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Plastic Surgery

Upper Limb Nec Fasc on the Rise, 3 Necrotising Fasciitis Diagnoses, & the Debridement Drill

In this week's edition 1. ✍️ Letter from P'Fella P'Fella on vacation mode! 2. 🤓 The

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Injectable Fillers: Classification, Indications, & Injection Techniques

Injectable fillers restore volume and contour without surgery. HA gives lift; biostimulants like PLLA and CaHA spark collagen. The filler choice depends on the zone and goals. Adverse effects include bruising, occlusion, and rare blindness. These emergencies may require hyaluronidase.

Cosmetic

Dead Textbooks, 3 DIEP Complication Tips, & Surgical Studio Updates

Also: Foundations in progress, podcast suggestions, & the Sunday quiz.

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Ischaemic and Congested Flap: Diagnosis, Management, & Outcomes

Flap vascular compromise, arterial ischaemia or venous congestion, usually emerges within 72 h post‑op. Watch colour, cap‑refill, Doppler/NIRS. Early re‑exploration or adjunct venous‑drainage within 6 h can salvage >60 % of flaps; delays sharply cut survival.

PrinciplesMicrosurgerySkin and Soft Tissue

Tariffs on Toxins,3 Extensor Tendon Truths, & Your Next Journal Club Pick

Also: Kessler technique in action, EURAPS annual meeting, & the Sunday quiz.

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Extensor Tendon Injuries: Anatomy, Clinical Assessment, & Management

Extensor tendon injuries affect hand and finger extension and are classified by anatomical zones. They result from lacerations, rupture, or attrition, with Zone I injuries (mallet finger) being most common. Assessment includes Elson’s test and imaging. Management varies by zone and injury severity.

Upper Limbs

Bilobed Flaps: Indications, Flap Design, & Complications

The bilobed flap is a two-lobe transposition ideal for small to moderate nasal/facial defects, pivoting around one point to redistribute tension and preserve contours. First lobe matches defect size; second is smaller. While outcomes are great, flap planning or design errors can cause complications.

We’re Growing, 3 Flap Classifications, & Sub-I Inequity

Also: The Sunday quiz, event calendar, & a video tutorial on fat grafting.

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Fasciocutaneous Flaps: Anatomy, Classification, & Clinical Applications

Fasciocutaneous flaps use skin, fat, and fascia (without muscle) for thin, pliable, well-vascularized coverage. Supplied by perforator-fed plexuses, they’re classified by vascular entry or pedicle type. Ideal for trauma and oncologic reconstruction, with low donor morbidity and muscle preservation.

PrinciplesSkin and Soft TissueMicrosurgery

Good Journals Making a Comeback, 3 Classic Hand Flaps, & Sub-I Accessibility

Also: The Sunday quiz, original Quaba flap, & AI surgical studio update.

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How much does a sub-internship actually cost? JPRAS Journal Club.

This study highlights large cost disparities for IMGs in plastic surgery sub-internships: fewer program acceptances and fees 17x higher. IMGs' median cost for ~4.5 away rotations is ~$9K vs. ~$500 for US peers, emphasizing the need for standardized fees and scholarships.

Journal Club

Total Body Surface Area Calculations in Burns

Burn size guides triage, fluids, and outcomes. Lund-Browder is most accurate, especially in children. Rule of Nines is quick but less precise in kids/obesity. Palmar method is handy for small burns. The revised Baux score uses age, TBSA, and inhalation risk to predict mortality. Accuracy is vital.

Burns

"The Match", 6 Fat Grafting Tips, & New Events Database

Also: A fresh round of the Sunday quiz, retention rate of fat grafts, & stats on matching in plastic surgery.

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Burns: Initial Assessment and Management

Burn management depends on type, depth, extent, location, and patient factors. Initial care includes cooling, preventing hypothermia, ABCDE assessment, and fluid resuscitation. Wound care involves debridement, dressings, and grafting. Complications range from sepsis to scarring.

Burns

Fat Grafting: Basic Science, Techniques, & Patient Management

Fat grafting transfers autologous adipose tissue for volume restoration, contour correction, and tissue repair. The process involves harvesting, processing, and reinjection. Key complications include fat resorption, necrosis, and embolism.

CosmeticBreastPrinciples

Upper Limb Cellulitis: Diagnosis, Management, & Complications

Upper limb cellulitis is a bacterial infection of the skin and subcutaneous tissue, causing erythema, warmth, and swelling. Diagnosis is clinical and involves imaging. Treatment includes cephalexin for mild cases, IV antibiotics for severe infections, and drainage for abscesses.

Skin and Soft TissueUpper Limbs

Cash Influences Research, 1 Important Podcast Guest, & All Things Vascular Anomalies

Also: Proper propranolol dosing, calling expert reviewers for the textbook, & 3 recommended articles.

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Carpal Tunnel Syndrome

The aim of this section is to improve your diagnostic skills in treating a common plastic surgery condition. A good

New AI Surgical Studio, 3 Local Flap Techniques, & Design the Rotation Flap (properly)

Also: Final round of the Sunday quiz, pincushioning explained, & original local flap publications.

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Rotation Flap: Design Principles, Complications, & Flap Modifications

Rotation flaps are curvilinear pivotal flaps ideal for triangular defect repair, commonly used for facial, cheek, chin, and scalp reconstruction. Success depends on defect triangulation, flap circumference, and pivot point positioning. Post-op focuses on hematoma prevention and sun avoidance.

Principles

New JPRAS Partnership, 2 Tips on Eyelid Recon, & Textbook Updates

Also: A video breakdown of SMAS lift Botox, the Sunday quiz, & 3 eyelid recon reads.

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Role of Tranexamic Acid (TXA) in Plastic and Reconstructive Surgery: A National Perspective

TXA is widely used in plastic surgery, especially in facelifts (83.6%) and rhinoplasty (55.0%), reducing bleeding (61.8%) and bruising (63.2%). Common methods include 1 g IV bolus or 3% topical solution, with 92.4% reporting no complications. Despite benefits, standardization is needed.

Journal Club

Finger Replantation: Indications, Surgical Technique, & Complications

Finger replantation restores function, sensation, and aesthetics following the traumatic or surgical loss of a digit. Success depends on injury type, ischemia time, and microsurgical repair. Complications like venous insufficiency and arterial thrombosis require early management.

Upper Limbs

Designer Nipple Filler, 3 Facial Nerve Landmarks, & Tips for Clinical Examination.

Also: The Sunday quiz, nerve recon tip, & 3 recommended reads.

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