Showing posts from May, 2019

making a tune for cleft children as we work on some major smile plans with friends

This is an improvisation of the Duane Eddy classic Stranger on the shore;I used an ordinary smart phone to record this guitar solo I imagined in my mind
as my fingers searched for ways to connect with what goes on in my mind
as I see notes flowing across the fretboards
and scales taking shape across the guitar body.

That is life in general for a physician musician who plays to help cleft kids.

I hope you guys enjoy the improvisations..bon chance

Using a bouffant hat in theatre?

Are you using a bouffant?

 ​Dear Bona,

Those bouffant OR hats ( green OR caps in operation rooms)have been shown to be porous compared to the only surgical caps and cloth hats--they are out of favor according to Amer.College of Surgeons.


John BM
Childrens MA

 A bouffant /buːˈfɒnt/ is a type of hairstyle characterized by hair raised high on the head and usually covering the ears or hanging down on the sides.

Midface Rejuvenation : The finer aspects of facial rejuvenation

The Lambada of Facial rejuvenation
Inject sc 40ml LA +360 0.9% NS for the midface rejuvenation surgery

Nuances: (better learnt in an OR demo, generally)-this is for the benefit of plastic surgeons already familiar with facial rejuvenation surgery

1.Incision lines from front of Ear to mastoid

2. Avoid lobe crease so that you do not get a  pixie ear deformity

3.Z plasty below tragus

4. Hydrodissect fat plane upto nlf and then corner of lips;no worry cos there is arborization of the nerves

5. Stay on sc fat ;No platysma entry,stay above it

6. Lower limit is the clavicle

7.Go to orb oculi and down to nlf

8. Stop over muscles,n go below

9.Go upto chin,stay on fat

10. Submental lipo helps some ;here, use left index to guide harvest needle, 3 hole and 2 or 3mm

11. Middle of neck,release bands that tether skin

12. Lower border of zygomatic arch incision,is an inverted L

13. Pull SMAS towards arch and Lower part superficial to platysma.The dissection over masseter is enough for f…

Total Aesthetic Recall of the Face Part 2: how to assess fat transfer for facial rejuvenation

I would like to thank my dear mentor John B Mulliken during those hectic Yemen days,for advising me to go "ballistically aesthetic" (I am paraphrasing)  when we would sit for coffee at his unit cateen,Childrens MA in August 2012.Thank you Dear John!

Journal Topic for reading: Fat grafting in facial rejuvenation*

In autologous fat transfer for facial rejuvenation, the appearance and quality of the results are the only reasonable means of assessment

Recent studies have shown that the best results were obtained by transplanting fat tissue into muscle, followed by transplantation into fatty tissue.Fat tissue transplanted onto the surface of bone, tendon, fascia, and aponeurosis will usually resorb What happens when you age:  Fat grafting introduces the plastic surgeon to a new dimension of volumetric rejuvenation,where traditional facelift surgery(*pic below of one of my patients)can be further enhanced by fat grafting.

When a patient comes for facial rejuvenation, there are thr…

Fat rejuvenation of your face and body using your own fat

Aesthetic rejuvenation of the face and body using one's own fat is a common aesthetic procedure with pleasing results.Although you need repeat sessions after three months,with time and subsequent touch ups,you will look and feel much younger.

This is the main advantage of fat rejuvenation,and it does not have side effects because your own body tissue is used as a filler.

The possibilities are many for the aesthetic world of fat rejuvenation. What was not possible in the past is now fast becoming a reality.Thanks mostly to the groundwork done by great pioneers in the field ,and others who have improved the concepts over time.

What we have today in total face and body rejuvenation  with autologous fat, is a huge step forward, with the availability of better techniques and increased patient satisfaction as a result.

One's own body fat can be used to enhance youth through face and hand rejuvenation.Doctors can now extend the benefits to other areas of the body,like the breast,tra…

AI and MAFT Bond: Taiwan Plastic Surgery group changes the Total Aesthetic Equation

That is what the good book of Total Aesthetic Rejuvenation would be all about.
The Micro Autologous Fat Transplantation gun is definitely the new kid in town.It transfers micro fat ribbons of your own body fat to rejuvenate your total face,hands and breasts.

The results are superior to traditional methods of fat grafting using mini lipo cannulae

Yes,agreed that the cost of the gadget is high and not many plastic surgeons can afford one easily. However,over time one would be able to get very good returns from this investment

Here is a video of me in Kaoshiung City Taiwan with the MAFT conference leaders after trainng in total face,hand and breast rejuvenation using the MAFT gun.

The results are quite amazing and I can only keep my fingers crossed for one such gadget in the near future.

The name is MAFT : MAFT Bond..xie xie...the rest is in English! Since that is all the Chinese one knows so far. Like the French say, " Who cares, as lon…

Lesson: Anatomy and uses of the buccal pad of fat in intraoral reconstruction

•      First described in 1802 by Bichat, the buccal fat pad lies in the masticatory space between the buccinator muscle medially and the masseter muscle laterally; it lieswithin a thin fascial envelope.

•       Dimensions: mean volume  of 10 ml, with a mean thickness of 6 mm and weighs about of 9.3 gm. It can cover defects upto 4cm.
•A pedicled buccal fat pad flap was first described in 1977 by Egyedi .   In 1986, Tideman et al, showed that the pedicled buccal fat pad flap is epithelialized within 3–4 weeks,* Mohan
•      Type of Flap:  The buccal fat pad flap is an axial flap which is supplied by branches from  the facial, transverse facial and internal maxillary arteries and their anastomosing branches which enter the fat to form a sub-capsular vascular plexus

•The parotid duct passes along the lateral surface or penetrates the body of the fat pad before traversing the buccinator muscle and entering the oral cavity
• Uses: used to fill small-to-medium sized soft tissue and bony defects …

Total Aesthetic Recall of the Face Part 1: regaining that youthful face once again

As one gets older,there are several changes that affect our faces: changes of the underlying facial skeleton,facial retaining ligamentsoverlying soft tissuesFacial fat comportments.Changes in the skin Treatment of all components can help achieve a natural and youthful appearance. A simple approach to regaining facial youth: Regular exercise and dietProper sleep timingsRegular skin conditioning with sunblock SPF 30 ,pigment correctors and mild superficial peels to maintain a good skin pH between 4.5-5.5Noninvasive or minimally invasive treatments like peels,microneedling,lasers,fat grafting from one’s own bodyFacial rejuvenation surgery can set back the facial ageing by several years and can include mid face lifting, with rejuvenation of the eyelids, ear lobes, neck, as well as the ageing hands with fat injection. Regular skincare regimes along with a few touch up procedures, both surgical and minimally invasive aesthetic medicine procedure like Botox, fillers, fat can enhance facial yo…

Genetic Analysis of 15 Risk Loci in a Novel Case–Control Sample Recruited in Yemen

Congratulations to Dr Khalid Al Dhorai for this work from Yarim Village Smile Train Programmes. We were happy to help with his study. To our knowledge,however, no Arab populations have yet been investigated for any of these risk loci, which is mainly attributable to the lack of an appropriate orofacial cleft sample.
The Yemen Smile and NYC Smile Train Programmes from 2003-2015 opened the doors for cleft research of this type Dr Khalid in Yarim Smile Train unit Yemen where the blood samples were collected from 425 non syndromic UCLP cases using the C flap modifications The Yarim cleft team
Nonsyndromic Cleft Lip with or without Cleft Palate in Arab Populations: Genetic Analysis of 15 Risk Loci in a Novel Case–Control Sample Recruited in Yemen Khalid Ahmed Aldhorae1, Anne C. B€ohmer2,3, Kerstin U. Ludwig2,3,Ahlam Hibatulla Ali Esmail4, Nezar Noor Al-Hebshi5, B€arbel Lippke2,3, Lina G€olz6,Markus M. N€othen2,3, Nikolaos Daratsianos6, Michael Knapp7, Andreas J€ager6,and Elisabeth Mangold*2 …