management Office and its staff, editors, authors and or contributors shall have any liability for errors and/or omissions. Readers should always consult with their doctors before any course of treatment. ©Copywright 2010 by the International Confederation of Plastic, Reconstructive and Aesthetic Surgery. All rights reserved. Contents may not be reproduced in whole or in part without written permission of IPRAS. Not for sale. Distributed for free.


IPRAS JOURNAL, 14th ISSUE, JULY 2013 The purpose of THE IPRAS JOURNAL is to provide a rapid reporting of things of interest to IPRAS member...

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