ISSN: 2241-1275 - International Confederation for Plastic ...

ISSN: 2241-1275

2 IPRAS Journal www.ipras.org Issue 7

• President’s Message . . . . . . . . . . . . . . . . . . . . . . . . . . 5
• The PIP Breast Implant Scandal . . . . . . . . . . . . . . . 6
• General Secretary’s Message . . . . . . . . . . . . . . . . . . 9
• Editor-in-Chief’s Message . . . . . . . . . . . . . . . . . . . 12
• IPRAS Management office Report . . . . . . . . . . . 14
• Pioneers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
• Rising Star . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
• Senior Ambassador . . . . . . . . . . . . . . . . . . . . . . . . 24
• Humanitarian Works . . . . . . . . . . . . . . . . . . . . . . . 26
• Surveys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
• National Associations’ & Plastic surgery
organizations’ news . . . . . . . . . . . . . . . . . . . . . . . . 50
• Historical Accounts . . . . . . . . . . . . . . . . . . . . . . . . 63
• Certificate of Membership . . . . . . . . . . . . . . . . . . 86
• Congresses and Events . . . . . . . . . . . . . . . . . . . . . 90
• National & co-opted societies future events . . . 114
• IPRAS website . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
• Industry news . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
• IPRAS Benefits for National Associations
& individual members . . . . . . . . . . . . . . . . . . . . . 119
C O N T E N T S
Humanitarian mission in Togo
IPRAS Booth at the 1st Chinese
European Congress of Plastic
Reconstructive and Aesthetic Surgery
Historical Account of BAPRAS
PAGE
14
IPRAS Presentation from
Mr. Zacharias Kaplanidis (IPRAS
Executive Director) during the 48th Brazilian
Congress of Plastic Surgery
PAGE
36
PAGE
55
PAGE
77
Issue 7 www.ipras.org IPRAS Journal 3

4 IPRAS Journal www.ipras.org Issue 7
A I M S A N D S C O P E
• 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

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
I P R A S J O U R N A L
P R E S I D E N T ’ S M E S S A G E
Dear colleagues,
2011 was the year of solidarity.
Solidarity with our brave colleagues in Japan
– while we felt powerless and helpless; solidarity
with our colleagues during the unrests in the Arab
world, with our colleagues in countries which had
to face crisis and disasters.
Solidarity with patients in developing countries:
the number of missions and the number of
active collaborators in our humanitarian projects
increase considerably every year.
Solidarity with patients who became victims of the
PIP crime, is our latest challenge. These patients
need all our support in their anxieties and in
their search for implant removal at affordable
expenses.
Solidarity with our young residents: the evaluation
form about training conditions will be launched
soon and the first “Residents World Congress”
will be held on November 1st , 2012 in Athens,
Greece. There, we also plan to start the Academy
for Residents Training.
With the foundation of our Board of Trustees,
we span the generations from the youngest to
our senior role models, our giants, our heroes.
Recently we honoured our new Board of
Trustees members during the Brazilian Congress
of Plastic Surgery: Ricardo Baroudi and Ivo
Pitanguy. They do not only stand for progress
and technical excellency in plastic surgery, they
are charismatic philosophers as well.
2012 will be the year of pioneers in Plastic
Surgery: Sydney Coleman has composed a
fantastic program for the 1st International
Congress of ISPRES in Rome, March 9-11, 2012.
I am excited about the incredible amount of
research programs in plastic surgery which will
be presented in Rome.
We feel overwhelmed by the interest of our
members in these innovative future oriented
techniques.
I never before experienced having to close the
registration two months prior to the start of a
congress!
Prof. Marita Eisemann-Klein
President of IPRAS
For all those who missed registration: We decided
to offer online-participation. Just watch out for
further announcements!
Keep monitoring at our other congress
announcements too: exciting topics and exciting
locations are offered to you.
There is a lot to look forward to this year!
There is also a lot to thank for during the past year:
Thanks, from the bottom of my heart, to all of you
Presentation of Prof. Marita Eisenmann-Klein,
Germany (IPRAS President) during the 48th Brazilian
Congress of Plastic Surgery
who supported and assisted to develop IPRAS
further – our humanity, our skills, our identity.
Thank you for your confidence in the IPRAS
leadership and in me personally.
It is such a pleasure to serve you as your
President.
I wish you all a year of happiness and joy and full
of chances to develop your identity as a plastic
surgeon even further!
Cordially yours
Marita Eisenmann-Klein
IPRAS President
Issue 7 www.ipras.org IPRAS Journal 5

Chronology:
As early as in May 2000 the US Food and Drug Administration
performed an inspection of the PIP production site in
Southern France. As a result of this inspection the sale of PIP
implants was stopped in the US. In a letter to Jean-Claude
Mas, the owner of PIP, the FDA stated that the implants
were “adulterated” along with eleven other deviations from
good manufacturing practices such as lack of sufficient
investigation of deflation rate and failure of reporting 120
complaints.
Whether the French Health Authority AFSSAPS was
informed by the FDA, about the results of their inspection
or not, is unclear.
PIP must have started to exchange the medical grade silicone
for industrial silicone probably in 2003. For a while, PIP
used both types of gel but probably stopped using medical
grade gel around 2005. From that time on, most likely they
only used industrial silicone. Roughly estimated: there must
have been around 200 000 kilograms of industrial silicone
delivered to PIP and nobody considered this suspicious!
Inspections were performed by TÜV Rheinland regularly but
they all were announced ten days prior to their visit, which
is in accordance with the requirements of the European
Medical Device Law.
Starting in 2008, more and more plastic surgeons reported
a high failure rate in PIP implants. After an investigation
by AFSSAPS, the French Health Authorities banned PIP
implants in spring of 2010.
Obviously the PIP implant stock or at least part of it was
sold to the Netherlands and the distribution was continued
by Rofil Medical under the name “M-implant”.
When the Dutch health authorities found out that PIP and M
were identical, M-implants were banned in June 2010.
Obviously, it was still possible to continue with the
distribution of M-implants. The last report we received was
about an M-implant inserted as late as October 2011! The
distributing company claims that this M-implant has nothing
to do with PIP. Only the name would be the same, but the new
product would be produced in Cyprus. The report from our
colleagues in Cyprus revealed that there was no production
site in Cyprus. Subsequently, the company claimed that the
production site was in Korea (North Korea??).
There are also hints that these products were sold to Middle
and South America. Hopefully through our well functioning
network with the help of our colleagues we can trace them
down.
In November of 2011 a patient with PIP implants in France
died from Anaplastic Large Cell Lymphoma, which developed
in the scar capsular tissue around the implants.
Subsequently, AFSSAPS released a warning that patients
with PIP implants should be examined regularly but they
did not suggest a prophylactic implant removal. After
6 IPRAS Journal www.ipras.org Issue 7
The PIP Breast Implant Scandal
thorough evaluations the French Society of Plastic Surgery
decided to recommend a prophylactic explantation of all
PIP implants.
Finally, on December 23rd 2011, AFSSAPS also announced,
that all PIP implants should be removed prophylactically.
Most of the Health Authorities in Europe were hesitant to
follow this recommendation, while plastic surgery societies
took the lead and recommended explantation. For example, the
German Association of Plastic, Reconstructive and Aesthetic
Surgeons convinced the German Cancer Society and the
Gynaecological Society to hold a press conference together
on January 6, 2012 to announce the recommendation for
explantation. BfArM, the German Health Authorities followed
and released a recommendation for explantation a few hours
later. In many other countries, health authorities are still
hesitant to come up with a recommendation for explantation.
In a telephone conference of most of the European Health
Authorities the majority recommended to wait for more data.
They claim that the potential risks of surgery and anaesthesia
might be higher than the potential risk of leaving the
implants in. There is an error in this logic: considering the
high failure rate of these implants, the probability, that these
implants rupture within the next few years is extremely
high, which means that there is an almost 100% probability
that these implants will have to be removed within the life
span of the patient, but then under much worse conditions.
What do we know about the health risks
of PIP implants?
We can only estimate the number of PIP implant patients
to be around 500.000 worldwide. We know that PIP also
produced other implants such as Testicle implants, buttock
implants and chest implants for men. We know that the
industrial gel which was used by PIP has been tested and
found not to be toxic. However, there are signs that the gel
might have been manipulated after it was delivered to PIP.
So, in fact, we do not know for sure whether or not it contains
toxic elements. This issue is still under investigation.
We know that the rupture rate of these implants is
considerably higher than the normal rupture rate for breast
implants which is considered to be 1%.
Most of the Health Authorities declared rupture rates
between 5 and 10% for PIP, but the declarations vary.
We also know that the inflammatory reaction in PIP implants
seems to be unusually high in case of rupture. But even
without rupture, patients may develop lymphadenopathy
with painful and enlarged lymph nodes as far away as in
the groin, mediastinum and neck. Axillary lymph nodes are
enlarged in many patients.
Although there were 16 cases of breast carcinoma reported
in France in PIP implant patients, there seems to be no
relation between PIP and breast cancer. These cases are

within the range of statistically expected cases.
Anaplastic Large Cell Lymphoma (ALCL) is a tumor of the
immune system. Worldwide 75 patients with breast implants
out of an estimated number of more than 10 million patients
with breast implants have developed this disease. Four of
these patients died.
It seems that the pre-disposition to develop this very
rare disease is multi-factorial and not yet completely
understood. Chronic inflammation usually plays a role in
the development of an ALCL. The risk of developing ALCL
for patients with breast implants is, according to the FDA, 1
in 500 000 to 1 million patients. The FDA states: “Patients
with breast implants may have a small but increased risk in
developing this disease”.
What we still need to find out:
We still don`t know the exact number of patients with PIP
implants and M-implants.
The estimation is around 500 000 worldwide.
We still do not know whether more M-implants are still in
use, may be even under a third name, either in Europe or
South America.
IPRAS conclusions:
1. There is no further room for discussion. It is mandatory
to recommend the explantation of PIP and M-implants.
2. Law suits against plastic surgeons should not be
successful according to our legal advisors, since a
stockholder must rely on the quality of a product that
has been granted a CE mark.
3. It is unnecessary to call for new laws. The existing
Medical Device Laws are sufficient.
The policies, however, should be changed e.g. inspections
without previous announcements.
The European Commission invited me today to join their
SCIENTIFIC COMMITTEE ON EMERGING AND
NEWLY IDENTIFIED HEALTH RISKS WORKING
GROUP ON PIP IMPLANTS.
The first teleconference will be held tomorrow. I am very
impressed by the ambitious time table of our chairman
Philippe Martin, with a deadline for the scientific opinion
to be completed by January 30.
4. This is not a scandal of the breast implant industry. This
is a scandal of a group of criminal individuals who don`t
mind to harm the health of 500 000 women.
Marita Eisenmann-Klein
President IPRAS
Daniel Marchac
IQUAM General Secretary
Nelson Piccolo
IPRAS General Secretary
The high quality and safety standards of our breast
implant industry deserve to be relied on.
5. We have to negotiate with health insurance companies and
convince them to provide the expenses for explantation.
We also have to negotiate with our managers to provide
replacement of implants at the lowest possible expenses.
6. We all need to cooperate in order to implement patient
registries in order to get reliable data and to have a tool
for postmarket surveillance.
7. Please bear in mind that our patients have to undergo a
period of fear and insecurity. It is essential that we avoid
public controversies regarding this issue.
Therefore we appeal to all of you to accept the following
organizations as the legitimate representation of all plastic
surgeons in the world:
1. On national level: the national society of plastic surgery
exclusively.
The national societies should also look for partners e.g.
medical associations, health care providers, government,
cancer societies, other scientific societies and consumer
groups, which could be involved.
The President of the German Association of Plastic,
Reconstructive and Aesthetic Surgeons, Prof. Peter Vogt,
was very successful in presenting the statement of the
society together with the German Cancer Society and the
Gynaecological Society in a press conference.
2. On regional level (such as African, Asian Pacific,
European, Ibero-Latin-American, Pan-Arab): the section
to which this area belongs should be responsible for
statements.
3. For global activities and cooperation with WHO: IPRAS
and its quality assurance committee, IQUAM, are the
legitimate representatives of plastic surgeons.
IPRAS is committed to serve the national societies and the
sections with its network and expertise. We continue to
prepare drafts for media releases and send them to you. We
shall only approach the media if you ask us to do so.
Thank you all for reporting back to us. All the useful
information we received from you helped to clarify the
situation and come up with important information which no
other institution or organization can provide.
Please continue to inform us!
Cordial thanks to all of you who supported our work. We are
very grateful for your cooperation and proud of our network
excellency!
Andreas Yiacoumettis
ESPRAS President
Constance Neuhann-Lorenz
IQUAM President
Issue 7 www.ipras.org IPRAS Journal 7

8 IPRAS Journal www.ipras.org Issue 7

G E N E R A L S E C R E T A R Y ’ S M E S S A G E
I am very happy to say that, once more, Plastic Surgery
has demonstrated its internationality and its boundless
features. Over 2150 surgeons from 14 countries came
to Goiania, in the central part of Brazil, to attend the
48th Brazilian Congress of Plastic Surgery. For me, this
was an extra special moment, since I have been living in
Goiania since 1963. Although I had lived away for 7 ½
years, coming back to establish my practice and also to
continue my family’s work in burns, in 1989, I certainly
consider this my town. And it was a great honor and and
unique pleasure to see this mega event happen here.
For the Sociedade Brasileira de Cirurgia Plástica it was
also a most special moment. There was a great homage
to Past Presidents, which brought honor and great
value to their deeds in improving all aspects of Plastic
Surgery in our country. Also, IPRAS President, Marita
Eisenmann-Klein and IPRAS Executive Director,
Zacharias Kaplanidis, were closely involved with all
official ceremonies and also had opportunities to present
their work, as well as the work of IPRAS, in several
48th Brazilian Cοngress of Plastic Surgery Homage to ExPresidents
Prof. Nelson Piccolo
IPRAS General Secretary
During the plenary session on “Women in Plastic Surgery”
fields. Dr Eisenmann-Klein took a moment during the
opening ceremony to honor Profs. Baroudi and Pitanguy
as Members of the IPRAS Board of Trustees – certainly
one of the night’s highlights.
Issue 7 www.ipras.org IPRAS Journal 9

Another first was the plenary session on Women in Plastic
Surgery, when the audience had a chance to hear from
Connie Neuhann-Lorenz (Germany), Lucie Lessard
(Canada), Antonia Marcia Cupello (Rio de Janeiro)
and Vera Lucia Cardim (São Paulo) presenting their
experience and trajectory as Plastic Surgeons and the
differences and similarities with their male colleagues,
in relation to career, profession and life.
As I have mentioned in the past, I believe one of the
most beautiful aspects of Plastic Surgery as a Specialty
is its internationality – how one can perform procedures
aiming at similar benefits for the patient, with knowledge
acquired though training and collective experience of
our colleagues and professors. We must, however, work
harder to ensure adequate and uniform training for our
residents, as well as adequate and uniform continuation
of education for ourselves, practicing Plastic Surgeons.
IPRAS is truly engaged in this! Our Board of Directors,
under the leadership of Marita Eisenmann-Klein, is
10 IPRAS Journal www.ipras.org Issue 7
48th Brazilian Congress of Plastic Surgery Opening Ceremony
continuously searching (and finding) ways of ensuring
that this very precious aspect of Plastic Surgery is
distributed as uniformly as possible.
There is, however, a lot of work still to be done for us
to attain that goal – Sarah Lorenz of Munich, Germany
and some colleagues of her, also residents in Plastic
Surgery, are launching a worldwide survey to ascertain
the quality, uniformity and content of training in Plastic
Surgery. When the survey reaches you, please make
sure you take a moment and help this dedicated group
of young surgeons to plan the world map in Plastic
Surgery Training. We need to know, so we can continue
to improve the equality of our already established
internationality.
Prof. Nelson Piccolo
IPRAS General Secretary

Issue 7 www.ipras.org IPRAS Journal 11

EDITORIALDuring the
12 IPRAS Journal www.ipras.org Issue 7
I P R A S J O U R N A L
E D I T O R - I N - C H I E F ’ S M E S S A G E
The bonds that unite us
Dr. Thomas M. Biggs, M.D.
Editor-In-Chief
fall months, from September into early December, your Editor-in Chief has had the pleasure
and honor of travel to various parts of the world and lecture, as well as speak with, colleagues on
four continents. My first stop was Lake Baikal, in Eastern Siberia, near the city of Irkutsk, which
was a geographic experience. The meeting was hosted by our able colleague Vadim Zelenin and
had an attendance that exceeded 300 Surgeons. The faculty consisted of Brian Kinney from Los
Angeles, Roberto Pizzamiglio from Marbella, Spain and your Editor. Also on the faculty were strong
representatives from St. Petersburg and Moscow, Irina Khrustaleva and Natalia Manturova. The
vast majority of the attendees were Plastic Surgeons from all parts of Siberia and the major topic of
discussion was the face, but all areas of Plastic Surgery were discussed. When I attend a meeting as a
lecturer I always try to give valuable information to the attendees and at Lake Baikal I was told this
was the case. But likewise, when I attend as a listener, I hear the points of view of the other faculty and
I leave a net winner in the information exchange.
In all my trips I try to learn something about the area to which I’ve come. Lake Baikal was a hidden
treasure. Sadly for me, my knowledge of the geography of that part of the world was underdeveloped
and I was not aware of the magnitude of Lake Baikal. There are too many aspects of it to be covered
in this short essay but it is known as the second largest lake in the world (the Caspian Sea is larger). At
one mile deep it is among the deepest and, by my own viewing, one of the clearest. It is a geographic
masterpiece and relatively unknown to the Western World.
After Siberia I went to Madrid, where I participated as the only non-faculty member in a meeting put
on by Jose Luis Martin Del Yerro, unquestionably one of the most skillful and knowledgeable Plastic
Surgeons I know and someone whose worldwide recognition will soon soar .
Dr. Riccardo Mazzola, IPRAS Historian, Dr. Thomas Biggs, IPRAS Journal Editor in Chief

After Madrid came Beijing, China, for the first Chinese-
European Congress, with Yi Lin Cao as our host. Those who
saw the Opening Ceremony of the 2008 Olympic Games
immediately appreciated the powerful arrival of China as a
world player, and this Congress was of similar style.
Afterwards on to Puerto Vallarta for the 38th Annual Meeting
of Jose Guerrerosanto, a major institution in the world of
Latin American Plastic Surgery, put on by one of the titans of
worldwide Plastic Surgery, who has been kind enough to invite
me for many years.
From Mexico, I went on to Goiania, Brazil, for their Annual
Meeting and this, my 37th visit to Brazil, confirmed what I had
learned on my first visit in 1972: that Brazil is inferior to none
in Plastic Surgery. During this visit, I enjoyed the company of
friends I have made over many decades. Among them was Ivo
Pitanguy, who was my gracious host on my first visit there, 39
years ago. The multitude of friends there is too great to name
individually, but I was pleased to visit with our Secretary General,
Nelson Piccolo, and felt the pleasure of knowing his hand will be
on the wheel of IPRAS for several years.
Finally I attended a meeting in the U.S. In New York City,
The Cutting Edge Meeting of old friends Sherrell Aston and
Dan Baker. It was a booming success with attendees from 60
countries. They had a large and diverse faculty, each speaker
being limited to 10-15 minutes, but each session being followed
by an intense questioning by either Dr. Aston or Dr. Baker.
The questions being those the moderators felt were probably
foremost in the minds of the attendees.
Finally, this message is being written from Miami, where I’ve
come to visit Roger Khouri (the first “Frontiersman” in this
Journal). I’ve been staying with him, seeing new patients, short
and long term follow ups, and spending many long hours in
the operating room. In between, I’ve been working to help him
assemble his thoughts for future publications.
All of the above experiences have added immensely to my
body of Plastic Surgery knowledge. My travels have exposed
me to the fact that many of our colleagues around the world
are performing operations in a way very similar to the way we
perform them in our own facilities; there are also colleagues
doing things differently, often with outstandingly good results.
I’ve met colleagues with huge experience, who have never
spoken of their findings, nor have they published, but their
work is outstanding. As Editor-in Chief, I’m making it a project
to bring these people out into the light, so we can all benefit
Prof. Ivo Pitanguy, Brazil (IPRAS Trustee), Dr. Thomas Biggs
(IPRAS Journal Editor in Chief) on 2007.
Dr. Thomas Biggs, USA (IPRAS Journal Editor in Chief) with Ms.
Maria Petsa, Greece (IPRAS Assistant Executive Director) at the
IPRAS booth during the 48th Congress of the Brazilian Society of
Plastic Surgery.
from their excellence.
What you’ve just read is true and extremely important to me….
but there’s more.
During my travels, I have found a great similarity in my life
and the lives of those colleagues from half a globe away….
from people with whom I often need a translator to adequately
communicate. There’s a similarity in the fact that our patients
come to us with a need and they carry with them the faith in
us that we can help resolve that need. I’ve found we share the
same deep misery when some aspect of our surgery doesn’t go
as we had planned, but we also share the same joy when we see
a smiling face walking into our clinic and we know things are
going well. The pink nipple rather than a blue one…a finger
with full flexion and extension….a soft, well-shaped breast
rather than one that is firm and contracted…..a happy smile
from a young girl whose retruded maxilla is now in the right
place. You, as surgeons, know what I mean…..the joys of our
work…the Holiday card that says “Thank You”.
All these things we share…whether it may be in Houston
or Hong Kong, Moscow or Montevideo, Denver or Dubai,
Stockholm or Sydney.
These are bonds, similarities of purpose, works done in
rooms that have a similar appearance the world over, the
same relationship between the patient in need with the skillful
physician who has the tools and experience to care for this
human being with some kind of pain. We also share the
knowledge, that in some areas our colleagues lack the tools to
adequately play their role in healing and we share the desire to
reach out and help.
We, as Plastic Surgeons, are separated by languages, by
borders and boundaries, and in some instances by cultures…..
but the bonds that unite us are far, far greater than those factors
that separate us. We truly are a family, brothers and sisters, all
working to take care of the family business.
What is the family business?
The family business is to make people’s lives better through
Plastic Surgery.
Dr. Thomas M. Biggs, M.D.
Editor-In-Chief
Issue 7 www.ipras.org IPRAS Journal 13

I P R A S M A N A G E M E N T O F F I C E R E P O R T
October 2011 - December 2011
Let’s give our answers to the Challenges
There is no doubt that the international community is
facing multiple and, perhaps, the most complicated
challenges of the last decades.
Europe continues to tackle, with limited success until now,
its fiscal issues; unemployment has reached dangerous
levels, especially in Southern Europe (in Greece alone
it has reached 20%), Europe and America’s problems
have began to burden China’s exports and developmental
rate (less than 9% in 2011). Northern African and Middle
East countries continue to be socially agitated, despite
the collapse of the dictatorship regimes (Egypt, Iraq,
Libya and Tunisia)
Dr. Gregory Evans, USA (ASPS President Elect) during his
presentation at the 1st Chinese European Congress of Plastic,
Reconstructive and Aesthetic Surgery.
14 IPRAS Journal www.ipras.org Issue 7
Mr. Zacharias Kaplanidis
IPRAS Executive Director
And if all the above were not enough, the PIP scandal was
added to the list of issues that trouble the International
Plastic and Aesthetic Surgery Community.
So, where does all this lead us??
- To the foresight of the Maya ancient tribe that the world
will come to an end in 2012???
- Or, on the contrary, to the perception that the “ship of
humanity” needs a change of course, so that it is not
left stranded.
Despite my utmost respect for the advanced civilization
of the Maya tribe, it is my belief that “we are going the
wrong way”.
It is entirely up to the leadership of the European countries
to solve their economical problems immediately and, at
the same time, Southern Europe must learn to comply
with the rules of a prudent management. The “Arab
Spring” must quickly come to the day-after decisions for
the benefit of its people. China, Brazil and all the other
rapidly developing countries must understand that they
are not “de facto” almighty, but depend on the peace and
financial progress of other countries.
Regarding the PIP case, the industry must respect the
common interest, especially public health and focus on
meeting the needs of the public and not risk the public’s
health in order to make a larger profit.
Finally, we, the people, are obliged to visit our doctors
on a regular basis, whether we have undergone
surgery (even for aesthetic reasons) or not.
The example was clearly set by our International
Confederation (IPRAS) which responded immediately
and positioned itself effectively on the PIP issue, by
sending its assessments to 101 National Associations
and 37000 Plastic Surgeons around the world. The main
points of the IPRAS statement were the condemnation

From the left: Dr. Theodoros Voukidis, Greece (ISPRES founding member), Mrs. Katherine Lee Tai, USA, Prof. Marita Eisenmann- Klein,
Germany (IPRAS President), (at the back) Mr. Fabian Wyss (Crisalix Chief Marketing & Sales Officer), (at the front) Dr. Josef Fedeles,
(member of the Training and Accreditation IPRAS sub-committee, IQUAM member), Prof. Yilin Cao, China (President of CSPS, IPRAS
Deputy General Secretary), Dr. Paul Ling Tai, USA, Dr. Pericles Serafim Filho, Brazil (member of the Scientific Advisory Board of
IPRAS), Dr. Ricardo Mazzola, Italy (IPRAS Historian).
Mr. Zacharias Kaplanidis (IPRAS Executive Director). IPRAS
presentation during the 48th Brazilian Congress of Plastic Surgery.
of the irresponsible companies, the recommendation
to all doctors and patients to keep a calm status, the
support to the healthy and serious industry of Plastic
Surgery and the urge towards preventive check-ups
of the patients.
Conclusion: All of the above complicated challenges
can be confronted with a wise and willing attitude,
but can also lead the “humanity ship” to much more
“tranquil ports” with a social, political and economical
complexion.
IPRAS, in the last 3 months of 2011, came closer to its
members and to the National Associations of nations
such as China, Brazil, Russia and Italy.
The 1st Chinese European Congress of Plastic,
Reconstructive and Aesthetic Surgery took place in
Beijing, China, from October 27th to October 29th with
the utmost success and attracted approximately 200
Chinese and more than 300 distinguished foreign Plastic
Surgeons. Apart from the scientific and organizing
success, this Congress could certainly be characterized
as a grand rehearsal for the IPRAS World Congress
of 2015. Important conclusions were drawn, which will
be utilized when the time comes.
Issue 7 www.ipras.org IPRAS Journal 15

From the left: Mr Alexey Kovalsky, POLYTECH Health & Aesthetics Director POLYTECH Health & Aesthetics Ukraine, Mr. Wilfried
Hüser, founder and owner of POLYTECH Health & Aesthetics, Mrs. Katherine Lee Tai, USA, Dr. Paul Ling Tai, USA, Prof. Yilin Cao, China
(President of CSPS, IPRAS Deputy General Secretary), Prof. Marita Eisenmann- Klein, Germany (IPRAS President), Mrs. Vivian Breinhild,
POLYTECH Health & Aesthetics Director International Sales, EMEA, Dr. Albert de Mey, Belgium (member of the Scientific Advisory Board
of IPRAS), Dr. Philippe Blondeel, Belgium (member of the Scientific Advisory Board of IPRAS), Dr. Pericles Serafim Filho, Brazil (member
of the Scientific Advisory Board of IPRAS).
Mr. Zacharias Kaplanidis (IPRAS Executive Director), Mrs. Carol
L. Lazier, USA (Staff Vice President and Chief Membership Officer
American Society of Plastic Surgery), Dr. Phillip Haeck, USA (
Former President of ASPS) at the IPRAS booth during 48th Brazilian
Congress of Plastic Surgery
16 IPRAS Journal www.ipras.org Issue 7
Furthermore, the IPRAS Executive Committee and
the Board of Directors convened during that time,
with a large participation of its members and important
decisions were made, such as the 2012 Budget approval.
Our President, Prof. Marita Eisenmann-Klein, our
General Secretary, Dr. Nelson Piccolo, the Deputy
General Secretaries, Dr. Yilin Cao and Dr. Ahmed Adel
Noureldin, our Parliamentarian, Dr. Norbert Pallua
and our Treasurer, Dr. Bruce Cunningham were all
present at this very important event. Additionally,
we must point out the impressive participation of the
Brazilian Plastic Surgeons (approximately 60) and the
Russian (approximately 70).
We would like to thank the Scientific and Organizing
Committee of the Congress, Prof. Yilin Cao, Prof.
Andreas Yiacoumettis, the greatly missed (due to a
personal issue) and NIKE Med, Polytech, Crisalix and
Silimed for its substantial contribution.
Immediately after China, we traveled to the other
side of the planet, to Brazil, for the 48 th Brazilian
Congress of Plastic Surgery, which took place in the
adorable city of Goiania, the homeplace and permanent
residence of our General Secretary from November 10 th
to November 15 th , Dr. Nelson Piccolo. With more than
2000 participants, Brazil proved once more that, not
only is it one of the largest associations (2 nd after USA)

Mr. Zacharias Kaplanidis (IPRAS Executive Director) with Mrs. Liudmila Antonova, Russia (General Director of Nike-Med) and Mrs. Anna
Pimenova, Russia (Nike-Med) addressing to Russian Plastic Surgeons concerning IPRAS benefits at the “NIKE-MED’s 15th Anniversary
Conference “Happy to be Together”.
in the world, but also that it is a great country on a
scientific level and dedicated to more ethical values.
For approximately 3 hours during the opening ceremony,
important personalities were honored, such as Prof. Ivo
Pitanguy, Prof. Baroudi and all the past Presidents of the
Association.
It was the most beautiful and emotional Opening
Ceremony that I have ever attended so far.
CONGRATULATIONS
Let us hope that all the other National Associations
will follow this bright example of acknowledgement
of personalities who have honored the field of Plastic
Surgery in their countries with their achievements and
ethos.
The truth is that I indeed experienced that same atmosphere
again in Cesme, Turkey, during the Congress of the
Turkish Association of Plastic and Aesthetic Surgery. It
is truly a remarkable feeling.
Our President, Prof. Marita Eisenmann-Klein,
Executive Director, Mr. Zacharias Kaplanidis and
Assistant Executive Director, Mrs. Maria Petsa,
represented IPRAS in Brazil and had the opportunity to
speak to hundreds of participants on issues concerning
the Confederation’s co-operation with the Brazilian
Association and its members.
We thank them all for their absolutely wonderful
hospitality, but especially we would like to thank the
President of the congress Dr. Carlos Calixto the
Scientific committee Member of the Brazilian Society
of Plastic Surgery, Dr. Pericles Filho, and, of course,
our General Secretary, Dr. Nelson Piccolo and his
truly beautiful family.
In mid-December (12 th - 15 th ), the executive Director,
Mr. Zacharias Kaplanidis, traveled to Moscow, where
he met with members of the Russian Association
of Plastic and Aesthetic Surgery and discussed the
potential for organizing a workshop based on new
developments in the field. Another great opportunity
to exchange scientific knowledge with a great country.
We would like to express our gratitude to the NIKE
med Company for its hospitality and support.
Our last journey in these 3 months took us to Italy and
specifically Rome (December 15th to December 17th ), where
we participated in a special scientific event with highly
distinguished scientists from the Italian and International
World of Plastic Surgery, the 3rd International Conference
on Regenerative Surgery. The President of the
Conference, Prof. Valerio Cervelli, Dr. Sydney Coleman
and Prof. Marita Eisenmann-Klein, Dr. Dan Del Vecchio
and Dr. Gino Rigotti were just a few of the basic speakers
of the Conference, which focused on the contemporary
issue of Regenerative Surgery and Fat-Grafting.
After all the above, 2011 comes to an end. It has been a
year with tremendous challenges for all to face, but with
the appropriate response by the bodies of IPRAS and its
mechanisms.
Zacharias Kaplanidis
IPRAS Executive Director
IPRAS Management Office
ZITA Congress
Issue 7 www.ipras.org IPRAS Journal 17

18 IPRAS Journal www.ipras.org Issue 7

Dr. Biggs: Dr. Rohrich, with your work as Editor-in-
Chief of the official Journal of the American Society
of Plastic Surgery, you play what I, and many others,
see as the most significant role in education of Plastic
Surgeons in the world and thus, the course into the
future of Plastic Surgery. For this, we are proud to
designate you as our “PIONEER” for this issue of
the IPRAS Journal.
We would like to use this interview as an opportunity
for the 37,000 recipients of our journal, to get a
better understanding of you and what is behind your
drive…and how you see the future.
Let’s begin by your giving us a bit on your
background.
Dr. Rohrich: I grew up on a ranch in North Dakota
and did not speak English until the age of five. I
learned early on, that the best way to succeed was
to be focused, work hard, and that it does not matter
where you are coming from, it’s where you are going
that’s most important. This is indeed the ultimate
American dream.
I did my Plastic Surgery training at the University
of Michigan after completing Medical School at
Baylor College of Medicine. I was highly motivated
and stimulated by Dr. Mel Spira, head of Plastic
Surgery at Baylor, who became one of my early
Plastic Surgery mentors. At the University of
Michigan, I worked with Drs. Grabb and Dingman
and was vastly influenced by these gentlemen, who
both subsequently died during my six-year Plastic
Surgery residency. I will never forget their total
focus and dedication to the excellence in Plastic
Surgery. Dr. Dingman instilled a sense of duty and
P I O N E E R S
An interview with Dr. Rod Rohrich
to always do the right thing: he was amazing. I was
strongly encouraged by Drs. Grabb and Dingman to
write, to promote and to give back to Plastic Surgery,
because we get so much from Plastic Surgery. There
is always time to give back and to contribute to
the advancement of the art and science of Plastic
Surgery. I was then brought under the tutelage of
Dr. Steve Mathes, who was my Chairman while I
was Administrative Chief in Plastic Surgery at the
University of Michigan.
These were highly formative years. I also spent a
significant amount of time doing Pediatric and
Craniofacial Surgery in my elective year. I spent time
at Oxford University with Dr. Michael Poole doing
Craniofacial Surgery and then met Drs. Marshac
and Tessier, two outstanding Plastic Surgeons, in
multiple trips to Paris. I also had the opportunity to
spend time with Dr. Fernando Ortiz-Monasterio in
Mexico City, in the pinnacle of his career.
At the Massachusetts General Hospital/Harvard
in Boston, Dr. James May taught me to focus on
excellence in all I do and always be better each
day. This continues to be a valuable life lesson. I
rapidly learned that Plastic Surgery, as a specialty,
does not have its own organ, such as the prostate for
Urology or the brain in Neurosurgery. Instead, we
have our own innovation and that is something that
has been the glue that’s actually been the foundation
for our specialty. This has guided me in my role as A
Plastic Surgeon and has motivated me to give back
to this wonderful specialty as a teacher, as a Program
Director and as a Chairman. We must teach the next
generation to pursue excellence, be innovative, create
an environment for innovation and to give back by
Issue 7 www.ipras.org IPRAS Journal 19

doing, not only superb clinical work, but to give
back by innovating and publishing in peer-reviewed
journals, as well as presenting our work worldwide.
My interest in writing began as a medical student at
Baylor College of Medicine, while working with Dr.
Mel Spira.
Dr. Biggs: I certainly agree with you about Mel Spira.
I met him in the emergency room the afternoon of
my first day as a resident at Baylor in Houston. I was
the Surgery resident on call and he was the plastic
surgery resident on call, on his first day working
there, like me. We became great friends then and still
are. He will always be my number one mentor….
but to get on with the interview: tell us about what
you’re doing in Dallas. You run probably the most
proficient and productive training programs in the
U.S. and even the world. Tell us about it.
Dr. Rohrich: You can always become and be
better, no matter how good you are at what you
do. It is helpful always to surround yourself with
people that have the same philosophy. I find that
the key to success is in picking great people, both
in residency and faculty, that are better than myself.
You have to be very selective and selfless in doing
so; it demands conducting a regular 360-degree
re-evaluation of yourself, so you can re-focus and
rethink on areas which are important. You have
to be focused long-term. For example, at UTSW,
we have taken a small division of Plastic Surgery
with a couple of faculty and staff, to a staff of
over one hundred and thirty, with twenty full-time
faculty, nine part-time faculty, six residents per
year and multiple fellows in Craniofacial, Hand,
Cosmetic, Micro and Breast Surgery and research.
We have multiple NIH grants and one of the most
largely productive clinical and academic faculty
departments in the U.S. Becoming a Department
of Plastic Surgery at UT Southwestern was pivotal
and has provided us with a basis for growth and
an example for other divisions and departments
around the country to succeed as well.
How can we become better at what we do in Plastic
Surgery? An “expert” is someone who is focused on
excellence through practice, focus and dedication
for over 10,000 hours. This type of training and
commitment holds true whether you want to be a
concert pianist or Plastic Surgeon. If you want to
be an expert in what you do, you have to focus on it
20 IPRAS Journal www.ipras.org Issue 7
and dedicate a significant part of your career to this
effort. The time to start doing this is now, while you
are a young Plastic Surgeon.
As I mentioned previously, I spent my formative
years growing up on our ranch in North Dakota, with
limited resources, but my parents wanted a better life
for all of us. They imparted to my two brothers and
me a tremendous work ethic and that one must lead
by example, like my parents did for us. I certainly
never ask a faculty member, resident, or anyone
else to do anything I would not do myself. It keeps
me grounded as well. One must lead by example to
become a role model or mentor. We are influenced
by and pattern our lives after these role models and
mentors. I certainly remember one of my earliest
role models, besides my parents, was one of my
science teachers, Mr. Schimcke, who challenged
me to find a new way to study Mendelian Genetics
using fruit flies. He allowed me to do things I had
never done before and to do them by myself. Just
remember that you have to aim high in life if you
want to succeed. Therefore, aim very high because
you will get where you aim. If you don’t aim high,
you’ll always get there, too, and you will not be
happy for aiming so low. You must aim higher than
you think is attainable and it will get you there. A
good work ethic is strong encouragement both at
home, at school and in your personal life and we
certainly try and gender that into our residents.
Coming from a high school class of twenty four
students, where I was one of the only ones that
actually finished college and went on to higher
education, helped me focus on setting high goals,
working hard, and pushing myself to a higher level.
That is what makes you succeed in life.
Dr. Biggs: For the past few years I’ve heard you
speak passionately about Evidence-based Medicine.
Please bring us up to date on that matter and how it’s
being reflected in the Journal:
Dr. Rohrich: I think one of the epic changes in
Medicine and in Plastic Surgery is that we are
owning our specialty, as we become more evidencebased.
Plastic Surgery has been an “expert-based”
specialty, where experts have driven the specialty
through innovation. These experts are incredibly
valuable and continue to be, but we must now go
to the next level of excellence. That next level

of excellence is that of evidence-based medicine
(EBM), where we must prove that what we learned
as experts can truly be done, not only by ourselves,
but by others and can be shown to work in both a
prospective and randomized manner. Whether it is
a product, a technique or a technology, it must now
be shown to truly work sufficiently, in a scientific
manner. That is the next level of excellence we
must achieve. Since becoming Editor-in-Chief of
the journal of Plastic and Reconstructive Surgery in
2005, we have pushed the technological envelope,
evolving the journal from being a print-only version
to being online in all aspects (including the peer
review process to the upcoming development of the
iPad app). Today, you can see, feel, and look at our
videos in the PRS journal instantaneously. That is
the natural evolution. Innovation, aiming high and
seeking new challenges brings you higher caliber
articles, as well as a higher caliber type of evidencebased
Plastic Surgery, which will help drive Plastic
Surgery to a better place in Medicine. The bar in
Plastic Surgery is being raised and we are pushing
that bar with evidence-based medicine. We need to
push our entire specialty of Plastic Surgery to come
and join us, to make sure that we truly are and remain
at the cutting edge, not only of innovation but that
of EBM, so we can show the rest of Medicine that
what we have done and what we continue to do is
evidence-based.
So, as a Plastic Surgery leader in the United States,
I think it is important for us to show and lead
by example, not only by our journal, but now in
our clinical practice. EBM is rapidly changing
how we practice Medicine and how we practice
Plastic Surgery. It will make us better. The goal
is to provide a foundation for doing evidencebased
Plastic Surgery. There is no better way than
mandating that Plastic Surgery programs become
their own departments; this must be solidified, so
we can allow for true innovation to occur, separate
and apart from General Surgery, which, I think, is
so critical. We are now, and have been for a long
time, our own specialty. Because EBM has proven
to be a highly effective methodology, the American
Society of Plastic Surgeons and the American
Society of Aesthetic Plastic Surgery, along with
other Plastic Surgery and related specialty journals
and societies, convened at the first Plastic Surgery
Evidence-Based Medicine Summit in Colorado
Springs, Colorado in August 2010 (see Figure
1). At that meeting we strongly encouraged all of
the journal editors to work with the ASPS and the
journal of Plastic and Reconstructive Surgery to
have a single grading system for evidence-based
medicine, similar to what we use in PRS, so we can
move forward together. A year later, in May 2011,
at the Plastic Surgery Journals Editor Round Table
Meeting in Vancouver, Canada (see Figure 2), PRS
was joined by other international Plastic Surgery
journals and we all agreed to work on establishing
uniform global EBM standards and Levels of
Evidence grading systems. At the Vancouver
meeting, we agreed to invite all of the world editors
of Plastic Surgery journals, as well as those of our
other related specialties, in Facial Plastic Surgery,
Dermatology, Oculoplastic Surgery, to attend our
next EBM strategic planning meeting in Colorado
Springs in July, 2012. EBM is for Plastic Surgery
worldwide, and Plastic and Reconstructive Surgery
stands as an advocate for unified, global EBM
standards among all Plastic Surgery and sisterspecialty
journals.
Dr. Biggs: How do you see the future of Plastic
Surgery?
Dr. Rohrich: The future of Plastic Surgery is very
bright. It lies in innovation, autonomy, becoming
departments, developing and expanding evidencebased
medicine through the entire world, and
developing a uniform platform for the language in
space medicine. We will focus on where we are going
to take EBM in Plastic Surgery in the future, how we
will become better: better in what we do, better in
our practice and better in improving EBM, because
that is our future. After all, the goal is to improve
patient care, drive innovation, drive cost efficiencies
and only then can we say we have given our best,
given back and left the world a better place, both for
Medicine and for PLASTIC SURGERY. That is my
goal and that is what I will continue to do.
It pleases me to get this message out to your 37,000
recipients and I want them to join me in this adventure
of the EBM world of Plastic Surgery. It will be a
better place for all of us as Plastic Surgeons and for
Plastic Surgery as well.
Dr. Biggs: Thank you Dr. Rohrich
Issue 7 www.ipras.org IPRAS Journal 21

22 IPRAS Journal www.ipras.org Issue 7

R I S I N G S T A R
An interview with Dr. Bouraoui Kotti
Dr. Biggs: Congratulations on being chosen as our
RISING STAR for this issue of the IPRAS Journal. As
you know, we select someone under the age of 45, who
has shown great promise in their pursuit of excellence in
Plastic Surgery. Tell the readers a bit about yourself. Begin
by telling us your background and your education.
Dr. Kotti: I was born in 1977 in Tunisia, a country of
11 million people and 80 plastic surgeons. My primary
education was undertaken there, as well as my medical
education. I graduated in June, 2000, from the Medical
School of Tunis and followed that by a broad medical/
surgical internship for one year.
From 2002 to 2006 I did a residency in Plastic Surgery
and completed a dissertation on “Plastic Surgery for the
Management of Pressure Sores”. I graduated Summa
Cum Laude from the Tunisian Public Health Department
and the Tunisian Higher Education, Scientific research
and Technology Department in Plastic Reconstructive &
Aesthetic Surgery (October 2007) and made the decision
to move to France, where I continued my studies. I
worked in Nice and Paris in services including breast
reconstruction, maxillofacial surgery, head and neck
surgery, and general Plastic Surgery, including Aesthetic
Surgery. I spent most of last year (to February, 2009)
with Dr. Claude Lassus in Nice. My studies and work
in France allowed me to be Certified from the French
College of Plastic Reconstructive and Aesthetic Surgery
(November 2007) and, in May 2008, by the European
Board of Plastic Reconstructive and Aesthetic Surgery.
Dr Biggs: And then you returned to Tunisia ?
Dr. Kotti: Yes, and in 2009 I joined the “Salah Azaiz”
institute (an anti-cancer centre) and have become Head
of the unit of Plastic Surgery in the Surgery Department.
Dr. Biggs: What Societies do you belong to?
Dr. Kotti: Tunisian Society of Plastic, Reconstructive,
Maxillofacial, and Aesthetic Surgery (STCPRMFE),
ASPS, SOFCPRE, and ISAPS of which I’m National
Secretary.
Dr. Biggs: I looked over your list of publications and
presentations, over twenty in all, and fifteen posters.
I noticed you have run the table on topics from digital
reattachment to abdominoplasty and blepharoplasty,
breast reduction and reconstruction, to extensive
maxillofacial reconstructions, and to burns. That’s a lot
of production for a young man and very impressive.
Dr. Kotti: And there is a lot more to do
Dr. Biggs: Tell me about that. What do you predict and
where do you see yourself in five years?
Dr. Kotti: I see myself still in pursuit of better ways to do
more for people. My interest lies more in reconstruction,
but with an increased attention to its aesthetic aspects.
My great hope is that the political situation in Tunisia will
be such, that I can expand my research capabilities and
impart progress made there into clinical applications.
Dr Biggs: Thank you Dr. Kotti. Your great hope is
shared by members of our Plastic Surgery family around
the globe and this is why I so often say that “the bonds
that unite us are greater than the borders, boundaries, and
languages that divide us”
Again, congratulations on being chosen our “RISING
STAR”.
Issue 7 www.ipras.org IPRAS Journal 23

Dr. Biggs: Dr. Mazzola, to those of us who have been on
the Plastic Surgery scene for a while you are a legend, but
this is an International Journal and many of our readers are
somewhat new to the field, so please give us a review of
your educational and training background.
Dr. Mazzola: I obtained my medical degree at the University
of Pavia in 1967, magna cum laude. I passed my Board
examination in ENT in 1970 at the University of Ferrara
and my Board in Plastic Surgery at the University of Milan
in 1974 (head Prof. G. Sanvenero Rosselli). I became an
Assistant Professor of Plastic Surgery at the University
of Milan in 1971 and I am currently Professor for Plastic
and Reconstructive Surgery at the Postgraduate School of
ENT, and Maxillofacial and Plastic Surgery at the School of
Medicine of the University of Milan.
Dr. Biggs: Tell us about your Foundation.
Dr Mazzola: In April 1975, I established the “Fondazione
G. Sanvenero Rosselli” for Plastic Surgery, as a tribute to my
late uncle Gustavo Sanvenero Rosselli, founder of Plastic
Surgery in Italy. The institution promotes various forms
of teaching, fulfilling a continuous postgraduate training
program, by arranging meetings, seminars and courses in
the field of Plastic Surgery. Directed by a Board of Trustees,
the Fondazione has coordinated more than 150 meetings
and seminars and organized 48 theoretical and practical
courses, with live surgery over the years. I am currently the
Vice-President of this Institution. The Fondazione houses
more than 4,000 books and boasts certainly one of the most
important rare book collections on Plastic Surgery in the
world. We have volumes dating from 1490 onward.
Dr, Biggs: Tell us about your professional life.
Dr. Mazzola: I am a Founding Member, Secretary General
(from 1995 to 2001) and President (from 2005 to 2006) of the
EURAPS (European Association of Plastic Surgeons). I was
Secretary of the Italian Society of Plastic Surgery (SICPRE)
from 2001 to 2004, and am a member of over 15 National
and International societies, among them the prestigious
American Association of Plastic Surgeons (AAPS).
Dr. Biggs: How about presentations and authorships?
Dr. Mazzola: I have participated in 450 invited panels,
lectures, conferences and courses at National or International
Meetings and Congresses. I have organised 52 Congresses
24 IPRAS Journal www.ipras.org Issue 7
S E N I O R A M B A S S A D O R
Dr. Riccardo F. Mazzola
and Courses.
I’ve been honoured to be the Keynote speaker in numerous
International Congresses, and was awarded the Maliniac
lectureship at the 2006 ASPRS Congress in San Francisco,
USA.
I am the co-Author of 3 textbooks (“Craniofacial
Malformations”, Churchill Livingstone 1990; “Velopharyngel
Incompetence”, Masson 1995, in Italian, “Fat Injection,
from Filling to Regeneration”, Quality Medical Publishing,
2009), 12 book chapters and 112 publications, 38 of them in
peer reviewed scientific journals.
Dr. Biggs: What are your primary surgical interests now?
Dr. Mazzola: My primary interests include Cleft Lip and
Palate, Head and Neck reconstruction, Nasal Reconstruction,
Fat injection, Rhinoplasty and History of Plastic Surgery.
Dr. Biggs: Where do you see us going in Plastic Surgery?
Dr. Mazzola: That is a good question, because I am both
optimistic and, at the same time, somewhat despondent. I’m
the latter because Plastic Surgery, by not being independent,
has less opportunity for research. Modern day Plastic Surgery
began with a collection of ENTs, General Surgeons, and several
others who had a common talent: innovation. Innovation
was necessary to deal with the massive wounds resulting
from World War I, wounds never seen before, because these
unfortunate victims were the beneficiaries of medicine which
was advanced enough to keep them alive but still lacking in
skills to reconstruct them. My despondency lies in the fact that
our lack of independence limits us in our quest for advanced
solutions plaguing modern surgical problems.
My optimism lies in the wonders that await us. These
wonders include wound healing, tissue regeneration,
concepts of neurogenesis, and many others.
Dr. Biggs: Do you have any advice for our younger
readers?
Dr. Mazzola: Yes. Go back several centuries and see how
brilliant minds were dealing with some of the same problems
we are dealing with now. See how Leonardo Da Vinci
understood anatomy, how concepts of wound healing have
evolved. Study the Masters and extrapolate their creative
thought processes into your own.
Dr. Biggs: Thank you Dr. Mazzola. You truly are a Senior
Ambassador for IPRAS and for physicians of all types.

Issue 7 www.ipras.org IPRAS Journal 25
© 2011 POLYTECH Health & Aesthetics, Germany.

26 IPRAS Journal www.ipras.org Issue 7
H U M A N I T A R I A N W O R K S
Developing Islamic countries are quiet and peaceful
areas, most of the time. In some cases however, the
work of humanitarian teams is not as easy as that… The
following lines try to analyze the specific problems that
could be encountered in some places, where the religion
is dominating and ruling the public life and the cultural
habits in such a way, that things are becoming so different
and thus more difficult to understand for an occidental
mind. And after all, if we want to help them, we first have
to understand them….
SPECIFICITY OF WORKING CONDITIONS
FOR THE HUMANITARIAN TEAMS
The teams are faced, most of the time, with a triple
specific deal: the religion, the women’s condition and the
corruption …
The religion
How to conciliate religion
and humanitarian surgery
in Islamic developing countries
• About Islam: Islam is a beautiful religion, spread all
over the world. However, the territory where it is the
A man in Kabul…
Dr. Christian Echinard
President, HumaniTerra International
President, IPRAS Foundation
predominant religion geographically extends, more or
less horizontally, from the western part of Africa to the
Far East end of the southern Asian continent, including
Malaysia and Indonesia. Historically and theologically,
there are several “families” of Islam, such as Shiites,
Sunnites, Kharijists… all of these groups coexist in a
more or less complex harmony in the many developing
countries, where humanitarian teams are performing
surgical camps or missions.
Moreover, Islam is, most of the time, a state religion
and therefore this religion often becomes a real
political-religious rule.
In fact, there are, as far as geography and culture are
concerned, several Islams… Because of local political
and cultural factors, Islam in Maghreb is not exactly
the same as the one in Indonesia and is also different
from the Islamic beliefs of central Asia or Turkey, for
instance.
The medical and surgical humanitarian teams working
in different parts of the world will be faced with a
“soft” or “moderate” Islam in some places, or with a
“hard” or “strong” Islam in other countries…
• The Muslim population: it seems that the actual
number of Muslims in the world reaches approximately
1.5 billion people. Etymologically, the word Muslim
comes from the Persian “Musilman”, plural of Musilm,
whose root is the verb “Aslama” (to be resigned, to be
submitted … to God, of course). This great number of
people and the strength of their faith put Islam as one
of the major religions in the world, especially in the
poorest parts of the world.
• Their position towards illness and medical care is not
identical everywhere. Muslims of the world, though
they cannot really read and deeply study the enormous
amount of rules of the Koran, are very faithful and,
most of the time, respect the 5 main rules (five prayers
a day, pilgrimage, Ramadan…) As far as illness
and medical care are concerned, there is, in fact, no

specific rule. For some of them, illness is considered
as a punition of God and requires little care, for some
others, on the opposite, it is something that must be
treated absolutely immediately.
The women, of course, have a special status… In
some remote places they should not be touched by a
male doctor… The problem is that, very often, there
is no female doctor… This is very frequently the
case in Afghanistan, where women die because their
husbands refuse the help of a male doctor, especially
for delivery. This is, of course, an extreme point of
view. In most cases things are much simpler and the
real rule in the Islamic religion is that, when there is a
necessity, women can be treated by any male doctor,
Muslim or of any religion. Necessity creates the law
and the rule… a safe and good advice…
The women’s condition: female mortality
creates a terrible disorder
• Gender mortality: this is a real economical and
demographical problem. In most of the Islamic
developing countries, the female to male ratio is, on
average, 900/1000; It is the opposite in occidental
areas: 100 females for 90 males in Europe, whereas
in Bangladesh and Pakistan the ratio is 100 women for
106 males. Another interesting sign is that, in those two
countries, the average duration of life is the same in men
and women (56 years); in Europe and America females
live approximately ten years longer than males…
This over-mortality in the female population is due to
several factors, such as the way of life, the number of
children, the amount work done by women… but also
due to the high maternity mortality and the increased
level of violence towards them.
Women from the mountains in Afghanistan
• Materity mortality: in Afghanistan, one woman dies
every 21 minutes due to delivery problems! In central
Asia Islamic areas, 2000 female patients die in 100 000
births! In Europe the average is only 10-20/100 000.
• Violence towards women is also an important cause of
female over-mortality.
It can be in the form of domestic and marital abuse. It
reaches 50% in some of these countries, the champion
being Bangladesh, where more than one wife out of
two is regularly beaten. In Pakistan, 300 women are
killed every year by their husband, brother or son, in
the name of honor.
Among the worst crimes, forced or induced suicides
by flame are very frequent in Iran, Afghanistan
(especially the Herat area), Pakistan, Iraq, but also in
Africa (Zimbabwe, Egypt…)
In Pakistan and Bangladesh, there are many acid attacks
against women, committed by jealous or unsatisfied
husbands. This type of acid burn on the face leads to
extremely severe contractures and real disfigurations of
the wives. Two NGOs have been created to fight against
that, the “Acid Survivors Foundation” ran by Valerie
Khan in Pakistan and Monira Rahman in Bangladesh.
Apart from marital aggressions, these gender crimes can
also be the result of abusive punishment or usual violence
such as stoning, rape, excision, any kind of mutilation
(hand or nose…), sexual slavery and forced pregnancy.
Moreover, many rapes have been committed in these
countries as a war weapon, in order to humiliate the
enemy. In Kuwait, over 5000 rapes were committed
against the local women by the Iraqi forces, when they
invaded this country in 1990. In Algeria, between 1995
and 1998, rapes were committed in the name of the Jihad
in order to render the females impure and dishonored…
Issue 7 www.ipras.org IPRAS Journal 27

Teaching women rights in Bangladesh
The corruption and … the narcotics business
• Corruption: last year, the UNDP (United Nations
Development Program) classified Afghanistan at
the 155th rank out of 169 countries in the world for
development and economy. Meanwhile, the NGO
“Transparency International” stated that this country
was placed third as far as corruption is concerned !
• Narcotic trafficking: most of the time, corruption is
connected to drug trafficking … Afghanistan is by far
the first opium producer in the world; before the Taliban
period (during the soviet domination) production was
estimated at 2500 tons per year. In 1999, at the end
of the dramatic Taliban government, it reached 4600
tons per year, proving that they did not do anything
against drug trafficking… In 2007, under the current
government, opium production in Afghanistan nearly
doubled, and was evaluated yearly to 8200 tons! And
this was of course very much to the benefit of the
political elite. The resulting gain from opium trafficking
is probably one billion dollar per year. One gram is
sold in the country about 2 or 3 dollars. It is re-sold in
Europe or America for 70 dollars. At the same time,
we found that it is still difficult to find narcoleptics for
anesthesia in a hospital in Kabul or Herat …
• Position of the medical team faced to this problem: this
shows how the task of the humanitarian medical teams
can be difficult in such countries… corruption must
not touch our teams. Everything possible must be done
in order to avoid any kind of collision with anyone.
And everyone must be aware that the manipulation of
the team about this problem can be very easy and can
be a source of conflicts…
WHAT MUST BE THE BEHAVIOR
OF THE HUMANITARIAN TEAM?
In the face of such a situation, the behavior of the
foreign surgical team must comprise of understanding
and adaptation, as long as we keep in minds the ethical
28 IPRAS Journal www.ipras.org Issue 7
rules of our action. We must understand what they are
and what they need and therefore respect their identity.
But we must never betray our principles. We must adapt
them to the local situation. The most important rule is to
respect three important things: the political and religious
authorities, the local medical teams and, above all, the
patients whom we are suppose to treat.
Respect of the political and religious authorities
• In every one of these countries the humanitarian teams,
or their delegates, must try to have a meeting with the
local or regional political authorities (governor, president
of local assemblies, Shuras…). A complete agreement
must be established before any action is taken on the
field. This makes things much easier for the rest of the
missions and always clarifies the situation.
• Mullahs and religious assemblies should also be
contacted, in order to explain to these dignitaries what
the aim of the mission is and get a complete approval
from them. This is particularly useful when a NGO is
working on a prevention campaign, in which women
are involved, such as campaign against suicide by
flame or against acid attacks. It is very important to
discuss with them, explain to them the work that will
be done, ask their opinion, see how they can help…
Communication is extremely important and, with
the consent of the Mullahs, the behavior of men and
women in the area will be very much in favor of the
NGO. On one hand we must absolutely avoid being
considered as neo-colonizers by the local population.
On the other hand, when we are supposed to deal with
situations related to women, we must avoid any kind of
frustration or dishonor from the men. This is also the
reason why it might be useful to work in collaboration
with a local NGO.
Respect of the local surgical teams
• Most of the time, the NGO surgical team is totally
welcome by the local medical teams, which are
A men session during the anti self immolation campaign

very often requesting this collaboration. Sometimes,
however, there is no local medical team and the
problem is different… Sometimes the local team is
not really expecting the arrival of a foreign team of
surgeons and, therefore, is not in complete empathy
with the NGO and vice versa…
In any case, there must not be any rivalry with the
local medical group. The NGO is there to take care
of the patients together with the local surgeons and to
teach them how to do better and how to improve the
quality of surgery and hospitalization. Religion must
not be a brake to relationship. The NGO team must
absolutely respect the faith of the local host: prayers
during the day, Ramadan period, alimentary habits,
time and menus of the meals…
There usually are few women surgeons or anesthetists
in these countries. However, in some of them, when
we have to work or train a female doctor, care must be
strictly taken not to disturb her in her religion habits
(no direct contact, no rudeness, respect of the veil, the
hidjab or the burka…)
Moreover, there must be complete cooperation between
the two teams, with respect, friendship, harmony and
mutual comprehension. The NGO teams must be very
humble. Respecting the religion and the culture of
our medical partners is essential. They must become
friends and feel a complete cohesion between the two
teams.
In many cases, we have invited them to come to Europe
(France in particular) for a more complete training in
surgery or hospital management, with their expenses
covered. For instance, HumaniTerra has completed the
medical or surgical training of 12 Afghan doctors in
France for two months or more. In each case, we paid
attention to their religion and faith when they were in
our universities or hospitals.
• Nurses and paramedical teams must also be treated
with a great deal of deference, respect and kindness.
This does not exclude friendship and convivial
behavior. We all need that. Again, total respect of their
religious convictions must be observed, particularly
concerning the the female dresses or the veil that they
can wear on their head. On the same topic, it seems
normal to us that our own nurses, female paramedics
or doctors wear a veil in public or when they work at
the hospital.
Respect of the patients
• A veil for the women of the NGO team is, as mentioned
before, an important thing if our nurses and women
surgeons want to be in perfect harmony with the Muslim
female patients. It makes the patients more confident
and it becomes easier to take care of them. They will
indeed appreciate the fact that we respect their beliefs
and habits (showing that we are open-minded people,
which, at first glance, is not evident to them) and
therefore will be, in return, very open to our treatment.
Culturally, philosophically and for religious reasons
women (and men sometimes) are very shy and pudic.
Some of them are naturally modest and chaste. Others
are extremely reluctant to be clinically examined and
to be shown half naked … More often, the reason for
this is that their husband strictly forbids this. Some
men are totally opposed to the fact that a male doctor
(Muslim or non-Muslim) can even touch their wife.
In some parts of Afghanistan, they would prefer that
the pregnant mother dies and sometimes the baby too,
instead of consulting a male doctor or gynecologist, in
case of emergency or imminent delivery! Fortunately,
this is less and less often the case and this behavior can
only be seen in some remote areas, for instance high
in the mountain. In Chagcharan, 3200 meters high in
the Afghan mountains, we have seen that it sometimes
took two or three days for a mother to reach the nearest
hospital on her own means…!
In any case, the attitude of the surgical team must pay
attention to all this and always respect the chastity and
modesty of the patients.
• We must always show great professionalism: surgical
NGOs are considered as a type of ultra specialized
NGO. People constituting the team are very often senior
surgeons or very well trained practitioners. And this is
always the case. Our attitude towards the patients is to
prove to them that we are good professionals. Nothing is
worse than doubt. If we are top level at home, we must
also be top level in missions. Good training of the local
doctors can only be achieved under these conditions.
A young woman after a suicide attempt by flame
Issue 7 www.ipras.org IPRAS Journal 29

They must be confident. Security is one of the most
important things. We must not appear as arrogant
cowboys invading the country, and giving orders. Our
role is to do the job as well as we do at home, or better,
although the conditions are often much more difficult,
due to a precarious situation or a lack of modern
material. Of course, professionalism goes together with
safety… “Safety first” is one of the phrases that we
must keep in mind. A small number of operations with
good results and good functional outcome is always
better than many operated cases with bad or mediocre
results… bad results are always interpreted and felt as
bad work or, sometimes, as a humiliation.
PROVIDE AN ADAPTED HELP:
Considering all these parameters… what can we do…?
• Build or Rebuild and help them to work in good
conditions: very poor countries, often belonging to
the Islamic area, have rather seldom good hospital
accommodations. There is often a lack of hospitals or
surgical wards, a lack of well trained surgeons, a lack
of paramedics…
A good occidental NGO must be aware of that.
Therefore, it is important for them to restore or even
to build specific wards for surgery. Reconstructive
surgery in particular is not well developed in these
countries. Our goal must be to help them to get new
buildings. In Islamic countries we try to build or restore
specific departments where physically abused women
Teaching afghan women how to fold the gauze
30 IPRAS Journal www.ipras.org Issue 7
can be treated. HumaniTerra, for instance, has built a
pilot burn center, in which women have a completely
separate ward from the men, just as if we had build
two burn centers… Physical rehabilitation is also done
in a specific area.
We have also been the leaders and initiators of the
HOT program (Herat Operating theatre, 6 very
modern operating rooms), together with the help of the
Japanese and Italian cooperation. This allows women
to be operated in conditions as good as the men…
An adapted help is, to try to study what will fit the best
to a specific situation, integrating the Islamic laws and
habits… To women, treatment is given by women.
• Prevent them from bad habits and help them to get
a better life: are we allowed to change the rules…?
Certainly not… just because we are foreigners there
is no reason why we should try to make new laws.
Nothing is justifying the fact that democracy is better
for countries that are used to live under tribal laws…
why would we interfere…? And after all, is Islam
compatible with democracy…? This is a question
difficult to answer, although Turkey, for instance, is a
good example showing that it is possible… on the other
hand, the Islamic countries of the “Arabic Spring” (
Libya, Tunisia, Egypt…) have also shown proof of
that… but we still don’t know what the outcome will
be in a few months…
However, even if we do not feel authorized to give them
lessons in life, the role of a NGO is to try to induce a
better way of life, a better equity between women and
men, a more reasonable sharing of knowledge, an
equal chance of happiness for everyone and dignity for
every human being.
Towards this aim, we have set up several Campaigns for
the dignity of women. In Afghanistan Two campaigns
were organized, in cooperation with the local NGO
“Voice of Women”, in order to fight against this
horrible endemic disaster of women forced to commit
suicide by flame. During the first campaign, Lectures
and discussions were organized for Women and for
men, separately, pointing out the unjustified reasons
of the crime, the expansive, long and painful treatment
and the horrible outcome with so many sequelae …
after one year, the percentage of suicide by burn in
the Herat Province, decreased from 43% of the total
amount of burn patients to 11%... very good results,
but still not sufficient.. A second campaign is currently
under way with TV videos and meeting, aimed at an
even larger amount of people.
In Bangladesh, a campaign against acid attack is
also actually being set up, for the numerous women
attacked by jealous men…
This type of action from the occidental NGOs must,
however, not be too visible to the public, as this can

Afghan women outside the mosque
lead to local problems with the NGO. This is a reason
why actions should only be performed after a total
agreement with the political and religious authorities.
They should also be carried out mostly by local NGOs,
under the control of the occidental NGO.
• Provide them with better surgical care and help
them to survive: In the remote areas of some Islamic
countries, illness or trauma are sometimes still
considered a normal thing or a punishment of god
(remember that the word Islam comes from the word
Aslama, “to be submitted”…) In the poorest Islamic
Consulting the local assembly in Asad Kashmere , Pakistan
countries, we see a lot of congenital malformations,
traumas, awful burns, post-delivery problems… Our
goal must be to reach these isolated people who cannot
pay for a hospital stay and get in touch with them,
wherever they are.
Illness must not be considered for them as a malediction
or a fatality anymore. The poorest of them don’t even
know that they can be treated. Burn contractures can
be treated, acid attacks must be cured, post delivery
vaginal fistulas must be operated, care should be taken
of cleft palates at any age, in any of these remote
areas… whatever the religion is, whatever the strength
and the power of religious fanaticism is…
Together with its partner NGO, Friendship,
HumaniTerra is providing high quality proximity
surgical care in northern Bangladesh, where the Chars
population cannot move from their semi-flooded
islands, using two river hospital boats, on which they
can be operated in good conditions. This hands-on
surgery, in the small Islamic villages, is also performed
in Pakistan, and southern Bangladesh, close to the
sea. Very soon it will be also done in the Bengal gulf,
thanks to a new sea hospital boat , the former “Rainbow
Warrior”, that has actually been transformed into a
surgical boat, on which every NGO teams of SHARE
(Surgical Humanitarian Aid Resources Europe) and
HUGS ( Humanitarian Union for Global Surgery) will
be able to operate all year long.
Issue 7 www.ipras.org IPRAS Journal 31

The Concept
It was during the visit of Dr. Rajeev B. Ahuja, to inspect
the newly introduced burn unit at the Tanda Medical
College, on behalf of the Government of India, that
the idea of having a surgical camp at this location was
mutually discussed between him and the Principal, Prof.
Anil Chauhan. The Principal showed enthusiasm for a
free Plastic Surgery camp, as the area has a lot of poor
patients requiring Plastic Surgery and such facilities are
not available in the region, including the college.
The Location
The historical town of Kangra nestles in the valley
of Himachal Pradesh. For the believers it is a place of
pilgrimage, devoted to the Goddess Parvati, the consort
of Lord Shiva. Over the years it has seen numerous
invasions, a grim reminder of its strength being the Kangra
Fort, which sits atop a steep 1000-foot cliff, rising like a
phoenix from the river bed. Kangra is derived from word
“Kanghara” which means “doctors who repair ears”. As
per hearsay, in ancient times, this town was famous for its
Plastic Surgeons. The RPG Medical College is a fledgling
College, which has only recently introduced post-graduate
courses. The College is a boon for the city and the
surrounding areas, which have scarce health care.
The Planning
IPRAS (Asia-Pacific Section) organized
a free Plastic Surgery Camp
Dr. Ahuja requested Dr. Chanjiv Singh (Chairman,
Humanitarian Committee, IPRAS) from Jalandhar to visit
the college and issue a feasibility report. Dr. Chanjiv visited
the college in June 2011. He assessed the patient load
and the facilities available for the venture. The Principal
deputed Prof. Sanjeev Sharma (General Surgery) to coordinate
the planning of this camp with Dr. Chanjiv.
Dr. Ahuja, as Secretary General of IPRAS (Asia-Pacific
Section), invited senior surgeons from the Asia- Pacific
region to volunteer for this humanitarian mission. As this
32 IPRAS Journal www.ipras.org Issue 7
at the Dr. Rajindra Prashad Government
Medical College of Kangra,
at Tanda (Himachal Pradesh) India
from 21st to 28th (31st)August 2011.
was the first mission of its kind in the area and the Hospital
is a governmental facility, the organizers went through a
lot of red tape to make arrangements for the camp.
The team co-ordinated with the Lions Club of the nearby
town of Dharamshala to publicize the event and to
accomodate the visiting team. The Lions Club did extremely
well in sending out information to district hospitals in the
region, and publicized the camp to the public through
banners and posters. Their efforts landed an overwhelming
number of patients for surgery at the camp.
Dr.Chanjiv Singh visited the college again in July to
oversee the boarding and lodging arrangements, to coordinate
with the hospital authorities for the provision
of supplies, to discuss with the anaesthetists and to coordinate
with the Lions Club.
The Teams
The Indian team, lead by Dr. Rajeev B. Ahuja, comprised
of other senior Plastic Surgeons, Dr. Vimla Rajan, from
New Delhi and Dr. Chanjiv Singh from Jalandhar. Senior
residents from Lok Nayak Hospital, New Delhi (Dr.
Dhirendra Suman, Dr Vinish Shrivastava, Dr Manish
Chopra); DMC & Hospital, Ludhiana (Dr. Manish
Sehgal); Amandeep Hospital, Amritsar (Dr. Seema
Mittal, Dr.Sandeep Kansal); and PGIMER, Chandigarh
(Dr. Anil Kumar, Dr.Raja Tiwari) had volunteered for
the camp through their respective Heads of Department.
OT assistants Mr. Harpreet, Mr. Gurnam Singh and Mr.
Vikramjit Singh volunteered from DMC Ludhiana, Civil
hospital, Jalandhar and Amandeep Hospital, Amritsar,
respectively. The staff of the College itself worked
around the clock, beyond their duty time to assist in the
camp.
The team from Thailand was headed by Prof. Apirag
Chuangsuwanich from Mahidol University, the President
of the Association of Plastic Surgeons of Thailand. The
team consisted of a Plastic surgeon, an Anaesthesiologist,
an OT assistant, nurses and volunteers and included

Mr. Sirichai Kamnerdnakta, Mr. Thara Tritrakarn, Mr.
Poom Tritrakarn, Mrs. Pensri Noocharoen, Ms. Thitima
Channawa, Ms. Susiri Charloenmit, Mr. Thanatpant
Manosittisak and Ms. Panipak Vareevanichaphan.
Dr. Fong Poh Him from the Institute of Plastic Surgery
represented Singapore. The foreign teams provided
their own instruments and materials. All overseas team
members covered their own expenses of travel to the
surgical camp site.
The Mission
The first day,August 21st, was used to inspect all facilities,
instruments, autoclaving procedure, and instrument
turnaround after surgery, and the number of theatres that
could be available. An informal inauguration of the camp
Team members
was done on the 22nd, with the visitors being welcomed
by the Principal and the President of the Lions Club, Mr.
P.C. Dhiman. Although patient registration had started in
July, the formal OPD for short-listing patients for surgery
and registering fresh patients started in the morning of
August 22nd. In spite of bad weather and constant rain,
the OPD was bursting at the seams with the crowds.
More than 140 patients were examined on the first day of
the camp. Nearly 100 more patients were seen during the
next few days. Seeing the gush of patients, it was decided
to have four OT tables, as there were enough surgeons
and supporting staff. Dr Sudarshan Choudhary (HOD
Dept. of Anaesthesia) and his senior colleague, Dr Shelly,
joined with Dr Thara’s team and anaesthetists from Delhi
to manage anaesthesia for the four tables.
Camp inauguration
in the hospital corridor.
Issue 7 www.ipras.org IPRAS Journal 33

Dr Fong Poh Him lighting the inaugural lamp.
Dr Apirag Chuwangsuwanich on extreme left.
The surgeries started on the 23rd and continued until
the 26th. A total of 91 surgeries were performed. The
OPD continued seeing the patient inflow on all days.
The hospital authorities admitted all patients free of
charge and also did not charge for the investigations. The
documentation and case recording was also done on the
hospital stationery as per the prescribed norms.
The spectrum of surgeries included patients with severe
post-burn contracture and deforming disabilities, cleft
lip and palate, syndactly, deforming scars, non healing
ulcers etc. Thirty-three beds were made available by
the hospital exclusively for this camp. Due to the sheer
numbers of patients that were operated, many of them
had to be accommodated as day care patients.
Postoperative examinations and change of dressings
started on the 25th in the OPD area and in the
wards. Patients were instructed in post op care and
physiotherapy. Two residents stayed back after the
camp for postoperative care, stitch removal and advice
on follow up until August 31st.
34 IPRAS Journal www.ipras.org Issue 7
Entertainment
The organizers were particularly concerned about
providing quality leisure time for all volunteers, to
avoid fatigue set-in over the week, especially for foreign
participants. The evenings were occupied by visits to
Mcleod Ganj (abode of His Holiness The Dalai Lama),
Dharamshala, nearby temples and rivers. A couple of
popular Bollywood movies (with English subtitles) were
screened on two days. A lot of friendship and bonding
developed between all participants and all of them
pledged to attend future camps also.
Press Coverage
There was extensive coverage in the press and media
about the camp. This further generated keen enquiries
about future camps.
Organizational structure
Publicity
The Lions Club played a major role in the publicity
campaign for the camp, which started about a month and a
half earlier. The pamphlets were distributed to peripheral
hospitals and schools. The routine patients visiting the
surgical OPD were also handed pamphlets.
Press Conference Press reports

Manpower
The visiting team comprised of 22 members (14 doctors,
6 paramedics and 2 volunteers).
Ten staff nurses from the Medical College were posted
with the team for operations and there were separate
nurses on shift duties for postoperative wards.
Two OT assistants were deputed from the hospital
strength.
Two consultant anaesthetists and two residents from
the hospital joined an equal number of anaesthetists
of the visiting team to provide anaesthesia on 4 tables
simultaneously.
Autoclaving was managed by one linear autoclave and one
table top autoclave in the side room of the operation theatre.
All autoclave linen and dressing material was prepared in
the evening just after the day’s work was over.
Boarding & Lodging arrangements
All visiting members were accommodated by the Principal
in the guest house of the Medical College. A kitchen was
set up in the guest house by the Lions Club for all catering
requirements.
Expenses
The hospital spent more than 0.4 million Rupees on
medicines, sutures and accessories for the patients.
Publicity and boarding costs was borne by the Lions
Club, Dharamshala.
International travel expenses were covered by individuals
or sponsors.
IPRAS Asia- Pacific Section covered license fees for
overseas doctors, transport of Indian teams and other
miscellaneous expenses.
Dr Rajeev B. Ahuja
(Secretary General,
IPRAS-APS)
Future and Past
As this area has no facility for Plastic Surgery, it is proposed
to have a camp at this same location every year. Earlier,
Dr. K.S. Goleria had been conducting free Plastic Surgery
camps with his team at Zonal hospital, Dharamshala for
22 years, in association with the Lions Club. This was
discontinued due to health reasons about 4 years ago.
Seeing the need of the people, IPRAS “Women for Women”
team also did a free camp in Jannani Hospital at Paprola
(Palampur) a few years ago. You can view the documentary
on www.youtube.com. The camp was the brainchild of Dr.
Marita Eisenmann-Klein, Secretary General of IPRAS and
was organized by Dr. Chanjiv Singh.
The idea of “Mission India”, a NGO, was floated by Dr.
Chanjiv Singh, so that American Plastic Surgeons of Indian
origin could work for the poor. It was created by Dr. Kusuma
Shashidhar, President of ASIPS and his colleagues. They
did a free Plastic Surgery camp in SR Hospital, Kalheli,
Bajaura, dist Kullu, Himachal Pradesh last year. The camp
report is on www.facebook.com as Kullu mission.
Pictures from the Kangra camp can be viewed at www.
iprasaps.org
Sponsoring:
1. Principal, Dr. Rajindra Prashad Govt. Medical
College, Kangra
2. IPRAS-Asia Pacific Section
3. Lions club, Dharamshala
4. Bangkok Botanica, Thailand
Report submitted by: Report prepared by:
Prof. Anil Chauhan
(Principal, RPG
Medical College, Tanda)
Dr Chanjiv Singh
Chairman-IPRAS,
Humanitarian Committee
Prof. Sanjeev Sharma
(Dept. of Surgery,
RPGMC, Tanda)
Issue 7 www.ipras.org IPRAS Journal 35

Togo is a “strip of land” between Ghana and Benin, in sub-
Saharan Africa. In the small village of Afagnan, 80 km from the
capital Lomè, there is the renowned Saint Jean de Dieu Hospital,
which is one of the most famous hospitals in the country. It was
built in 1964 by the Hospitaller Order of Saint John of God.
Since the early 1980’s several doctors and nurses from the Italian
St John Calabita Hospital have participated in mission trips,
offering voluntary medical assistance and teaching local staff as
well. Plastic Surgery missions have been carried out in the past
by French and Swiss surgeons, but these missions ended ten years
ago; therefore, my first mission in January 2007 was particularly
appreciated by local colleagues. Since then, I have been there six
times, for two to three weeks on each mission, trying to enlist
the help of other “friends”, with the aim of ensuring further and
regular Plastic Surgery missions in the future.
Saint Jean de Dieu Hospital - The hospital has a capacity of 269
beds and serves a population of 100,000 inhabitants. It performs
more than 8,000 admissions a year with more than 3,000 surgical
operations. Patients come from the surrounding area, from the
capital Lomè, as well as from the rest of the country and abroad.
The surgical block is made up of four operating rooms which are
in acceptable condition, considering the poor economic situation
of the country and the hospitals, but it is very difficult to find
surgical instruments, drugs and medical equipment. A new
operating block has already been planned for the future and will
be constructed as soon as the funds are found.
Close to the units there is a social area, where mothers or sisters
live during the patients’ medical stay, washing, cooking and
resting together. The patients are informed of the humanitarian
missions of specialists by bill posting or relevant announcements
on the local radio, so that they can come to the Hospital for a first
medical examination and for surgical treatment, if required.
Patients - A common characteristic among all the patients requiring
medical assistance is that they have not sought medical assistance
at an early stage, so their symptoms have worsened, limiting the
possibility of immediate medical or surgical treatments. A focus
on their social and cultural life may explain the high incidence
36 IPRAS Journal www.ipras.org Issue 7
Plastic Surgery Mission in Togo,
Claudio Bernardi, MD (Italy)
of traumatic pathologies: the almost total absence of light in the
streets is responsible for several road accidents; children are often
left without any surveillance, running very close to fireplaces or
big pots of hot water, where there is a considerably high risk
of burns. Infections are never recognized in time but only at a
late stage, with striking symptoms (e.g. bowel perforation due to
typhus or flexed limbs for post-burn scar contracture, etc). After
a trauma, due to poor health education, they look for curers or
sorcerers rather than doctors and, after months or years, when
they decide to go to the hospital, it often takes days to reach it.
Plastic Surgery procedures – I have generally found four kinds
of pathologies in Plastic surgery: Keloids, scar contractures, lip
and palate clefts, wounds and loss of skin. During my 2-week
stay, I operate on about 40 patients, which means more than 50
plastic surgery procedures performed, as associated pathologies
are quite common in the same patient (i.e. post-burn contracture
affecting all the fingers or different parts of the body). In
addition, the clinical cases are always complex, thus: no simples
procedures are performed in Africa! Co-operation with the local
staff is good: I am frequently asked for consultation by other local
specialists or, when necessary, assistance in General Surgery. In
this sense, a broad surgical mind is helpful!
Humanitarian personal experience – After each mission, I return
to Italy with a great personal satisfaction that I rarely feel in my
daily work, although I really love it. Plastic Surgery missions are
of vital importance for patients in underdeveloped countries but,
at the same time, they are extremely useful experiences for the
surgeons too, even spiritually.
I still have in front of my eyes the image of the children after
cleft lip repair, smiling for their first time, and their mothers, too.
This is the best gift that a Plastic Surgeon may receive from his
work.
Claudio Bernardi, M.D.
Plastic Surgery, Rome, Italy
Via Ennio Quirino Visconti, 55
00193 – Rome - Italy
www.claudiobernardi.it

Third International Conference
on Regenerative Surgery
The Lazio Regional Agency for Organ and Tissue
Transplantation, in collaboration with the University of
Rome “Tor Vergata”, has organized the Third International
Conference on Regenerative Surgery, which took place on
14th - 16th December 2011, in Rome.
S.Coleman, G. Rigotti, D. Del Vecchio, M. Lafontan focused
their speeches on fat transplantation, while E. Anitua, I. Martin,
M. Marazzi, G. Stacy, G. Bauer, together with other researchers,
presented the edge of progress on laboratory work.
Plastic Surgeons, such as J. Planas, R. Mazzola, T. Tiryaki,
From the left: Dr. Dan Del Vecchio, USA (ISPRES Founding Member), Mr. Zacharias Kaplanidis, Greece (IPRAS Executive Director), Dr.
Gino Rigotti, Italy (ISPRES President), Prof. Marita Eisenmann-Klein (IPRAS President), Dr Sydney Coleman, USA (ISPRES General
Secretary), Dr. Theodore Voukidis, Greece (ISPRES Founding member)
The Conference President, Prof. Valerio Cervelli, Director
of the Plastic Surgery Department at the University of Rome
“Tor Vergata”, offered the participants a unique opportunity
to follow the lectures of some of the world’s most prominent
authorities in the field of Regenerative Surgery.
Not only Plastic Surgeons, but also the most active scientists
on the relative topics, biologists, ENT, orthopedics,
gynecologists, hematologists, dermatologists and trauma
surgeons, were present there, to announce and discuss their
latest achievements and experience, on the most promising
and upraising field of tissue regeneration, bioengineering
and nanotechnology.
The rich Faculty of more than 80 scientists and doctors have
thoroughly covered all the topics of the meeting.
Prof. Valerio Cervelli, Director of the Plastic Surgery Department at the
University of Rome “Tor Vergata” during the conference dinner of the
3rd International Conference on Regenerative Surgery
P. Gentile, V. Cervelli, F. Moschella, M. Klinger, K.
Schlaudraff, T. Voukidis shared their experience on everyday
surgical praxis, emphasizing Aesthetic Regeneration on new
critical areas.
Laboratory researchers, such as S. Pek, S. Akita, M. Dominici
and A. Orlandi gave their lectures on Bioengineering and
Nanotechnology and the new ways of pharmaceutical
administration through new regenerative technologies.
Practical issues on the application of the new medical
procedures, in Europe and worldwide, were raised and
answered by experts, according to the present status on
moral, ethical and of course legislative data.
The Conference, strongly supported by the Province of
Rome, the Lazio Region and the Italian Ministry of Health,
offered the opportunity to all the participants to enjoy the
famous excellent Italian hospitality together with typical
Roman entertainment.
The appointment has been renewed for December next year
and the organizers guarantee a scientific meeting of equally
high standards.
In the meantime, a more Plastic Surgery-orientated meeting
will be organized by the newly founded ISPRES (International
Society of Regenerative Surgery) on the 9th– 12th of March
in Rome, where all the new ideas and developments on
Regenerative Plastic Surgery will be presented and discussed
by an international faculty of experts.
Theodore Voukidis MD, PhD, FACS
ISPRES Founding member
Issue 7 www.ipras.org IPRAS Journal 37

Liposuction is one of the most popular aesthetic surgeries
performed worldwide, but its long-term impact on body
composition and on the metabolic profile remains unclear.
It has been speculated that the immediate decrease in body
fat may trigger feedback mechanisms of body-fat regain.
In several species, surgical fat removal is accompanied by
fat regain within a few weeks, mostly due to compensatory
fat growth in the intact depots. Recent data has confirmed
that women undergoing liposuction gain upper-body
fat within six months, which may be associated with
increased cardiovascular risk. Importantly, no study
of the long-term effects of liposuction has controlled
for the subjects’ physical activity levels which may be
considered an important confounder because exercise
per se is believed to improve body composition. Thus,
the purpose of this study was to investigate the effects
of small-volume abdominal liposuction on body fat
distribution in normal-weight women, who were either
exercise-trained or not after surgery. We hypothesized
that liposuction surgery would cause body-fat regain in
physically inactive subjects, whereas a supervised exercise
training program would counteract such detrimental
outcomes. A six-month randomized controlled trial was
conducted. Thirty-six women underwent a small-volume
abdominal liposuction (20 to 35 years old; BMI: 23,8 ±
2.2 Kg/m2). Two months after surgery, the subjects were
randomly allocated into one of the two groups (trained,
T, n=18; or non-trained, NT, n=18). Trained subjects
undertook a four-month exercise program. Non-trained
subjects remained physically inactive throughout the
study period. Prior to the intervention (PRE), immediately
before the beginning of the exercise program (i.e., two
months after surgery, or POST2) and at the end of the
study (POST6), food intake and body composition were
assessed. Energy expenditure, dynamic strength and
aerobic fitness were assessed at PRE and POST6. POST
6 assessments were performed 60 to 72 hours after the
last training session in the trained group. Subjects were
instructed to maintain their food intake pattern throughout
the study. Liposuction was effective in reducing body
38 IPRAS Journal www.ipras.org Issue 7
S U R V E Y S
Honoured with the award of “Ivo Pitanguy”
during the 48th Brazilian congress of plastic surgery
Liposuction induces a compensatory increase of visceral
fat which is effectively counteracted by physical activity
Author: Eduardo Montag a
Sub-authors: Fabiana Braga Benatti b ; Fábio Lopes Saito a ; Rolf
Gemperli a ; Antonio Herbert Lancha Junior b
a) Division of Plastic Surgery and Breast Surgery Group,
University of São Paulo School of Medicine
b) School of Physical Education and Sport –
University of Sao Paulo
weight, fat mass, and subcutaneous abdominal fat (SAT)
(PRE vs. POST2, p=0.0001). Despite the sustained SAT
decrease at POST6 (p=0.0001), body weight returned to
baseline values in both groups. The NT group showed
a significant 10% increase in visceral fat (p=0.04) and
decreased energy expenditure (p=0.01) when compared
with TR. TR showed an increased fat-free mass (p=0.03)
and improved physical capacity (p

Introduction
Degloving injuries of the lower limbs are frequently
characterized as severe injuries and there is difficulty in
deciding what the best surgical approach is1.
Purpose
The aim of this study was to develop a degloving
experimental model in rat hind limbs and to observe the
viability of the flap after its repositioning to the bed wound,
in order to study the changes related to this injury.
Method
Honoured with the award of “Evaldo D’Assumpção”
during the 48th Brazilian congress of plastic surgery
Development of experimental model of avulsion
of the flaps in the lower limbs of rats
Ninety male Wistar rats were divided into four
experimental groups (G1 = 22, G2 = 24, G3 = 22, G4 =
22). A degloving model was performed in the rats’ hind
limb based on four different pedicles as follows: G1 -
proximal flow, G2 – distal flow, G3 – lateral flow, and G4
– medial flow (Figures 1 and 2).
After the incision mark, the skin and subcutaneous tissue
were incised. Four Backhaus clamps were positioned
at the edge of the skin incision margin and progressive
contrary traction was applied, strong enough to produce
a degloved flap of the subcutaneous tissue and skin of the
hind limb, resulting in a partial avulsion flap. After five
minutes the flap was repositioned in its original situation
and the incision was closed with continuous skin suture
(nylon 5.0).
The rats were observed daily for signs of flap necrosis
for 7 days (Figure 3), after which they were sacrificed by
overdose of thiopental.
Measurements of the areas of necrosis in the flap, as well
as the total area of the flap, were performed after total
removal of the avulsed flap. The flap was
then laid on the operating table and photographed (Figure
4). Photographs were taken of each rat and analyzed using
ImageJ software2, which is suited for area calculation.
Total flap area (cm2), area of necrosis in the flap (cm2) and
the ratio between the necrotic and total areas (percentage)
were determined.
Statistical analysis was performed using Kruskal-Wallis
nonparametric test for independent samples among the
four groups. The Dunn test of multiple comparisons was
used to assess differences between matched group pairs.
Significance level was 95% (p < 0.05). The statistical
analysis was done with the software Prism 4b for
Macintosh, version 4.0 (Graphpad Software, Inc, USA).
Results
Authors:
Dimas André Milcheski, MD a
Hugo Alberto Nakamoto, MD a
Paulo Tuma Jr, MD a
Lucas Nóbrega, Medical Student b
Marcus Castro Ferreira, Professor and Chairman a
a) Division of Plastic Surgery, Faculty of Medicine,
University of São Paulo, São Paulo, Brazil
b) Faculty of Medicine,
University of São Paulo, São Paulo, Brazil
After exclusion of animals by flap autophagy and death,
17 rats remained in the G1 and G2 groups, 15 rats in the
G3 group and 16 rats in the G4 group. The total flap area
was 12.41 cm2 for the G1 group, 5.63 cm2 for the G2
group, 3.88 cm2 for the G3 group and 4.25 cm2 for the
Ratio between the necrotic area
and total area of the avulsed flap.
Issue 7 www.ipras.org IPRAS Journal 39

Degloving injury performed. Proximal flow flap
(A and B) and distal flow flap (C and D).
Degloving injury performed. Lateral flow flap (A and B)
and medial flow flap (C and D).
G4 group. The necrotic flap area (cm2) was 0.51 for the
G1 group, 3.64 for the G2 group, 0.39 for the G3 group
and 0.75 for the G4 group (p = 0.0001). The ratio between
the avulsed flap necrotic area and total area in the G1
group was 0.041 (4.1%), 0.39 (39%) in G2, 0.09 (9%)
in G3 and 0.08 (8%) in the G4 group. The comparison
between the means showed a statistically significant
difference among the four groups (p = 0.0001) (Graphic
Partial flap necrosis
on postoperative day 7.
40 IPRAS Journal www.ipras.org Issue 7
Flap removed and placed
on operative table.
1). The Dunn test showed significant differences between
pairs G1 and G2, G2 and G3, and G2 and G4 (p < 0.05).
There was no statistical difference between G1 and G3,
G1 and G4 and G3 and G4 groups (p > 0.05).
Discussion
The simple repositioning of the avulsed flap in clinical
practice often results in partial or total necrosis of
tissue repositioned3. Thus, it is useful to develop an
experimental avulsion flap model so that it is possible
to test therapeutic modalities, in order to improve the
outcome of the repositioned flap.
We could find three avulsion flap models4,5,6. None of
these models were performed in the lower limbs. It was
considered important to develop a hind limb degloving
model in rats, closer to that observed in clinical practice
in trauma centers, because the lower limb is the area most
often affected in this type of injury.
In addition, by using four different flap orientations, it was
observed that the distal flow flaps were the most affected,
having the poorest prognosis. The avulsion model with
distal flow (G2) represents a more severe injury, compared
to other flap orientations (proximal, medial or lateral flows).
It presents a greater degree of ischemia and congestion,
resulting in a more extensive necrotic area.
Thus, we suggest the use of the distal flowgroupmodel(G2)
to test drugs with potential improvement of flap viability,
since this reverse flow flap allows easier observation of the
drug effects in decreasing the necrotic flap area.
Conclusion
The distal flow group (G2) had a larger area of necrosis
in relation to the total flap area and is considered the most
suitable for testing therapeutic agents in avulsed flaps.
References.
1. Mandel M. The Management of Lower Extremity
Degloving Injuries. Ann Plast Surg. 1981; 6 (1): 1-5.
2. Image J 1.42q for Macintosh. Versão 10.2. Wayne
Resband National Institutes of Health, USA. Available
at: http://rsbweb.nih.gov/ij/download.html.
3. Milcheski DA, Ferreira MC, Nakamorto HA, Tuma
Jr P, Gemperli R. Tratamento cirúrgico de ferimentos
descolantes nos membros inferiores – proposta de
protocolo de atendimento. Rev Col Bras Cir. 2010;
37(3): 195-203.
4. Oztuna V, Eskandari MM, Unal S, et al. The effect of
pentoxifylline in treatment of skin degloving injuries:
an experimental study. Injury 2006;37:638-641.
5. Kurata T, O’Brien BM, Black MJ. Microvascular
surgery in degloving injuries: an experimental study.
Br J Plast Surg 1978;31:117-120.
6. Wang ZT, Guo SZ, Xiu ZF, et al. A new model of
skin avulsion injuries in rats. Chin J Plast Surg
2008;24:212-215.

Syndactyly Correction by “Duoderm-plasty”:
An Original Model for Mastering Plastic Surgery
Summary
А novel technique is presented for mastering skills in
Plastic Surgery, using only improvised means, particularly
the self-adhesive Duoderm ® CGF ® , which is very similar
to the human skin. An example of its application for
syndactyly correction by trilobed flap is shown. The
so-called Duoderm-plasty is an easy and cost-effective
method, which allows mastering and perfection of
different Plastic Surgery ‘tricks’, planning a scheduled
surgery and can also serve as a measure for such skills of
the medical students and residents.
Keywords
Residency training; Surgery planning; Z-plasty;
Syndactyly
Introduction
Training in the specialty of Plastic Surgery deals with the
resection, repair, replacement and reconstruction of defects
of form and function of the integument and its underlying
anatomic structures. It is a long-lasting and laborious
process, requiring not merely an excellent, advanced
knowledge of medical science, but also a well-developed
spatial reasoning and ‘sleight of hand’. The latter can be
improved using different contemporary technologies and
equipment offered by many companies.
Prior to the 1950’s, the operating room (OR) represented
the only place to visualize surgery outside the classroom.
The introduction of film allowed residents to build and
integrate verbal and pictorial representations of disease.
Movies became particularly useful in surgical learning to
help describe anatomic relationships and procedures. In
the 1980’s computers became an additional tool, with the
potential to model the complexity of real tissues and to
G.V. Yaghjyan, D.O. Abrahamyan
Plastic Reconstructive Surgery and Microsurgery Centre, University Hospital № 1.
58 Abovyan street, Yerevan, 375025, Republic of Armenia
e-mail: plastam@yahoo.com
gain insight into surgical outcomes through simulation. 1
It is known that learners retain 10 to 15% of what is read,
10-20% of what they hear, and 20-30% of what they see,
but when audiovisual materials are integrated, knowledge
retention increases to 40-50%. 2
Therefore, simple inanimate models have been developed
for practice of basic surgical skills. Synthetic skin
suturing models and computer simulations of surgery are
emerging as a prime education tool at several surgical
skills centres in the West. 5,6
Despite all these advances, the system of surgical skills
teaching in Armenia, as well as in many other developing
countries still remains on the 1980’s level because the
abovementioned training systems are too expensive.
Maintenance of well-equipped dissecting rooms and
biomedical laboratories is impossible in the present
economic status. Residents can hone their skills only
at the OR, which is not so simple, because each expert
surgeons seek to achieve the best results and he/she will
rarely agree to ‘rely’ on a novice’s skills. On the other
hand, patients or patients’ relatives always want to be
operated by the best, famous expert surgeons. Another
problem is that trainees often ‘wait’ for a specific case for
a long time: there are many residents and trainees, more
than the specific cases.
All this forced the authors to propose a model, which
would facilitate and improve the skill acquisition process,
at least to some extent, in one of the basic sections of
Plastic Surgery – integument (cutaneous) surgery.
Model description
The proposed model is based on the use of self-adhesive
hydrocolloid dressings (Duoderm ® CGF ® ) as human-skinsubstitutes.
That is why we called this method ‘Duodermplasty’.
The unique elastic properties of Duoderm ® CGF ®
Issue 7 www.ipras.org IPRAS Journal 41

Duoderm ® CGF ® and Hand model
Duoderm ® CGF ® pasted on the middle and ring fingers to achieve syndactyly. (A) Dorsal view. (B) Palmar view.
42 IPRAS Journal www.ipras.org Issue 7
Flap markings. (A) Dorsal view. (B) Palmar view.
are very similar to those of human skin, allowing one to
perform incisions, dissections and suturing on it. Since
2003 we have used Duoderm-plasty to illustrate and
explain to medical students and residents the different
techniques of plastic skin-surgery (Z-plasty, V-Y-plasty,
syndactyly correction etc.), in order for the residents and
trainees to master their skills.
A ‘case’ of Duoderm-plasty for correction of ‘syndactyly’
is presented below (Fig. 1-5). Syndactyly is obtained by
pasting the Duoderm ® CGF ® on the 3 rd and 4 th fingers
of the hand model (Internal Hand Structure Model,
American 3B Scientific, Tucker, GA, USA) (Fig. 2). Flap
markings are done as per description of the Niranjan and
De Carpentier trilobed-flap technique 6
According to Niranjan and our experience with patients
(Figures 6-7), skin grafting is not required in all cases

Prepared trilobed and triangular flaps. (A) Dorsal view. (B) Palmar view.
Flap markings on patient
Flaps ‘sutured’ (pasted) in place. (A) Dorsal view. (B) Palmar view.
Preparation of trilobed and triangular flaps on patient
Issue 7 www.ipras.org IPRAS Journal 43

where the trilobed flap 6 is used. Therefore, if any uncovered
‘defect’ remains after the performed Duoderm-plasty, it
means that there has been an omission in the technique
of flap harvesting and one should repeat the Duodermplasty
until the ideal result is obtained.
Discussion
Research shows that motor skill acquisition occurs in
three phases. 7 Ideally, only the last phase of learning
should be performed on actual patients. In the first phase
of motor-skill acquisition, or ‘cognitive phase’, the learner
gains an understanding of the task through explanation
and demonstrations. Cognitive science studies show
that the power of a teaching tool is directly related to
the level of interactivity and the method of information
delivery. 8 The second phase of motor-skill learning is the
‘associative phase’, where the learner practices the task
and eliminates error from the performance. This phase
could utilize the suggested ‘Duoderm-plasty’ model that
places the learner in a lifelike situation providing almost
real-time feedback on decisions, actions and questions.
Our choice focused on Duoderm ® CGF ® as this was the
only dressing available at our Centre at that time. In other
words, any self-adhesive hydrocolloid dressing similar to
Duoderm ® CGF ® can be used for Duoderm-plasty.
The benefits of this model are different for novices and
experts. Residents in training can avoid causing iatrogenic
complications in real patients, while still being exposed to
a wide range of scenarios and complications posed by the
expert surgeon. It helps to develop the manual dexterity
of the future Plastic Surgeon. Repetition and learner
feedback, neither of which are easily accomplished in the
OR, improve skill acquisition. Wanzel and Matsumoto
found improved execution of Z-plasty skin closure by
residents in response to immediate faculty feedback. 5
Scott and Young showed it took an average of 32
repetitions to reach the 90 th percentile in performance. 4
Thus, Duoderm-plasty can serve as a measure for skills
of the residents.
For expert surgeons, Duoderm-plasty can be used to
maintain proficiency during times of absence from the
operating room, an academic sabbatical or family leave. It
is also very useful for planning the scheduled operations,
44 IPRAS Journal www.ipras.org Issue 7
as well as to show and explain to the patient and his/her
relatives the plan of the surgery to be performed.
Thus, the so-called Duoderm-plasty is an easy and costeffective
method allowing the mastering and perfection
of different Plastic Surgery skills and the planning of a
scheduled surgery and can also serve as a measure for
such skills of the trainees.
References
1. Kawabata H, Kawai H, Masada K, Ono K. Computeraided
analysis of Z-plasties. Plast Reconstr Surg
1989;83:319–325.
2. Mehrabi A, Gluckstein C, Benner A, Hashemi B,
Herfarth C, Kallinowski F. A new way for surgical
education--development and evaluation of a
computer-based training module. Comput Biol Med
2000;30:97–109.
3. Dunnington GL, DaRosa DA. Changing surgical
education strategies in an environment of changing
health care delivery systems. World J Surg
1994;18:734–737; discussion 733.
4. Scott DJ, Young WN, Tesfay ST, Frawley WH, Rege
RV, Jones DB. Laparoscopic skills training. Am J
Surg 2001;182:137–142.
5. Wanzel KR, Matsumoto ED, Hamstra SJ, Anastakis
DJ. Teaching technical skills: training on a simple,
inexpensive, and portable model. Plast Reconstr
Surg 2002;109:258–263.
6. Niranjan NS, Azad SM, Fleming AN, Liew SH.
Long-term results of primary syndactyly correction
by the trilobed flap technique. Br J Plast Surg
2005;58:14–21.
7. Rogers DA, Elstein AS, Bordage G. Improving
continuing medical education for surgical techniques:
applying the lessons learned in the first decade of
minimal access surgery. Ann Surg 2001;233:159–166.
8. Edmond CV, Jr, Wiet GJ, Bolger B. Virtual
environments. Surgical simulation in otolaryngology.
Otolaryngol Clin North Am 1998;31:369–381.

iPhone and iPad applications
for plastic surgeons
Issue 7 www.ipras.org IPRAS Journal 45

46 IPRAS Journal www.ipras.org Issue 7

By kind permission of JPRAS
Issue 7 www.ipras.org IPRAS Journal 47

The Plastic Surgery Hyperguide ® is a free interactive
continuing medical education (CME) Web site for plastic
surgery professionals. It is available at any time from
any computer with an Internet connection. This site was
established in 2006 and is sponsored by Vindico Medical
Education, an ACCME level 3 accredited provider of
AMA PRACategory 1 Credit(s)TM .
The Plastic Surgery Hyperguide® is overseen by Chief
Medical Editor Seth Thaller MD, DMD, Professor and
Chief of Plastic Surgery at the University of Miami,
Florida, and Associate Chief Medical Editor Mimis Cohen,
MD, FACS, FAAP, Professor and Chief of Plastic Surgery
at the University of Illinois at Chicago. Assisted by an
Editorial Board of experts from across the plastic surgery
specialty, we ensure that the Plastic Surgery Hyperguide ®
contains the most recent educational material that will
benefit the practice of any plastic surgeon. The site is
constantly updated and expanded to ensure that the most
recent information is available, allowing users to target
the information that is most relevant to their practice.
The Plastic SurgeryHyperguide ® currently contains
educational material in the following modules: Aesthetic
Surgery, Bariatric Surgery, Breast, Congenital; Cleft/
48 IPRAS Journal www.ipras.org Issue 7
Plastic Surgery Hyperguide:
An Interactive Continuing
Medical Education Web Site
Dr. Mimis Cohen
MD, FACS, FAAP
Associate Chief Medical Editor
of the Plastic Surgery Hyperguide ®
Professor and Chief
Division of Plastic, Reconstructive and
Cosmetic Surgery
And Director Craniofacial Center
University of Illinois Medical Center
Chicago, Illinois
Dr. Seth Thaller
MD, DMD, FACS
Chief Medical Editor
of the Plastic Surgery Hyperguide ®
Chief and Professor
Division of Plastic Surgery
The DeWitt Daughtry Family
Department of Surgery
University Of Miami Health System
Miami, Florida
Craniofacial, Craniofacial Trauma, Head and Neck
Tumors, Patient Safety. Each module contains peerreviewed
educational content focusing on cutting-edge
treatments, novel surgical techniques, and clinical reviews.
All content submitted for publication goes through a
rigorous editorial and review process, which includes a
peer-reviewed step where the content is reviewed by 1-2
plastic surgery physicians.
To register, one just needs to go to: www.plasticsurgery.
hyperguides.com, select the Login button and follow the
instructions. Once registered and logged in, you will have
access to hundreds of articles, lectures and video’s to help
keep you updated in the field of plastic surgery. Much of
the content on the site is available for CME credit; you will
just need to complete a pretest, posttest and evaluation in
order to receive your credit. All credit earned on the site
will be stored in your “MyCME” section so that you can
always go back and print out the certificates when you
need to submit them for you maintenance of certification
or maintenance of licensure.
We hope that members of IPRAS will take advantage
of this opportunity and register to the Plastic surgery
Hyperguide ® .

Issue 7 www.ipras.org IPRAS Journal 49

NATIONAL ASSOCIATIONS’ & PLASTIC SURGERY ORGANIZATIONS’ NEWS
Plastic surgeons are perfectionists by nature. As such, it
makes sense that complications associated with cosmetic
and reconstructive surgical procedures performed by
board-certified plastic surgeons are rare; it’s also why,
when something does go wrong, it can be devastating for
both physician and patient.
While no plastic surgeon expects a complication to
surface in his or her O.R., no procedure is 100 percent
safe – and the best surgeons need to be prepared to deal
with problems as they arise.
A new symposium developed by ASPS members Maurice
Nahabedian, MD, Washington, D.C., and J. Peter Rubin,
MD, Pittsburgh, takes a bold approach toward a subject
few want to discuss by shining a light on plastic surgical
complications. Challenging Complications in Plastic
Surgery: Successful Management Strategies, slated for
July 13-14 in Washington, D.C., is designed to foster a
frank discussion of what goes wrong in common plastic
surgery procedures and challenge surgeons to re-think
their various approaches on issues ranging from where to
place a scar to how they communicate with patients. The
symposium is supported by an educational grant from
Synovis Surgical Innovations.
“Complications are underemphasized in most meetings
where the focus is primarily on how to do a specific
procedure,” says Dr. Nahabedian. “This meeting will
focus on providing useful information to help the average
surgeon in the day-to-day management of complications
with an emphasis on breast and body contouring – two
areas in which the number of operations is increasing
every year.”
Specific solutions
More than anything, Challenging Complications in
Plastic Surgery intends to dive deep into specific,
algorithmic approaches to correcting unfavorable
50 IPRAS Journal www.ipras.org Issue 7
New symposium aims to confront
complications, offer concrete fixes
scars and managing complications in the areas breast
augmentation, breast reconstruction, body contouring
procedures and abdominoplasty. A wide range of panels
and case discussions will cover subjects such as “tips
and traps” in the management of capsular contracture,
flap salvage and alternative approaches when a flap dies,
cardinal rules for liposuction safety and revision surgery
for recurrent laxity after body contouring.
“This meeting will be far more concrete than theoretical,”
adds Dr. Rubin. “Attendees will receive information
that can be implemented overnight and used to make
an immediate impact on their practices by managing
techniques and communication.”
The meeting will also feature a module dedicated to
abdominoplasty complications, the area of plastic
surgery in which problems are statistically most likely
to occur. Course topics include “The Seven Deadly
Sins of Abdominoplasty,” managing and avoiding
wound breakdown and infectious complications, and
a comprehensive approach to diagnosing and treating
abdominoplasty complications.
A complicated faculty
By Mike Stokes,
Plastic Surgery News
The esteemed faculty members assembled for Challenging
Complications in Plastic Surgery are renowned for their
exemplary surgical techniques, but this meeting will call
on them to share what has gone wrong with their patients
and subject their own problematic cases to analysis and
debate.
“The faculty is an outstanding group of thought leaders
who can provide up-to-date and useful algorithms in
managing complications,” says Dr. Nahabedian. “They
were hand-picked for their experience, integrity and
standing in the specialty – these are people who aren’t
afraid to air their dirty laundry and know how to treat
complications.”

Attendees are also encouraged to submit questions and
their own challenging cases as part of what organizers
expect to be a truly interactive dialogue between the
faculty and those in attendance.
For many ASPS members, an increasingly common source
of surgical complications is the population of patients
seeking corrective surgery for operations performed by
someone else. Amid the current climate of “white coat
deception” – where practitioners without core training
in plastic surgery are dabbling in cosmetic procedures
– organizers hope the symposium will also give ASPS
members greater confidence in dealing with the surgical
mistakes of others by bringing these complications into
the open where surgeons can discuss how to correct them
if – and when – they occur.
A cut above
The symposium will also cover the fundamentals of
evidence-based medicine and its potential impact on
health quality and pay-for-performance metrics amid a
changing regulatory landscape.
July 2012
The meeting will also feature medico-legal tips to
“bulletproof” your informed-consent process and the “do’s
and don’ts” of going on the record when a complication
occurs. A keynote lecture on VTE prophylaxis as well as
panels that explore outcomes measurement in breast and
body procedures, establishing your own quality measures
in your practice and techniques for benchmarking
complications will also be included in the symposium.
Additional meetings offered by ASPS include:
• From Residency To Tenure: A Road Map For Success
for the Academic Surgeon , June 16-17, 2012, Ann
Arbor, Michigan
• Breast & Body Symposium: August 22-25, 2012/
Downtown Santa Fe, New Mexico
• Annual meeting: Plastic Surgery THE Meeting:
October 26-30, 2012/New Orleans, Louisiana
For information on how to register for any of these
conferences, visit www.plasticsurgery.org/meetings,
email registration@plasticsurgery.org or call 847-228-
9900, ext. 471.
CHALLENGING COMPLICATIONS IN PLASTIC SURGERY SYMPOSIUM:
SUCCESSFUL MANAGEMENT STRATEGIES
Dates: 7/13/2012 - 7/14/2012
Meeting Location: Grand Hyatt Washington, Washington DC
Contact: American Society of Plastic Surgeons
444 E. Algonquin Road Arlington Heights, IL 60005
P: 847-228-9900 F: 847-228-9131
Sponsored by: ASPS
Issue 7 www.ipras.org IPRAS Journal 51

48th Brazilian Congress of Plastic Surgery
It took place at the Brazilian
“Planalto Central”...
It was a sunny begining of the southern hemisphere
summer, between November 10th and 15th, when the
48th edition of the Brazilian Congress of Plastic Surgery
took place in Goiania, Brazil. The host city, Goiania,
boasts to be the heart of the huge brazilian agricultural
infrastructure, the birthplace of important traditions that,
even to this day, markedly permeates the brazilian culture
with flavors, colors, accents, trends and fados. Hospitality
was a the most abundant comodity!
With 2146 registered participants this year, the Brazilian
Congress has secured its place between the most acclaimed
52 IPRAS Journal www.ipras.org Issue 7
Goiania, Brazil, November 10-15, 2011
Brazilian Society
of Plastic Surgery
(SBCP)
Plastic Surgery Continued Education events on the planet.
The Brazilian Society of Plastic Surgery, founded in
1948, has topped the 5000-member mark, and currently
certifies 81 plastic surgery training facilities throughout
the nation. Today, with many different departments to
fullfil its needs, simultaneous translation to English in
all the presentation rooms and an ever growing number
of foreign registered participants, its main goal is to go
global.
Evidence-based Medicine has played a key role in the
selection of the topics and new, different presentation
formats were introduced with a variable degree of
overall satisfaction. This certainly reflects a worldwide
trend towards boosting the credibilty of our Specialty,
saves money and assures that our patients will have
good Medicine at their disposal. The Brazilian Scientific
Opening ceremony of the 48th Brazilian Congress of Plastic Surgery. Next to Prof. Marita Eisenmann-Klein (IPRAS
President) on the left Prof. Sebastiao Nelson Edy Guerra, Brazil (Former President of the Brazilian Society of Plastic Surgery),
and on the right, Prof. Ivo Pitanguy (IPRAS Trustee)

During the opening ceremony of the 48th Brazilian Congress
of Plastic Surgery. Prof. Ricardo Baroudi (IPRAS Trustee),
Prof. Marita Eisenmann-Klein (IPRAS President)
Commitee, composed by seven members and chaired
by Dr. Osvaldo Saldanha, is actively involved with
Continued Education and has worked hard to innovate,
stimulate, access and control the processes involved in
this large Plastic Surgery gathering. This was the result
of a complex series of brainstorming and benchmarking
from previous editions, along with the knowledge
acquired from other national Plastic Surgery Societies.
This Congress also marked, during the opening
ceremony, the triumphant come-back of IPRAS as an
active world confederation and major player. Dr. Marita
Eisenmann-Klein, IPRAS President, alongside Goianiaborn
Dr. Nelson Piccolo, IPRAS Secretary General, on
behalf of our World Confederation, together with Dr.
Sebastião Nelson Guerra, President of the Brazilian
Society of Plastic Surgery, honored colleagues like Dr.
Ivo Pitanguy and Dr. Ricardo Baroudi for their body of
work throughout their lives as Plastic Surgeons. Former
Presidents of the Brazilian Society of Plastic Surgery
were also honored during that ceremony. The IPRAS
coming back to the scene has everything to do with a
display of good management principles and orthodoxy.
IPRAS has recently pursued its goals by means of what
seems to be a mix of pragmatism and a globally oriented
vision, focused on inclusion.
For the years to come, the project of the Brazilian Society
is to upgrade its ties with other national Plastic Surgery
Societies in order to be able to share the expertise in
Aesthetic Plastic Surgery and other related topics that we
have acquired through the years, with colleagues from
Prof. Sebastiao Nelson Edy Guerra, Brazil (Former President of the
Brazilian Society of Plastic Surgery) with Ms. Maria Petsa, Greece
(IPRAS Assistant Executive Director) at the IPRAS Booth.
distant corners of the world. We all, who compose the
body of the Brazilian Society of Plastic Surgery, await
our colleagues from different countries, to visit us in the
Brazilian Plastic Surgery booth, which is set to be present
at major Plastic Surgery Congress venues, during the
year of 2012.
For the colleagues who came to Goiania this year, thank
you once again for your invaluable presence and for those
who couldn’t make this year, our hearts and minds will
allways be open to receive you in future meetings.
“Planalto Central” stands for “Central Highlands” in
Portuguese.
Love from Brazil!
Pericles Serafim Filho
Brazilian Society of Plastic Surgery,
Scientific Committee Member
IPRAS, EXCO Member
IPRAS, Scientific Committee Member
Issue 7 www.ipras.org IPRAS Journal 53

1st International Meeting of the Cyprus Society
of Plastic Reconstructive and Aesthetic Surgery
Dear Colleagues,
It gives me great pleasure to report back on the success
of the 1st International Meeting of the Cyprus Society of
Plastic Reconstructive and Aesthetic Surgery, which took
place under the auspices of IPRAS on the 14th and 15th
October 2011, in Limassol. This is the first time such a
From the left: Dr. Dana Jianu, Romania, Dr. Katharina Russe-
Wilflingseder, Austria, Dr. Marco Klinger, Italy, Prof. Marita
Eisenmann-Klein, Germany (IPRAS President), Prof. Andreas
Yiacoumettis, Greece (IPRAS Deputy General Secretary), Dr. Roger
Khouri, USA (ISPRES Vice President), Dr. Theodoros Voukidis,
Greece ( ISPRES Founding member), Dr. Hatem May, Lebanon
Among others: Dr. Kenan Arifoglu, Cyprus, Dr. Andreas
Foustanos, Greece (Former President of HESPRAS), Dr. Lefteris
Dimitriou, Cyprus, Dr. Georgia Koulermou, Greece, Dr. Michail
Stampos, Greece, Dr. Zavrides Harris, Cyprus, Dr. Anastasios
Tsekouras, Greece, Prof. Andreas Yiacoumettis, Greece (IPRAS
Deputy General Secretary), Prof. Marita Eisenmann-Klein,
Germany (IPRAS President), Dr. Marco Klinger, Italy, Dr.
Katharina Russe-Wilflingseder, Austria, Dr. Christos Merezas,
Cyprus (President of the Symposium), Dr. Giorgos Psaras,
Cyprus (President of the scientific committee of the symposium),
Dr. Dana Jianu, Romania, Dr. Sofoclis Nicolaides, Cyprus
54 IPRAS Journal www.ipras.org Issue 7
meeting has been hosted in Cyprus, and we hope that this
will be the start of a fruitful and productive cooperation
between our society and IPRAS.
Close to 45 delegates participated in the Conference, with
a large number of international attendees and over these
2 days, a variety of extremely interesting topics were
presented by our invited speakers, as well as by local
Plastic Surgeons. Of great interest were the talks pertaining
to the exciting field of stem cell research and fat grafting,
as related to all aspects of Reconstructive Surgery.
Such meetings are of great importance to our Society
and its members, not only because they provide us with
a unique chance to present our work to the wider medical
community, but more importantly because we have the
opportunity to expand our knowledge, interact with experts
and discuss clinical issues within an appropriate setting.
From the left: Dr. Christos Merezas, Cyprus (President of
the Symposium), Dr. Kenan Arifoglu, Cyprus, Prof. Marita
Eisenmann-Klein, Germany (IPRAS President), Prof. Andreas
Yiacoumettis, Greece (IPRAS Deputy General Secretary), Dr.
Borman Huseyin, Turkey
The breadth and variation of Plastic Surgery makes it the
central link between many other medical disciplines and
it is our duty to ensure that we maintain this diversity and
educate our colleagues correctly. Aesthetic Surgery forms
a small part of our profession, and it is therefore essential
that, as Plastic Surgeons, we protect this multifaceted
specialty and expand our autonomy. Through such
meetings we are able to stay up to date with ever changing
practices, share our experiences and join forces on how
we can improve patient care.
Christos Merezas,
President of the Cyprus Society for PRAS

The First Chinese-European Congress of Plastic,
Reconstructive and Aesthetic Surgery
Beijing, China, October 27-29, 2011
The first Chinese-European Congress of Plastic,
Reconstructive and Aesthetic Surgery was held in Beijing
from 27 to 29, October, 2011. It was the first Congress that
co-organized by the Chinese Society of Plastic Surgeons
(CSPS), The European Society of Plastic, Reconstructive
and Aesthetic Surgery (ESPRAS) and the International
Confederation for Plastic, Reconstructive and Aesthetic
Surgery (IPRAS). In addition, it was supported by the
cooperation between Prof. Andreas Yiacoumettis in Greece
and Prof. Zunli Shen in China, a comprehensive program
was made with a wide coverage of many important
fields. These were complications in plastic surgery,
breast reconstruction, anti-aging, liposuction, tissue
engineering, breast augmentation, ear reconstruction, facial
aesthetic surgery, stem cells, genitalia, torso, extremity
reconstruction, rhinoplasty, facial rejuvenation, hand, laser,
Opening Ceremony of the 1st Chinese European Congress of Plastic, Reconstructive and Aesthetic Surgery
American Society of Plastic Surgery, the Brazilian Society
of Plastic Surgery, the European Society of Preventive,
Regenerative and Anti-Aging Medicine (ESAAM), as well
as the International Society of Aesthetic Plastic Surgery
(ISAPS).
It was a big international congress which attended by
approximately 300 plastic surgeons outside of China with
48 accompanying persons, while the international faculty
number was consisted of approximately 100 prominent
plastic surgeons. 146 Chinese plastic surgeons attended
the congress, in which 20 Chinese plastic surgeons held
keynote speeches. 57 international and Chinese companies
had exhibitions and provided financial support for the
congress. The Plastic Surgery Hospital, affiliated to
Peking Union Medical College and Chinese Academy of
Medidical Sciences, offered a substantial support for the
congress with translations and entertainment programs
during the opening ceremony.
Due to scientific committees’ hard work, especially close
From the left: Dr. Pericles Serafim Filho, Brazil (member of the
Scientific Advisory Board of IPRAS), Prof. Marita Eisenmann-Klein,
Germany (IPRAS President), Dr. Albert de Mey, Belgium (member
of the Scientific Advisory Board of IPRAS), Prof. Yilin Cao, China
(President of CSPS, IPRAS deputy General Secretary), Dr. Sukwha
Kim, Korea (IPRAS representative of Asian-Pacific region).
Issue 7 www.ipras.org IPRAS Journal 55

Faculty Dinner of 1st Chinese European Congress of Plastic,
Reconstructive and Aesthetic Surgery
scars, maxillofacial, craniofacial, burns, eyelids and orbit,
oncology and reconstruction, experiment, fat and so on.
The master classes, keynote lectures and oral presentations
were well selected with high academic standard.
There were also some round tables such as ESPRAS/
SHARE round table (Humanitarian), Laser round table,
Brazilian round table (facial aesthetic surgery in Brazil),
ESAAM round table and ASPS round table. These
round tables provided a nice chance for Chinese plastic
surgeons understood more deeply about the related
international societies.
During the congress, Marita Eisenmann-Klein, President
of IPRAS and Yilin Cao, President of CSPS, Zuoliang
Qi, President-elect of CSPS, signed a Memorandum of
Understanding. This indicated that CSPS would have full
support of IPRAS on establishing a Chinese Society of
Preventive, Regenerative and Anti-Aging Medicine as a
chapter of the CSPS.
Prof. Zuoliang Qi, President-elect of CSPS, Prof. Marita Eisenmann-
Klein, IPRAS President and Prof. Yilin Cao, President of CSPS,
signing a Memorandum of Understanding, establishing a Chinese
Society of Preventive, Regenerative and Anti-Aging Medicine as a
chapter of the CSPS
56 IPRAS Journal www.ipras.org Issue 7
Anti Aging meeting during the 1st Chinese-European Congress
of Plastic, Reconstructive and Aesthetic Surgery for establishing
a Chinese Society of Preventive, Regenerative and Anti-Aging
Medicine as a chapter of the CSPS. First line from the right: Mrs.
Katherine Lee Tai, USA, Prof. Yilin Cao, China (President of
CSPS, IPRAS Deputy General Secretary), Prof. Marita Eisenmann-
Klein, Germany (IPRAS President), Prof. Chistos C. Zouboulis,
Germany (ESAAM President), Prof. Zuoliang Qi, China, Presidentelect
of CSPS. Second line from the right: Mr. TT Durai, India, Dr.
Michael Klentze, Germany, Dr. Paul Ling Tai, USA, Mr. Zacharias
Kaplanidis (IPRAS Executive Director), Prof. Zunli Shen, China
(EXCO member in China)
Opening Ceremony of the 1st Chinese European Congress of Plastic,
Reconstructive and Aesthetic Surgery
It was also the first time for Zita congress S.A. to organize
a Chinese European Congress in China with the help
by Shanghai Hongbo company (China). After mutual
understanding and close cooperation, we believe that the
world congress of IPRAS will be held successfully in
Shanghai in 2015.
In a word, IPRAS and other international societies
became well-known in China after this great congress.
And the international societies also learned more about
Chinese plastic surgeons and the CSPS. The congress has
strengthened our cooperation and friendship.
More information available at www.China-europe2011.com
Prof. Yilin Cao
President of CSPS
Co-President of the Congress
Prof. Zunli Shen
EXCO member in China

The First Dutch “National Day
for Plastic and Reconstructive Surgery”
successfully showed the importance and wide scope
of Plastic Surgery to the general public.
On the 25th of November, the Dutch Society for Plastic and Reconstructive Surgery (NVPC,
www.nvpc.nl) organized the National Day for Plastic and Reconstructive Surgery.
As in many other countries, Dutch Plastic Surgeons struggle with an image of being solely
cosmetic surgeons. Therefore, the goal of that day was to show the wide scope of our
profession to the public. Special focus was set on subjects other than cosmetic surgery, such
as Hand Surgery, Craniofacial and Reconstructive Surgery, illustrating and underscoring
the significance of our field in modern society and the medical institutions.
The Netherlands has 17 million inhabitants and approximately 300 Plastic Surgeons. We
invited all Plastic Surgery units to participate. Approximately 70% of all clinics did so. The
Society supported the units by providing a central website and electronic documents to be
used as banners on websites. Press release formats, to be adjusted to specific needs, were
also distributed in a ‘tool kit’. Local and national media were used, as well as social media,
such as twitter (@nedverplastchir) and Facebook, to spread the word. The day was open
for the general public, as well as anyone interested, such as students and local hospital staff
and nurses.
Programs included lectures and live surgery through in-house TV channels or local stations.
Other units organized tours through the various rooms, as well as the quite popular suturing
courses on bicycle tires or bananas.
The result of the day was measured in many ways. First, the number of visitors varied
between 40 and 200 per unit, adding up to approximately 1000 persons in total. Second, the
number of articles and interviews in the national and local media and in the social media
(twitter/facebook) was quite significant.
In conclusion; the day was a tremendous success for the Plastic and Reconstructive Surgery
Society, the local organizers and our field. Next year 100% of the participants of this
edition will join, as well as a number of units that did not choose to participate this year.
In addition, the number of positive news articles put our specialty in an especially positive
and respectful perspective, which can only be of help for the future of our Plastic and
Reconstructive Surgery.
Hinne Rakhorst MD, PhD.
General Secretary Dutch Society of Plastic
and Reconstructive Surgery (NVPC)
www.nvpc.nl
twitter: @nedverplastchir

58 IPRAS Journal www.ipras.org Issue 7
23rd Annual EURAPS Meeting,
Munich, Germany, May 24-26, 2012
Dear colleagues and friends,
Having been appointed as the EURAPS local host, it is my
pleasure and privilege to welcome you to the 23rd Annual
EURAPS Meeting, which will be held on May 24th – 26th,
2012 in Munich, Germany. A cosmopolitan and hospitable
city with excellent infrastructure, Munich offers its guests
a unique atmosphere. Munich’s world-class transportation
system allows visitors to easily reach the city by train, plane
or car. In 2010, Monocle ranked Munich as the world’s most
liveable city.
The meeting venue, The Bayerischer Hof, is a leading
world-class luxury hotel, ideally situated in the old town
district of Munich, in direct proximity to the most important
sights and shopping opportunities. The hotel maintains
traditional Bavarian values (http://www.bayerischerhof.
de). In addition, participants will be able to indulge in a
special “Oktoberfest atmosphere” at the bavarian evening.
Furthermore, a magnificent gala dinner at the BMW Welt
will be one of the social highlights of the meeting.
EURAPS Meetings offer a great opportunity for all of us to
update our knowledge, meet with both old and new friends
and colleagues and to enjoy each other’s company. This is
the best occasion to prepare the ground for fruitful scientific
co-operation in the field of Plastic Surgery.
The Scientific Program will focus on new developments in
Plastic, Reconstructive and Aesthetic surgery, especially in
the multidisciplinary setting of Regenerative Medicine. In
particular, the Program will concentrate on approaches from
diagnosis to state-of-the-art, less invasive treatments. This
Meeting will offer new insights, which will be a platform for
scientific exchange and discussion.
For the first time, all participants will have the opportunity to
attend the best research paper of EURAPS Research Council
Meeting on Thursday afternoon (May 24th, 2011) instead of
the Refresher Course. This will be the last session of the
EURAPS Research Council Meeting that will take place in
Munich from May 23rd – 24th, 2012. With this idea from
the new General Secretary of EURAPS Manfred Frey, we
would like to emphasize the importance of research work
and give the younger generation an opportunity to attend the
EURAPS Meeting.
Apart from the exciting scientific schedule, you will
certainly have the opportunity to sample Munich’s artistic
and cultural richness. This includes splendid and exciting
concerts, impressive exhibitions, culinary delights, sporting
events and excellent shopping. There is more to Munich
than meets the eye!
For further information on the 23rd Annual EURAPS
Meeting and booking details, please visit us online on
WWW.EURAPS.ORG.
I look forward to spending some inspiring days with you.
Milomir Ninkovic
MD, PhD, EURAPS Local Host, Munich 2012
German Association of Plastic, Reconstructive
and Aesthetic Surgeons (DGPRÄC) goes Web 2.0
Tweets, posts, wikis and friends – the “Web
2.0” calls for everyday interaction. Millions
of users work with Facebook, Twitter and
Wikipedia day by day – creating an “internet
within the internet” on computers, cell
phones and pads. The German Association
of Plastic, Reconstructive and Aesthetic
Surgeons (DGPRÄC) is now also present
on these channels and welcomes you to
participate:
Hans Strömsdörfer
• Facebook:
www.facebook.com/dgpraec
Log in and “like“ us. You will receive all new information about
DGPRÄC (in German).
• Twitter:
http://twitter.com/dgpraec
Sign in for our Twitter account!
• Wikipedia:
http://de.wikipedia.org/wiki/Deutsche_Gesellschaft_der_
Plastischen,_Rekonstruktiven_und_Ästhetischen_Chirurgen

Increasing the visibility and awareness of the possibilities
of Plastic Surgery remains the concern of Plastic Surgeons
worldwide. To make it possible, the Association of
Plastic Surgeons of India, led by its President, Dr. S. Raja
Sabapathy, hit upon a novel concept of the creation of a
“Plastic and Reconstructive Surgery Day”. The date was
fixed as July the 15th. Though it did not commemorate a
birth or signal an event in the history of Plastic Surgery,
the day was chosen for logistic reasons. It was also felt
that more than the date we choose, what we do with the
concept will count more.
What was done on the Plastic &
Reconstructive Surgery Day?
Plastic and Reconstructive Surgery Day
15th July, 2011
A call was given by the President of the Association
of Plastic Surgeons of India, Dr. S. Raja Sabapathy,
requesting all their members to do at least one free
surgery on that day. The day could also be utilized to
conduct programs to popularize Plastic Surgery. Plastic
Surgeons from all over the country responded with great
enthusiasm and the concept was a phenomenal success.
Activities done on that day included:
Throughout the country
the media responded very well.
Dr. S. Raja Sabapathy,
MS, M.Ch, DNB, FRCS(Ed), MAMS Director
& Head Department of Plastic Surgery, Hand Surgery,
Reconstructive Microsurgery and Burns.
Ganga Hospital, INDIA
• APSI members performed free surgeries varying
from free flaps to replace a giant hairy nevus on the
face and reattachment of a hand in a rural setting,
to the correction of post burn deformities, repair of
Replant for a poor child done in Nanded, Maharashtra
State on Plastic Surgery Day
Issue 7 www.ipras.org IPRAS Journal 59

Surgeons conducted meetings in the hospitals to make more
people aware of their department on Plastic Surgery Day.
cleft lip and palate and rhinoplasty. The surgeries
performed covered almost the whole spectrum of
Plastic Surgery.
• Press conferences were conducted by many Plastic
Surgery departments. This gave Plastic Surgeons
the opportunity to explain to the media the scope of
Plastic Surgery. The media responded very well and
carried the message to the masses.
60 IPRAS Journal www.ipras.org Issue 7
• Utilizing the concept of the day, Plastic Surgeons
in many places met senior government officials
and ministers to describe the local needs for Plastic
Surgery services. Extra funds were sanctioned
for various schemes and for the creation of Plastic
Surgery hospital beds exclusively for patients with
Hansen’s diseases who need tendon transfers. Some
young surgeons even started their practices on that
day. Specialized services in hand injuries were
started by some hospitals to coincide with the day.
• Taken as a whole, the concept of Plastic and
Reconstructive Surgery Day provided the much needed
opportunity for Plastic Surgeons to reach all sections
of the society, from Government administrators to the
public. Perhaps the most gratifying response was that
from the President of the International Confederation
for Plastic, Reconstructive & Aesthetic Surgery,
Prof. Marita Eisenman-Klein, who suggested in
her newsletter that July 15th, 2012 be celebrated
as “World Plastic & Reconstructive Surgery Day”.
Neighbouring countries like Sri Lanka have agreed
to this concept. We do hope that this will help us
provide yet another avenue for Plastic Surgeons
worldwide to reach the masses. Since the response
was overwhelming, the Association has decided to
celebrate this day every year.
Hon’ble Minister for Health, Government of India, Shri. Ghulam Nabi Azad,
commented the Association of Plastic Surgeons of India on their innovative idea.

Legalization of the Nicaraguan Society
of Plastic Surgery
Early in 2010, the Nicaraguan Society of Plastic
Surgery initiated the necessary procedures in order to
be legally registered for the first time after almost 20
years of history, according to the prerequisites of the
local laws.
The first legal procedure was completed in March of the
same year. The legal foundation under constitutional
articles, which was then followed by the application of
the Nicaraguan Society of Plastic Surgery presented to
the National Assembly to possess legal status.
The board of directors monitored the process until
the 6th of July 2011, when the Nicaraguan National
Assembly granted the Nicaraguan Society of Plastic
Surgery status of a legal entity.
The SNCP celebrated this important accomplishment
last July, receiving recognition from the Nicaraguan
Medical Association for its organizational growth.
Dr. Guillermo Echeverria, President of the Ethics
Committee of the FILACP was invited as a special
guest and gave a speech on “Ethics and Commerce in
plastic surgery” suitable for the occasion, taking into
consideration that as members of the Ibero-American
Federation of Plastic Surgery we all abide by our
legislation and code of ethics. A fact that makes us a
respected and solid Association.
By being granted the long awaited legal status, our
association reached a milestone in its long and successful
history. We reaffirmed our position in the world of
Founding Board of Directors.
Dr. Alfonso Pares Vice President, Dra. Rossana Trejos,
Secretary, Dra. Carolina Franchini Treasurer, Dra. Sandra
Gutierrez President, Dr. Leandro Perez, Fiscal.
Plastic Surgery as a professional and experiences group
of scientists committed to the highest levels of service,
quality and ethical values in the entire Nicaraguan
medical field.
Dr. Pablo Mongalo President of the Nicaraguan Medical
Association Hans in Recognition Diploma to Dra. Sandra
Gutierrez President of SNCP, for its Legalization.
Nicaragua, election of the new board of the
Nicaraguan Association of Plastic Surgery
On November 25th the Nicaraguan Association of Plastic
Surgery conducted an election for the new Board of
Directors which corresponds to the period of January 2012-
January 2014.
The event resulted in the reelection of Dr. Sandra Gutierrez
as President, Dr. Alfonso Pares as Vice President and
Dr. Carolina Franchini as Treasurer accompanied by Dr.
Edgard Ibarra elected Secretary, Dr. Juan Carlos Arguello
responsible for fiscal issues, and Dr. Dolores Brockmann as
spokesperson for the Association.
On December 15th 2012, the Association will be holding
the inaugural ceremony for the new board, as well as the
end of the year General Assembly.
2011 ends, and will remain in the Associations history as
an important year, when one of the greatest achievements
in our history was recorded! We obtained our official legal
status in July 2011.
Dra Sandra Gutierrez.
President. Nicaraguan Society of Plastic Surgery.
Issue 7 www.ipras.org IPRAS Journal 61

Panamanian Association of Plastic, Aesthetic
and Reconstructive Surgery (APCPER)
Here at the Panamanian Association of Plastic, Aesthetic
and Reconstructive Surgery (APCPER), having a very
small number of plastic surgeons we are currently
working on projects relating to academic and social
fields. On November 18 and 19 we are holding a small
meeting in Panama with the attendance of three very
important international professors. We named it the
“first APCPER Journeys”, where topics in aesthetic
surgery will be covered with open discussions of diverse
themes. Professors Celso Bohorquez, Gabriel Alvarado
and Santiago Umaña from Bogota are attending after
The Congress of the Paraguayan Society of Reconstructive
and Aesthetic Plastic Surgery in Asuncion, Paraguay on
September 8th to 10th, 2011.
The proceedings took place in a context of warmth and
friendship among all the attending local and by foreign
surgeons of different nationalities. We had the joy of
welcoming colleagues from France, Italy, Spain, Mexico,
Brazil, and Argentina.
It was nice to exchange scientific and cultural information
in parallel to the numerous scientific contributions.
Some of the topics we talked about were, facial
62 IPRAS Journal www.ipras.org Issue 7
accepting an invitation by dr. Raul de Leon, president of
APCPER. The purpose of the activity is to strengthen
academic activities for the APCPER.
Also, “Operation Smile”, Panama Chapter, will be
holding its annual mission at the beginning of next year,
totaling 21 years of work in the country, offering surgery
for the needed with birth and acquired defects.
Dr. Raul de Leon
President
APCPER
Paraguayan Society of Reconstructive
and Aesthetic Plastic Surgery
rejuvenation, rhinoplasty, breast surgery, hair implants,
lip and palate surgery, burns etc.
The event played a significant role to increasing the
global knowledge on our specialties and in improving the
human quality of the plastic surgeon generally.
It is in our plans to continue conducting scientific events
in partnership with countries of the region as well as the
rest of the world.
We sincerely thank IPRAS for the support and look
forward to all our common future scientific events!

H I S T O R I C A L A C C O U N T S
The history of Plastic and Reconstructive
Surgery in Australasia
Presented at the RACS AGM Plenary Session “75 Years of Surgical
Progress” on the 13th of May, 2002.
History can be said to be the story of man’s advances in
the world and of the contributions of individuals. Thus,
the history of Plastic Surgery can be said to be based on
the achievements of individuals, who have advanced their
discipline, made contributions to science and, through
their work, have allowed evolution to occur in this
branch of Surgery. Aristotle, in his work ‘On the Parts
of Animals’, said: “Art indeed consists in the conception
of the result to be produced, before its realisation in the
material”. How true this is of the Art and Science of
Plastic Surgery, which has its foundations in the concept
of repairing and changing human tissues.
As in art, imaginative and creative new ways of looking
at surgical problems have pushed Plastic Surgery towards
the ever-advancing frontiers of surgery, resulting in
“spin¬offs” that have affected many other branches of
medicine.
We should be grateful to all those surgeons whose
innovations have made our speciality what it is today and
to those whose vigilance has ensured that standards of
excellence are maintained.
The origins of Reconstructive Surgery procedures are to
be found in Antiquity and hidden in the mists of time.
Amazingly, some of the original methods remain in use
today. Perhaps those surgeons who have missed out on
the experience of “waltzing” a tube pedicle in multiple
stages into position or the fixation of a cross-leg flap by
the use of plaster and broom sticks -along with the coating
of plaster on the nurses and an irate theatre supervisor on
a floor liberally coated with slippery plaster -have been
deprived of some of the joys of the “Early Days”. There
were many others, but surgical advances bring changes.
But one thing never changes. To produce a result that
provides a reconstruction with the minimal amount of
scarring in both the area of deformity and the donor site
is still the ultimate aim of all Plastic Surgeons.
And we can be proud that Surgeons from Australia and
New Zealand have made significant contributions to
Plastic Surgery, especially from the period following the
First World War up until today.
Bruce Walton Taylor
In the programme of the Inaugural meeting of our College
held in Canberra in March, 1928, what stands out is the
number of presentations the subject of which was Plastic
Surgery. The first clinical paper was entitled “The Plastic
Surgery of the Human Body”. I doubt whether any of us
would be so bold as to deliver such a paper today. Henry
Newland (later Sir) gave papers on whole thickness skin
transplants and pedicle skin grafting. There were others
dealing with facial injuries, hand injuries and bums.
The Royal Australasian College of Surgeons became a
reality 75 years ago. It took another thirty years before the
foundation of the “Section of Plastic and Reconstructive
Surgeons of the RACS”. Of the 21 Foundation members
of the section, 6 were from N.S.W.; 6 from Victoria;
2 from South Australia; 2 from Western Australia; 1
from Tasmania and 4 from New Zealand. Some time
should be spent in reviewing some of these individuals
and their contributions. However, before doing this, it
would be interesting to mention three individuals who,
prior to 1928, were carrying out early Plastic Surgical
procedures.
John Reissberg Wolfe (1823-1904) was a Hungarian
Ophthalmologist, who worked in Scotland and was the
first to report the repair of lower eyelid defects using full
thickness skin grafts. He practiced in Melbourne between
1889 and 1901 before returning to Glasgow.
In 1899, William Moore, a Melbourne surgeon, published
“Plastic Surgery”, probably the first book written in
English on the subject. He received the first Master of
Surgery degree from Melbourne University and worked
at both Melbourne Hospital and St. Vincent’s.
And thirdly, Henry P. Pickerill, was a New Zealander from
Dunedin, with both Medical and Dental degrees, who had
worked in England with Harold Gillies. Following his
return to Wellington, he wrote a book on Facial Surgery
in 1924. Later on, in 1934, he began annual visits to the
Royal North Shore Hospital in Sydney, in the capacity of
Plastic Surgeon, that position said to be the first Plastic
Surgery post in Australia. He is remembered as the first
surgeon to use a tube pedicle to close a palatal defect.
Issue 7 www.ipras.org IPRAS Journal 63

It was, however, not until shortly after World War Two
that Plastic Surgery was truly recognized as a subsurgical
speciality in Australia. At that time working in
Australia were Benjamin Rank in Melbourne; David
Officer Brown, Kenneth Starr and Basil Riley in
Sydney; Philip MacIndoe and Llewellyn Swiss Davies in
Brisbane; Leslie Le Soeuf in Perth and Henry Pickerill,
Bill Manchester, Frank Hutter, Joe Brownlee and Leslie
Roy in New Zealand.
In 1956 Sir Harold Gillies, a New Zealander by birth
and then aged 74, attended the AGM in Christchurch
and, believing that the time was overdue, gave great
impetus for the further recognition of Plastic Surgery
as a Speciality. A letter signed by David Officer Brown,
Phillip Macindoe and Benjamin Rank had already been
sent to the College in 1950, suggesting the formation of a
Plastic Surgery Section. But it took until 1956 before the
Section was founded and the inaugural meeting was held
in Melbourne in 1957.
The 21 Foundation members of the section were:
Rank, Newing, Snell, Gunter, Hueston and Wakefield
from Victoria
Riley, Dey, O’Mara, Gibson, Officer Brown and Starr
from New South Wales
Newland and Robinson from South Australia
Le Souef and McComb from Western Australia
Stephenson from Tasmania
Hutter, Manchester, Brownlee and Roy from New
Zealand
Some of these surgeons had worked at Sidcup, England,
at the Queen Mary’s Hospital, later named St. Mary’s.
By 1917, this was a 600-bed hospital devoted to
Maxillofacial and Plastic Surgery and was divided into
British, Canadian, New Zealand and Australian sections,
while later on American casualties were treated as well.
Sir Henry Newland, later to become the inaugural
Chairman of the newly formed Section of Plastic Surgery,
was in charge of the Australian section. Born in Adelaide,
be obtained his English fellowship in 1899, after which
returned to practice in Adelaide. During World War One
he served in the Middle East, Gallipoli and France, before
his transfer to Sidcup. For his service he was awarded
the DSO. He returned to Adelaide after the war, was
awarded a CBE, followed by a Knighthood in 1928 and,
amazingly, continued to work until the age of 78.
He was the President of the Section of Surgery of the
British Medical Association in Australia and of many other
organisations. From 1929 to 1935 he was the President
of the Royal Australasian College of Surgeons and, even
more importantly for us, he was the first Chairman of the
Section from 1957 to 1960.
The second Chairman of the Section was David Officer
Brown, from 1960 to 1962. A graduate of Melbourne
University, he also obtained his MD and MS degrees
64 IPRAS Journal www.ipras.org Issue 7
from that University. After a period in general practice
he obtained the FRACS in 1935. As was the custom,
he trained further in the U.K., working with Harold
Gillies, Rainsford Mowlem, Archibald McIndoe and
T. P. Kilner who had joined Gillies in 1919, and on his
return to Australia he confined his practice to Plastic and
Reconstructive Surgery. When World War Two first broke
out, he worked in the Maxillofacial and Plastic Unit at
the 2nd AGH, coincidentally with Benjamin Rank.
In 1940 he returned to the U.K. to work with Gillies
until 1942, when he rejoined the Australian Army in
Alexandria. On his return to Australia he was appointed
to St. Vincent’s and RPA Hospitals in Sydney and there
he trained many of the Sydney Plastic Surgeons.
The third chairman of the Section, between 1962 and
1965 was Sir Benjamin. Rank, a graduate of Melbourne
University who gained his English Fellowship in 1938
also came under the influence of Gillies, McIndoe and
Mowlem (as a matter of interest, all originally New
Zealanders).
When war broke out, Rank joined the Australian Armed
Forces and saw action in Egypt and EI Kantara, before
being transferred back to Australia to set up the Plastic
and Maxillofacial Unit at Heidelberg Military Hospital in
Victoria. In 1946 he took up the first Plastic Surgery post
at the Royal Melbourne Hospital.
Undoubtedly, Sir Benjamin helped to put Australian
surgeons on the international map, being honoured in
Great Britain, India, the United States and Canada. He has
been a Carnegie Fellow, a Sims Professor and Moynehan
Lecturer, as well as presenting the Gillies Memorial
Lecture in 1973 and the Syme Oration in 1976.
In 1965 he was the President of the British Association
of Plastic Surgeons and Chairman of the British Surgical
Colleges in 1967. From 1966 until 1968 he was the
President of the Royal Australasian College of Surgeons,
while in 1971 he was President of the International
Confederation of Plastic and Reconstructive Surgeons at
the 5th International Congress held in Melbourne, after
which he was knighted. Sir Benjamin retired just a few
years ago, as the President of Interplast Australia. He was
the author of several books and a distinguished painter
in oils.
William Manchester, the fourth Chairman of the
Division, was a graduate of Otago University in 1938.
During his service in the New Zealand Army he was sent
to England for training in Plastic Surgery under Gillies,
McIndoe and Mowlem, after which he set up the Plastic
and Maxillofacial Unit near Cairo. He was recalled to
Christchurch in 1944 and after his discharge in 1945 he
established the first Plastic Surgery Unit at Burwood.
More training followed in the UK, after which he returned
to Middlemore Hospital in Auckland.
Amongst many honours he received a knighthood and

was, importantly, the first Professor of Plastic Surgery
in the Antipodes. In addition, he served as General
Secretary of the Asian Pacific Section of the ICPRS and
on the Committee of the International Confederation. He
was Chairman of the Section from 1964 to 1966.
Apart from the distinguished Chairmen we have just
profiled, there were other surgeons who deserve mention
because of their efforts in establishing Plastic Surgery as
a speciality in Australia and New Zealand. It is so easy to
take the present status of the speciality for granted, but we
owe an expression of gratitude to those who can really be
termed pioneers and who worked hard to establish Plastic
Surgery as a separate entity.
Kenneth Starr, an honours graduate from Sydney, worked
at RPA. He too had worked with Gillies and McIndoe
in England before returning to Sydney in 1942 to set
up a Maxillofacial Unit at the 13th General Hospital in
Concord. Starr was President of the RACS from 1964 -66
and awarded many honours, although he did not confine
his work to Plastic Surgery. He was knighted in 1971.
Basil William Birkenhead Riley was born in Sydney in
1885 and served in the First World War as a Lieutenant.
He graduated in Medicine from Sydney University in
1923 and trained at Royal North Shore Hospital before
moving to London to work with Mowlem and Gillies.
Back in Australia his return to North Shore was followed
in 1937 by 18 months in Europe and the United States,
studying Plastic Surgery. The Second World War saw him
working in the Plastic Surgery Unit at Concord Hospital,
while at the end of the war he was appointed Surgeon-incharge
at the Royal North Shore Hospital and periphery
hospitals. He is remembered with affection by all who
knew him.
Frank Leo Hutter graduated from Otago University
in 1935. He worked in Palmerston North for a while
before moving to London, where he spent time in several
hospitals, including Great Ormond Street Children’s
Hospital, in 1938. In 1940 he joined the New Zealand
Army Corps, serving in Plastic Surgery and General
Surgery Units. After his discharge in 1945 he worked
with Gillies, McIndoe and Mowlem at East Grinstead.
On his return to New Zealand, he was appointed Plastic
Surgeon to Wellington and Palmerston North Hospitals.
In 1952 the unit was moved to Hutt Hospital, from which
he retired in 1973 to a farming career.
Leslie John Roy was also a graduate of Otago University
in 1936. Having worked in Christchurch, he travelled to
the U.K. and, like Hutter, he did a stint at East Grinstead,
after which he was appointed as a Plastic Surgeon in the
West of Scotland. When war broke out, he joined the
New Zealand Army Corps, serving in Egypt and Italy.
Following his discharge he returned to New Zealand to
an appointment at Burwood Hospital in Christchurch.
Philip Hudson McIndoe graduated from Sydney
University in 1935 and, after having obtained his
fellowship in Edinburgh two years later, was appointed
to Prince Henry Hospital in Sydney. During the war he
served at Gaza Ridge in Palestine and later in Egypt,
Greece, Crete and finally in New Guinea. In 1945 he was
appointed Officer in Charge of the Plastic Surgery Unit
at Greenslopes, later working at Brisbane General as a
Plastic Surgeon, before changing direction to become
Medical Superintendent at Goulbourn Base Hospital in
NSW.
Llewellyn Swiss Davies was a Melbourne graduate who
did his residency at Brisbane General Hospital. During
the war he was posted to the Concord Military Hospital
Plastic and Maxillofacial Unit, under Colonel K. W. Starr.
Later he served in Moratai and Greenslopes in Brisbane.
He remained in charge of the Greenslopes unit until after
the war, when he became Senior Visiting Plastic Surgeon
at the Royal Brisbane and Repatriation Hospitals, as well
as the Mater and Children’s Hospitals.
We must not forget Thomas Graham Humby, a colourful
and controversial character who was an English 1935
graduate. Whilst still a student at Guy’s Hospital, he
modified the skin graft knife then in use, introducing his
moveable roller, which allowed more precise skin grafts.
His residency at Guys was anything but dull. He was
an understudy to Fred Astaire in “Funny Face”; gained
the first gliding certificate in England and represented
England in international yachting. He joined the British
Navy in World War II and trained as a Fleet Air Arm pilot
in Florida. The war over, he trained in Plastic Surgery
and was appointed to Stoke Mandeville Hospital. Again,
he did not restrict his life to surgery but started a freight
carrier,”London Aeromotive Service”, using old RAF
bombers.
A bout of TB, farming in Dorset and a Plastic Surgery
practice in the West Indies occurred before he finally
came to Sydney in 1956. He went into practice as a
Plastic Surgeon in Rose Bay, concentrating on Cosmetic
Surgery, one of the early surgeons to do so. There are
many tales about his eccentricities but these must remain
untold as it is impossible to confirm their authenticity.
Ian Ross Wakefield, known to all as “The Vicar” -what else
-graduated in 1941 from Melbourne University, gaining a
Masters degree in 1946. During the war he was in the A1F
Medical Corps. He obtained his Australian and English
fellowships, then carried out Plastic Surgery training in
England. Back in Melbourne he worked at The Royal
Melbourne, The Royal Women’s and Royal Children’s
Hospitals. With B.K. Rank he published a noted textbook
on Hand Surgery. He was the first secretary of the Section
and later its Chairman (1966-1967)
Arthur Stephenson graduated from Sydney University
Issue 7 www.ipras.org IPRAS Journal 65

in 1941, gaining a Masters Degree in 1949. During the
war he served as a Captain in New Guinea and Tarakan.
He settled in Tasmania, where he was Senior Plastic
Surgeon at the Royal Hobart, as well as consultant to the
Repatriation Hospital.
Leslie Ernest Le Soeuf was a Melbourne graduate, 1922,
obtaining a Doctorate two years later, before travelling
to England to obtain his Fellowship. During the Second
World War he served with the A1F in Libya, Greece and
Crete, being mentioned in despatches, and was awarded
the OBE as well as French decorations. He was also a
prisoner of war in Germany. He held many official posts
in Western Australia and served the Royal Perth and
Princess Margaret Hospitals for many years.
There were other dedicated surgeons who impacted on
the recognition of Plastic Surgery as a separate entity.
Men like Richard Newing, John Snell, George Gunter,
John Heuston, David Dey, Ted Gibson, Max O’Mara,
David Robinson, Harold McComb and Joe Brownlee
were all Foundation members of the Section who served
the speciality with dedication and enthusiasm and whose
contribution is not forgotten.
In 1956, following the inception of the Section of Plastic
Surgery, the first College Plastic Surgery examination was
held and by 1960 a Sub-Committee on Surgical Training
was founded. Due to the increase in trainee numbers in
1970, a Committee on Surgical Training was elected,
the chairman being David Robinson of South Australia,
Harold McComb of Western Australia and Don Marshall
of Victoria. In order that there be regional representation,
the Committee was enlarged to include John Williams of
New Zealand, Noel Sweeney of NSW, Trevor Harris of
Queensland and Arthur Stephenson of Tasmania. Later
on there were two additions, Ted Gibson of Sydney and
William Manchester of New Zealand.
In 1977 the College determined that each speciality should
have a board, in order to determine their own destiny,
under directions of the College. The first Chairman was
David Robinson, who served until 1980. He was followed
by John Hanrahan, (1980-84), who later was elected
President of the College and Tony Rieger (1984-1987).
Originally, most of our Plastic Surgeons received their
training overseas. When Plastic Surgery residency posts
first became available in our public hospitals, trainees were
selected by the hospital and normally remained in one place
throughout their training. However, in 1987, it became
obvious to the Board that this restriction to one hospital
offered a limitation of experience. To ensure exposure to
all facets of Plastic Surgery, a hospital rotation system was
introduced, with the selection of the trainees being made by
a sub-committee of Plastic Surgeons in each state on behalf
of the Board, instead of the hospital administration.
Regional sub-committees were set up, reporting to the
Board. These sub-committees kept close contact with
66 IPRAS Journal www.ipras.org Issue 7
trainees who were selected on a state-by-state basis.
Since 1990, the continuation and approval by the Board
in Plastic Surgery is required for each trainee. Regular
inspections of hospital training posts are carried out by
board members to ensure they fulfil the requirements
for the teaching programmes. On completion of their
training and the RACS exam, many go overseas for
further experience in centres of excellence, chiefly in
North America, the UK or other European destinations.
In 1979 David David suggested annual week-long courses
for trainees and these have been held in different centres
since 1980.
The late sixties and early seventies saw the beginning of
many changes in the delivery of health care in Australia.
Because the College of Surgeons is responsible only for
training and standards and does not deal in the political
and financial aspect of practice, the Australian Society of
Plastic Surgeons was incorporated in 1971 to deal with
such matters, in an environment of constantly changing
ground rules. A similar Society was founded in New
Zealand. ASPS is open only to Fellows who fulfil the
Plastic Surgery training and examination standards laid
down by the College.
An application was made in 1974 for establishing
Armorial Bearings for the Society. In 1976 a Grant of
Arms was made by the College of Heralds in London.
The Kings of Arms noted that “the elements of the grant
symbolise the essence of Plastic Surgery in the most
pleasing and truly heraldic manner”.
In 1998 the decision was made to dissolve the Division.
However, while ASPS is now the sole body covering
the day to day matters of the Specialty, all training and
standards remain, as it always had, under the auspices of
the College via the Board in Plastic Surgery.
As specialisation in individual aspects of Plastic Surgery
became more widely spread, the Aesthetic Society of
Plastic Surgery was formed and Plastic surgeons also
joined various hand, head and neck and burn societies,
while small study groups continued to meet.
As we have seen from the very early days of the speciality,
Australasian surgeons have trained and made their
mark overseas. Internationally, following the Second
World War, Plastic Surgery as a speciality was gaining
momentum. In 1955 the first Congress of the International
Confederation of Plastic and Reconstructive Surgery
was held in London, coincidentally the year after two
Americans from Boston, Joe Murray, a Plastic Surgeon,
and Hartwell Harrison, performed the first human kidney
transplant in the world.
Since that time, the Congress of the International
Confederation of Plastic and Reconstructive Surgery has
been held every four years. In 1971 the Meeting was held
in Melbourne, under the chairmanship of B.K. Rank, while
next year the Congress will again come to Australia, to

Sydney. Australian Surgeons have played an active role
in the International Confederation with representatives on
the central Committee and the Asia Pacific section.
Over the years since the inception of the College, great
advances have been made in Plastic Surgery. In Paediatric
Surgery, for example, craniofacial procedures, genitalia
correction, velopharyngeal procedures and improvements
in cleft lip and palate offer new hope for children born
with congenital abnormalities.
Victims of trauma can receive replacement of severed
body parts such as fingers, hands, scalps and ears, while
the treatment of burns sees an ongoing quest for ever
better methods of skin culture and grafting and post burn
scar relief.
Breast reconstruction, as well as reduction and
augmentation, the treatment of male and female genital
abnormalities and of facial palsy are only some of the
areas in which plastic surgery advances provide a better
and more normal life to patients.
With the use of the surgical microscope, osseointegration,
plate fixation,tissueandboneexpansion,musculocutaneous
flaps, free flap transfers, muscle and nerve transposition
and transplantation, vascularised bone grafts and bone
substitutions, we have reached results in reconstruction
undreamed of 75 years ago.
The elixir of eternal youth or a magic wand have not yet
been developed but the subperiostal face lift, brow lift,
hair micrografting, liposuction, laser surgery, implants,
collagen, abdominoplasty and so on offer ways of defying
the physical signs of ageing or creating a new image for
the patient.
Many surgeons from the Antipodes have made significant
contributions on the International scene. Moore, Pickerill,
Rank, Wakefield, Hueston, Thompson, David, O’Brien
and Morrison have written well known textbooks, while
they and others have contributed chapters to Plastic
Surgery literature worldwide. B. K. Rank, Ian Taylor,
Wayne Morrison, Bernard O’Brien, to name just a few,
have been major presenters at International Meetings.
Some of the World’s first microsurgery procedures were
carried out and reported in Australia. Let’s look with
pride at these examples.
Replacement of completely severed digit (P.G.
Lendvay and E.R Owen:1970)
The first Free Transfer of tissue by vascular
anastomosis (G.I.Taylor and RK. Daniel: 1973)
The free vascularangeal bone graft (G.I.Taylor,
G.D.H. Miller and F.1. Ham: 1975)
Replantation of an avulsed scalp by microvascular
anastonosis (G.K.H. Miller, E.1. Anstee and J.A
Snell: 1976)
*The iliac crest free flap (G.I. Taylor, P. Towns and R
Corlett: 1979)
Replantation of a completely avulsed ear (D.G.
Pennington, M.F. Lai and AD. Pelly: 1980)
“Wrap around” toe to thumb transfer for
reconstruction(W. Morrison, B. O’Brien and A
MacLeod: 1984)
Since 1974 the B. K. Rank Travelling Professorship
has been awarded annually, to a distinguished Plastic
Surgeon from an overseas centre of excellence. The list
reads like the Who is Who of the speciality. But it has
not always been one sided. Australian Plastic Surgeons
have been awarded Overseas Visiting Professorships
and, particularly in the Asia Pacific region, have served
to benefit the hospitals in their host nations.
In addition, overseas visits by groups of Plastic Surgeons
from our area have been well organised and visits to
centres in the United States, China, India and Russia
have led to great interchange of ideas.
Until recent times, there were no professorial
appointments in Australia, however Wayne Morrison
was the first such appointee and is now Professor of
Surgery at St. Vincent’s Hospital, Melbourne. The first
academic Chair in Plastic and Reconstructive Surgery is
held by Michael Poole in Sydney at St. George Hospital.
The University of Auckland New Zealand appointed Sir
William Manchester Professor of Plastic Surgery in 1977,
the first such appointment in our area.
It should also be noted that a federally funded Craniofacial
Unit exists in Adelaide, under the Chairmanship of David
David. However, there are other Craniofacial units in other
Plastic Surgery departments. These all draw patients, not
only from Australia, but from countries near and far.
Here we must make mention of Interplast Australia, which
is a medical relief organisation initiated in 1983, which
sends Australian Plastic Surgery teams to some twenty
different areas throughout the South Pacific. These teams
consist of two Plastic Surgeons, an Anaesthetist and nurse,
all volunteers. Procedures are carried out in the field but
there have been some forty five patients who have been
brought to centres in Australia, while approximately
forty eight doctors and nurses from eleven different areas
have secured valuable experience here, which they take
back to their country of origin. Since 1983, 286 teams
have examined over twenty thousand patients and carried
out over twelve thousand operations, assisted by local
medical and nursing staff.
As previously mentioned, Sir Benjamin Rank was the
first President of Interplast, followed by Don Marshall.
When Plastic Surgery was first officially recognised as a
Surgical Speciality by the College in 1956, there were just
21 qualified Surgeons. Last year, 2001, there were 257.
Like all other surgical groups, Plastic and Reconstructive
Surgery has had its problems; a lack of realistic level of
visiting medical officers, shortage of Hospital beds and
Issue 7 www.ipras.org IPRAS Journal 67

lack of funding and facilities for research and training
posts.
As we look back into the history of Plastic Surgery in
Australasia, we see that it is indeed an example of the
participation of individuals in advancing a field of
medical science. Time does not allow me to name all the
many Fine Plastic Surgeons who have contributed to and
received recognition for their part in the development
of their speciality. Not all innovations have made their
way into textbooks but many have been shared with
students and fellow Surgeons in the operating room
SELECTION OF FOUNDATION MEMBERS OF THE PLASTIC SURGERY SECTION OF RACS
68 IPRAS Journal www.ipras.org Issue 7
or via meetings, such as the one being held this week.
There is no doubt that the advances in all branches of this
Surgical Speciality have been rapid and the future is very
encouraging.
The progress that Plastic Surgery has made throughout
the world and especially in our area during the past few
decades has been remarkable. Plastic and Reconstructive
Surgery is truly at the forefront of the advancing frontiers
of Surgery. Just as truly, it has played an important part
in the history of the development of medical care in
Australasia.
I-r: J.A. Snell, B.K. Rank, G. Gunter, J.T. Hueston, A.R. Wakefield, B.W.B. Riley, D.L. Dey, M.L. O’Mara,
E.W. Gibson, D. Officer Brown, K.W. Starr, H. Newland, D.N. Robinson, H.K. McComb, A. Stephenson,
W. Manchester, LJ. Roy. Not appearing: F.L. Hutter, L.E. Le Souef, R. Newing, J. Brownlee.
Sir Henry Newland
1929-1935
PLASTIC SURGEONS WHO HAVE BEEN RACS PRESIDENTS
Mr Kenneth Starr
1991-1993
Sir Benjamin Rank
1964-1966
OTHER MEMORABLE PLASTIC SURGEONS
H.P. Pickerill, L.S. Davies, P.H. MacIndoe, T.G. Humby, J.R. Wolfe
Mr John Hanrahan
1966-1968

Just as the Sun rises in the East, the science of Plastic
Surgery first dawned in the ancient Indian civilization. In
India, from the beginning of recorded history, offenders
or sinners were punished with mutilation or severance
of the nose, ears or parts of limbs. Indian mythology
and history are replete with stories of Surpanakha and
Nakatapore i.e. ‘City without Nose’. Moreover, in India
the nose is considered to be the organ of respect and
reputation, hence plastic surgical procedures to correct
these deformities were a necessity.
The first detailed description of plastic surgical procedures
is found in the clinical text on Indian Surgery, the ‘Sushruta
Samhita’ (circa 600 B.C.). Atharva Veda, the root of
Ayurveda, the classical text of Indian medical knowledge,
includes two seminal texts, Charaka Samhita, on medicinal
aspects and Sushruta Samhita, which incorporates details
of surgical tools and operative techniques. Sushruta wrote
this treatise based on the lectures of his teacher, the famous
surgeon king, Devadas (‘incarnation of Dhanwantari, the
Divine Physician). In the fourth century A.D. Vagbhat, an
Indian Physician, recounted the plastic surgical procedures
with more details than provided in Sushruta Samhita. In
his book, ‘Astanga Hridyans Samhita’ he credits the
techniques to Maharishi Atreya. It is interesting to find
mention of plastic surgical procedures such as rhinoplasty,
otoplasty, tissue grafting, organ transplants, transfer of
embryo, cross-grafting of head and reattachment of limbs
etc. in these ancient Indian Medical Treatise and Puranic
Literature.
The gradual decline of this golden era of Hindu Surgery
began at the time of Buddha (562- 472 B.C.). Buddhist
scripture Mahavagga Jataka enforced strict prohibition
on Surgeons and Manusmriti prescribed special rituals
for their purification. Contemporary teachings, based
on Ayurveda, basically supported medicinal treatments.
Ayurveda forbade surgery, as contact with blood and
pus was considered polluting. Hence, during this period,
these great surgical skills were delegated to lower castes
like ‘Koomars’ or potters, who were known for their
manual dexterity. They kept this valuable knowledge
alive and passed it from father to son, as a family secret.
Some of these families were identified in the latter half
of eighteenth century. Marathas of Pune, Kangharias of
A combined historical account
of Plastic Surgery in India and the
Association of Plastic Surgeons of India
Kangra (Himachal Pradesh) and some families in Nepal
were practicing ancient Indian surgical skills; most
notable amongst them being midline forehead rhinoplasty.
In Kangra, forehead rhinoplasty had been practiced for
centuries by a family of Hakim nose surgeons called
‘Kanghiaras’. They had been operating in Kangra since
the time of Raja Sansar Chand (1440 A.D.) and had also
obtained certification from Mughal kings. Hakim Dina
Nath Kanghiara was the last surviving descendent of
the family, known to have performed such an operation.
Details of their surgical skill appeared in Punjab Medical
Journal in 1967. Later still, Dr. Tribhovandas Motichand
Shah, the then CMO of Junagadh is said to have performed
400 rhinoplasties by forehead flap.
In fact, India and Egypt are considered as the fountainheads
from which the stream of knowledge flowed to
the Middle East, eventually to reach the Mediterranean
civilizations; the Greeks and the Romans. The ancient
Indian medical knowledge was carried into Greece and
Arabia by Buddhist Missionaries. Further still, avenues
of trade were set up between Greece and India following
the conquests of Alexander ‘The Great’. Arabs played
an important role in transmitting the surgical knowledge
to the West. The Persian hospital at Gandi-Sapor (6th
– 10th century A.D.) was a great learning centre of that
era, permitting the amalgamation of Hindu, Greek and
Arab schools of thought. Here, the Sushruta Samhita was
translated into Arabic and later into Latin. Arab physicians
of that time, Rhazes and Aviceruna, often referred to the
teachings of Sushruta and Paulus Aegina. Paulus Aegina
was a 7th century physician who was responsible for the
integration of Indian and Western surgical knowledge
and summarized it in a seven-volume compendium.
Further down the timeline, Aulus Cornelius Celsus (25
B.C.) propagated this science to Rome in his book ‘De
Re Medica’. During 525 A.D. the Christian Orthodox
Church started rising and the enthusiasm towards surgery
declined. Surgical skills were now reared in the hands
of people of lower status like barbers, a situation similar
to what had happened in India centuries ago. Sushruta
Samhita was translated into English by Kariraj Atrideo
Gupta Vidyalankar Bishangar (1950) and Kaviraj
Kunjalal Bhishagranta (1963).
Issue 7 www.ipras.org IPRAS Journal 69

Despite these hurdles, reconstructive operations of
the nose and face received an impetus in the European
countries during the 19th century. The German, French
and English Surgeons were introduced to the older Indian
method. During that period, certain German scholars who
studied the original text in Sanskrit, British surgeons and
French travelers, who saw for themselves the rhinoplasty
operations performed in India, revealed the wonders and
practical possibilities of this specialty to the Western
world.
It was, however, the discovery of anaesthesia (Morton,
Long and Wells) and anti-sepsis (Lord Lister) which
revolutionized the practice of surgery and made it
painless and infection-free. Modern Plastic Surgery in
India started after World War II. During the war, there
were a couple of British Maxillofacial Surgery Units
and a special mention was made about them by Mr.
Tom Gibson (Canniesburn Hospital) at Bangalore and
by Mr. E.W. Peet at Pune, during their visits to India.
This kindled the interest in Plastic Surgery among a few
young Indian surgeons working then with the armed
forces as “temporary commissioned officers”. After the
war, two of them, Dr. C. Balakrishnan and Dr. R.N.Sinha,
specialized in Plastic Surgery, while Major Sukh pursued
his interest in the specialty as a pioneer in the field of
Plastic Surgery at the Armed Forces Medical College and
Hospital, Pune.
Plastic Surgery did not exist as a recognized specialty
in the country. While in training at Stoke Mandeville
Hospital, U.K., Dr. C. Balakrishnan sent a memorandum
to the Director General of Health Services, New Delhi,
proposing the development of a Department of Plastic
& Maxillofacial Surgery, because there was a crying
need for at least one such department in the country.
After great persuasion, he was offered the post of
Lecturer and Surgeon at Medical College and Hospital,
Nagpur (at that time known as the Central Provinces
of Madhya Pradesh and Bihar State). He accepted the
offer and started to develop a Department of Plastic and
Maxillofacial Surgery. Dr. R.N. Sinha, who was trained
under Prof. Kilner, on his return to Medical College,
Patna (Bihar State) made pioneering efforts to educate
surgical colleagues, State and Central Government and
the Medical Council of India about the need to develop
Plastic Surgery as a specialty. He wrote numerous
articles in scientific journals and lay press to drive home
the point. This indeed was a great task, since there were
no books or literature available to read, learn from and
receive guidance about the new specialty. During those
days, even minor progress was very difficult, because the
development of specialties was generally frowned upon
and frankly discouraged by General Surgeons. Slowly,
even the patients started realizing that a person who
concentrates in one field, does much better than one who
70 IPRAS Journal www.ipras.org Issue 7
is a “jack of all trades and master of none”. It required
all the tenacity and dedication of a handful of pioneer
Indian Plastic Surgeons, who made Plastic Surgery their
career, to overcomethe initial difficulties. For almost 8
to 10 years, these pioneers at Nagpur, Patna, and later at
Lucknow, Bombay and Calcutta, struggled hard for their
existence and worked as sections in the departments of
General Surgery.
Dr. N.H. Antia, after his post-graduate training in Plastic
Surgery in the U.K., started working in a private hospital
in Pune and was also engaged in Rehabilitative Surgery
at the ‘Kandhwa Leprosy Centre’ outside the city. He
carried drums with sterilized linen and instruments from
Pune to the leprosy centre. Dr. Antia worked here in a
makeshift O.T. on absolutely voluntary and honorary
basis in spite of considerable hardship. His pioneering
work on leprosy was rewarded by an invitation from
England to deliver the Hunterian Lecture at the Royal
College of Surgeons, London in 1955.
Sir B.K. Rank visited India from Australia, on a goodwill
mission under the Colombo Plan to advise the Government
of India and his own Government about the possibilities
of developing Plastic Surgery in India. He spent two
weeks in India and recommended the development of
a Centre of Excellence at Nagpur, under the dynamic
leadership of Dr. Balakrishnan. This was to be aided up
to 50% under the Colombo Plan and the rest to be granted
by Central and State Governments. Unfortunately, the
plan never materialized. However, the first independent
Department of Plastic Surgery in the country was finally
created at the M.C. Hospital, Nagpur, in 1958.
By 1955, there were about four to five Plastic Surgeons,
devoting their full time to this specialty and there was
a desire to form an Association. Thus, in the Annual
General Body Meeting of A.S.I. (Association of Surgeons
of India) held in December, 1956 at Indore, Dr. R.N.Sinha
required a resolution to this effect. A sub-committee was
formed with Dr. C.P.V. Menon of Madras as its Chairman
and Dr. R.N. Sinha as the Convener to frame By-laws
and Regulations for an Association of Plastic Surgeons
of India - as a Section of Association of Surgeons of
India. However, it was only in December 1987 that APSI
became a Registered Society with the government.
In the year 1957, considerable interest was created in
Maharashtra, following the visit of Sir Harold Gillies. He
was pleasantly surprised to see deformities being treated
by tube pedicles and other modern techniques of Plastic
Surgery. He applauded the excellent work that Major
Sukh was doing in the field of Rehabilitative Plastic
Surgery at the Armed Forces Medical College, Pune. It
was not only an eye-opener for all, but a surprise to Dr.
Gillies himself. Many war casualties needed extensive
stay in his unit for such procedures of rehabilitation. Sir
Harold Gillies also demonstrated various operations and

techniques at Kandhwa Leprosy Centre, where Dr.N.H.
Antia was working. Dr. Gillies, as the founder of modern
Plastic Surgery, was keen to propagate knowledge in this
specialty in one of the most populous countries of the
world. He visited and lectured at several centers in the
country including Nagpur, Calcutta, Delhi, Patna and
Jaipur. At Nagpur, in December 1957, he inaugurated the
Association of Plastic Surgeons in India - as a section
of A.S.I. The Association elected the following office
bearers:
Dr.R.N.Cooper President
Dr.C.Balakrishnan First Vice-President
Dr.R.N.Sinha Founder Secretary
Dr.R.N.Sharma Founder Members
Dr.N.H.Antia Founder Member
Dr.Hirdeis Founder Member
(ENT Specialist from Bangalore)
This was indeed a great historic moment and Dr. Gillies
was made the first Honorary Member. Dr. Gillies stayed
in India for about three months and, before leaving for
England, he insisted on a token payment of Rs.100/-
to Dr. Antia, as an inspiration to continue his efforts
in establishing a Department of Plastic Surgery at the
Government Medical College in Bombay. This proved
to be a great morale booster and the first unit of Plastic
Surgery started at J.J. Hospital, Bombay in December
1958 with Dr. Antia as its Head.
A Burns and Plastic Surgery Unit was established in 1961
at K.E.M. Hospital, Bombay, by Dr. Charles Pinto. Mr.
E.W. Peet of Oxford was a regular visitor to this unit.
The first summer conference of the Association was
held at Nagpur in 1964. The most outstanding feature
of the conference was the brilliant presentation on
the classification of cleft lip and palate by Prof. C.
Balakrishnan; now known throughout the country as The
Nagpur Classification. The first batch of post-graduate
students trained in our country appeared for their
examination from Nagpur and Patna Universities in 1962
and 1963 respectively.
In 1963, the Government decided to start a Department
of Burns, Plastic and Maxillofacial Surgery at Safdarjung
Hospital in Delhi. Dr. J.L. Gupta had the honour of starting
and developing this unit which, by sheer hard work and
dedication, became a major unit of Plastic Surgery in
India in a very short time.
In 1964, during the first Post-graduate Medical Education
Conference, convened by the Medical Council of India,
under the Chairmanship of the then Union Minister of
Health Dr. Sushila Nayyar at Delhi, the first curriculum
and physical standards for MCh postdoctoral training in
Plastic Surgery was drafted.
In 1967, Dr. R. N. Sharma represented our Association at
the International Meeting held in Rome, and thus, APSI
joined the International Confederation of Plastic Surgeons.
By December 1967, the Association had grown to about
66 members (including 37 full members). By 1968, we
had 11 plastic surgery centers in the country at Nagpur,
Inaugural ceremony of IPRAS 2009 at Siri Fort Auditorium on 29th Nov 2009. (L-R Dr. G. Balakrishnan, President APSI, Dr. Suresh Gupta,
President IPRAS 2009, Dr Marita Eisenmann-Klein, Secretary General IPRAS, Dr. Kiran Walia, Chief Guest and Minister of Health in
Government of Delhi, Dr. Rajeev B. Ahuja, Chairman IPRAS 2009, Dr. Rakesh Khazanchi, Secretary General IPRAS 2009).
Issue 7 www.ipras.org IPRAS Journal 71

Patna, Lucknow, Bombay, Pune, Delhi, Chandigarh,
Patiala, Madras, Madurai and Calcutta.
In the last four decades there has been a tremendous
growth of Plastic Surgery. The number of teaching
centers has increased in the country and today hardly
any student is going abroad for basic Plastic Surgery
training. The Association has established several
traveling fellowships for training within and outside the
country (appendix I), as well as several Professorships
(appendix II). A few specialized centers of excellence
for management of burns, Hand and Micro-vascular
Surgery, Craniofacial Surgery and Aesthetic Surgery
also developed, in different parts of the country, by
dint of hard work and special interests. The Indian
Journal of Plastic Surgery started in 1981, in order to
bring together all the professionals involved and to
disseminate and advance their knowledge. Very proudly,
IJPS (India Journal of Plastic Surgery) is now a popular
journal, indexed with Medline and publishing papers
from across the world.
There are about 800 Full members and 150 Associate
members of APSI today.
72 IPRAS Journal www.ipras.org Issue 7
India had the privilege of hosting the IXth and the
XVth Congresses of IPRAS in Delhi, in 1987 and 2009,
respectively. Dr Suresh Gupta and Dr Rajeev B. Ahuja,
respectively, were principally responsible for the organization
of the events. Both the events were a huge success, with
the delegates who enjoying the Indian hospitality. APSI
also has the privilege of giving two Secretary Generals to
the Asia Pacific Section of IPRAS; Dr B.M. Daver (1997-
2001) and Dr Rajeev B. Ahuja (2009-2013).
APSI has recently established a Humanitarian activity
corpus and the interest from this will be available to any
APSI member to use for a humanitarian project in the
country. APSI has also leaded in proposing and observing
July 15th as the Plastic Surgery Day, when all Plastic
Surgeons are urged to contribute free services to the needy
in their Region. IPRAS has promised to propagate this
concept. APSI has also started professional development
courses, which are topic-based and held three times a
year, rotating across the country. They are delivered at no
cost to students and APSI members, through sponsorship
from Ethicon. These courses are extremely popular and
have been a huge success.
Past Presidents of APSI during APSICON at Goa in 2010. (L-R Dr K.S. Sekhar, Dr N. Pandya, Dr V. Bhattacharya, Dr Suresh Gupta,
Dr Mukund Thatte, Lt Gen L.P. Sadhotra, Dr Rajeev B. Ahuja, Dr K. Sridhar, Dr. Rajasabapathy)

The upcoming events of the APSI are:
20-22nd Jan 2012 ISAPS Course, Goa
19-20th Feb 2012, APSI-Ethicon accredited course on
Reconstruction in Abdominal & Trunk.
27-29th April 2012, APSI-Ethicon accredited course on
Basics in plastic surgery.
2-3rd Nov 2012-Preconference APSI-Ethicon accredited
course in cleft surgery. Lucknow
6-8th Nov 2012 Main APSICON Conference, Lucknow
4-8th March 2013, World Congress of IFSSH
The current Executive members
representing APSI:
President: Dr A.K. Singh
President Elect: Dr Ashok Gupta
Immediate Past President: Dr Raja Sabapathy
Secretary: Dr Atul Shah
Treasurer: Dr Sailesh Ranade
Editor: Dr Surajit Bhattacharya
Council Members: Dr.B.G. Tilak,
Dr Amresh S. Baliarsingh,
Dr Nitin Mokal,
Dr Ravi Mahajan,
Dr Subramanian Iyer,
Dr Hari Venkataramani
Trustees: Dr K.S. Sekhar,
Dr J.K. Sinha,
Dr K. Sridhar,
Dr Suresh Gupta,
Dr Rajeev B. Ahuja
Appendix I.
1. Ethicon Plastic Surgery Traveling Fellowship
2. Ethicon traveling fellowship in Microsurgery
3. Ethicon cosmetic surgery traveling fellowship
4. R.G. Saraiya international fellowship –
5. Brig. Kathpalia fellowship in hand surgery
6. Myovatec fellowship for training in Plastic surgery
7. Vasudhan Arjin Fellowship in Laser Surgery
8. APSI sponsorship to attend APSICON
9. IX IPRAS Congress fund international traveling
Fellowship.
10. IX IPRAS Congress fund national traveling
Fellowship.
11. K.E.M. Microsurgery fellowship
Appendix II.
1. Plastic Surgeon of the Year award – from DR KS
Shekar endowment
2. Honorary Membership Award
3. Ethicon Visiting Professorship in Plastic Surgery
4. Ethicon Visiting Professorship in Microsurgery
5. Ethicon Visiting Professorship in Cosmetic Surgery
6. Gen. N.C Sanyal - Armed Forces Professorship
7. Peet Prize for best presentation during Annual
Congress in Award category
8. Kilner Essay Award
9. APSI Junior Best Paper Award at Annual congress.
10. McNeil audio-visual award for best presentation by a
junior plastic surgeon at Annual congress.
11. Kammath Memorial prize for best poster during
Annual congress.
12. N H Antia award for best publication from India.
13. Army Endowment for best report.
14. R. N. Sinha award for best paper Published in IJPS.
Contact for APSI
Dr. Atul Shah, Secretary APSI
20, Om Park, Near Andhra Bank, Stadium Road, Akota,
Baroda. Gujrat 390 020, India
Ph: +919825033832 ; +912652321769
E-mail: secretary.apsi@gmail.com; secretary@apsi.org.in
Website; http://apsi.org.in
Dr Rajeev B. Ahuja
Trustee and Past President of APSI
Issue 7 www.ipras.org IPRAS Journal 73

TPCD
It is an interesting coincidence for me that this article
is written just on the 50th Anniversary of the Turkish
Society of Plastic Surgeons. The society was founded in
1961.
The history of Turkish Plastic Surgery goes back to
the 8th century. German scientists found 64 Turkish
manuscripts, dated 1902 – 1914 years ago, in the
Sincan region of “East Turkistan” (in present-day northwestern
China, where Uygur Turks live). These are
the oldest documents in Turkish and Turkish Plastic
Surgery 1,2 ,written in three different alphabets: the Uygur
version of the Sogd alphabet, the Brahmi alphabet
of Indian root and the Nestori/Suryani alphabet 1,2 .
They are kept in the Brandenburg Academy of Science
in Berlin and consist of mostly traditional medical
documents, dealing with subjects including nasal tumors,
fascial palsy, head and neck tumors, skin lesions, wound
healing and other plastic surgical problems.
All documents were read by Ord. Prof. Reşid Rahmeti
Arat (Gabdul Raşid Rachmati Arat) in Berlin.
Most of the Turkish physicians often used to work on more
than one subject and the languages of the scientific arena
at that time were Arabic and Persian 4 . One of them was
AviCenna 4 (Ibn-i Sina) (980 – 1037) from Harmaysan,
near the Buhara; in his well-known book “Tıp Kanunu”
(Law of the Medicine) he gave details about “Ectropion
and Entropion” and the muscles of the eyelids.
74 IPRAS Journal www.ipras.org Issue 7
History and present situation
of Turkish Plastic Surgery
50th Anniversary of the Turkish Society
of Plastic Surgeons
Prof. Ibrahim Yıldırım MD
Plastic, Reconstructive and
Aesthetic Surgery Department,
Cerrahpaşa Medical Faculty,
İstanbul University, İstanbul Turkey
At the beginning of the 13th century, the first Turkish
Medical Book “Tuhfe-I Mübarizi” was written in Turkish
by Hekim Bereket 8 .
As it is known, the first University was founded in Istanbul
in 1453, just after the conquest of the city by the Ottoman
Turkish Empire. Şerefeddin Efendi of Amasya 3,4,5,6 was
a pioneer in Turkish Plastic Surgery and he published a
superb and beautifully illustrated surgical book, named
“Cerrahiyyetü-l Haniyye 3 in 1465, written in the Turkish
language. He described many different techniques and
he demonstrated these techniques with 140 diagrams
in his two-volume book. Most of the cases were related
to congenital problems and trauma. Additionally,
gynecomastia, hermaphrodism, mandibular subluxation,
and carcinoma of the lip, etc. were also described.
In the 15th century, Mümin bin Mukbil 16 from Sinop,
described techniques for the treatment of diseases and
coloured lesions on the eyelids and orbital region; in
addition, blepharoplasty and special surgical instruments
for these procedures as well.
After the “decline of the Ottoman Empire”, new
understandings and modern establishments brought new
horizons to medicine. The first modern school of medicine 7
was established in 1827 in Istanbul by Sultan Mahmud.
The Second one was a military medical school 9,10 . In order
to be able to relate to the Western World, the teaching
language was converted to French, starting in1839 and,

accordingly, the methodology of teaching was mostly
French. This school was re-organized in 1866 – 1867, and
the linguafranca was converted to the native language; the
school was re-established with a civil section 11 . This was a
very satisfactory situation; at the end of the 19th Century,
there were many very well-trained phyicians.
It is possible to see some plastic surgical articles 17 in
the of “Tıb Cemiyeti Mecmuası” journal (the Medical
Journal) between 1856 and 1906, such as “Tagliocozzi
Procedure for the Repair of the Nose”, “Cleft Lip and
Palate repair”, “Eyelid operations”,“Indian Flap for
Nasal Reconstruction (1858)”, “Partial resection of jaws
(1868)”,“Epidermo-dermal Graft Application (1872),
“Ollier-Thiersch Graft (1885) etc.
The first modern literature in Plastic Surgery apperared
during this period. Dr.Cemil Topuzlu 12 presented 120
plastic surgical cases, among his series of 758 surgical
cases, between 1893 and 1897. He was the first surgeon
in the world to recommend “Z-Plasty” for contractures of
the Achilles tendon 12 and to use sutures to repair arteries.
The period between the two World Wars was an excellent
time for Plastic and Reconstructive Surgery, both at home
and abroad. It is important to mention Dr. Cafer Tayyar
Kankat, Dr. Şerif Korkut and especially Dr. Halit Ziya
Konuralp, who were the pioneers of modern Plastic Surgery
in the country at that time. Dr. Kankat 13,14 performed many
reconstructive and aesthetic operations; the first Turkish
Journal of Plastic Surgery was published by him under the
name of “Modern Cerrahi ve Nöroşirürji (Modern Surgery
and Neurosurgery)” in three sections: General, Neuro- and
Plastic Surgery, between 1936 and 1947.
Dr. Kankat 14 published “The First Penile Reconstruction”,
“Cartilage Grafts for Impotence”, and aesthetic operations
such as “Face Lifting”, “Rhinoplasty” and “Abdominoplasty”
etc., in this journal. Later on, in 1953, he started publishing
the first journal purely for Plastic Surgery under the title
“Plastik, Reparatris ve Estetik Şirürjisi”.
Dr. Konuralp 15,18 performed many reconstructive surgical
techniques, which he had learned from the book by
Kirschner and Nordmann (1927) and published several
papers in surgical journals between 1930 and 1935. Dr.
Konuralp founded the first Plastic Surgical Ward in Turkey
in 1938. It had 49 beds and was under the Department
of General Surgery in Istanbul University Hospital.
The first teaching program in Plastic Surgery was started at
that time. Many very well-known Plastic Surgeons visited
this clinic. They included Maliniac (USA), Rose Tilley
(Canada), John Conley (USA), Heuser (Germany), Milton
Freeman (USA), Griffith (USA), Polzer (USA), McDowell
(USA), Schimitzu (Japan), Organe (UK), Broadbent (USA),
Kilner (UK), Matthews (UK), Longacre (USA) , Skoog
(Sweden), Bardach (Polonya) and others. These individuals
visited at various times. In one occasion, Dr. Kilner invited
Dr. Konuralp to England, where he spent time with Gillies,
McIndoe, Kilner, Mowlem, Matthews, Barron, Osborne,
Peet, Reidy, Dennis Brown and Sedden. His first book
was published in 1952, entitled “Main Priciples in Plastic
Surgery” 2 . He was also one of the eminent Plastic Sur
geons of the fırst IPRS Congress in Stockholm, in 1955.
The second Plastic Surgery center was founded in the
Military Medical Academy 11 in Ankara, in 1943, as “Jaw
Surgery Center”, by Dr. Necdet Albay, but later, in 1958,
it was changed to the “Maxillofacial and Plastic Surgery
Department” by Dr.Cihat Borçbakan 19 . As it has been
mentioned previously, the Turkish Society of Plastic
Surgeons 7 was founded in 1961 in Ankara. The founders
were eight Plastic Surgeons, two general surgeons, and
two ENT Surgeons. The first president was Dr. Konuralp
from Istanbul.
The first National Meeting 18,19 of this society was held in
Ankara and Tord Skoog from Sweden was the honorary guest
and speaker. Afterwards, the first Skoog fellow was sent
to Upsala. The International Association of Maxillofacial
Surgeons was founded in Leipzig and Dr.Konuralp was
founder and elected vice-president in 1970.
Turkish Plastic Surgery Society has organized National
Meetings every two years, and, in 1983, a Symposium
was added to the program. Since 1988, a National
Meeting and Symposium have taken place each year.
Some combined meetings and courses were arranged
together with other countries, such as the Turkish – French
(Istanbul 1980), Turkish – Greek (Athens1988) and
several Aesthetic Surgery courses of ISAPS, as well as Hand
Surgery courses held in different cities of the country.
The Sixth European and the Fifth Asian – Pacific
Congresses were organized by the Turkish Society in
Istanbul in 1989.
Dr. Güler Gürsu from Turkey was the President
of ISAPS between 2000 and 2002 and she was
also the President of the World Congress of
ISAPS, which was held in Istanbul in 2002.
Over the past twenty years, new establishments like the
Turkish Society of Aesthetic Plastic Surgeons, the Society
of Interplast Türkiye, the Society of Hand Surgeons,
the Society of Maxillo facial Surgeons, the Society of
Aesthetic Face and Nasal Surgeons and the Society of
Reconstructive Microsurgeons have become closely
affiliated with the Turkish Society of Plastic Surgeons.
Interplast Türkiye has, so far, offered its services to
nearly 40 countries.
There is a two-step national examination twice a year to enter
the specialty training. The first step is a foreign language
exam, the second part a professional exam, similar to the
USMLE in the USA. This is a fairly competitive exam.
After passing the exam, medical doctors earn the right
to enter to the specialty programme. In Turkey, the total
training time in Plastic Surgery is five years, including
rotational programs in General Surgery, Pediatric Surgery,
ENT, Orthopedics and traumatology, Neurosurgery,
Anaesthesiology, Emergency Medicine and Anatomy.
At the end of the five years residents, must have prepared
a thesis, which is an experimental or a clinical research
study, conducted under the instruction of a tutor. The
candidate must take an examination to earn the specialty
diploma, which consists of three steps:
1. Thesis must be accepted by jury members
2. An oral examination organized by jury members.
3. A practical examination in the operating room with a
Issue 7 www.ipras.org IPRAS Journal 75

andom choice of cases, watched by the jury members.
The jury members are three lecturers from Plastic Surgery
and two lecturers from any other of the close specialties
like ENT, Paediatric Surgery, etc.
The first specialty exam for Plastic, Reconstructive
and Aesthetic Surgery took place in 1965.
Training centers are allowed to conduct this exam on
behalf of the Ministry of Health. Diplomas are awarded
after successful examination. Any specialist with this
diploma is entitled to have a practice, either in one of the
official institutions or in the private sector. The public
still looks at Plastic Surgery as Aesthetic Surgery. That is
why this field is highly popular.
Nowadays, we have 53 training centers all over the country,
in University and State Hospitals. There are around 900
Plastic Surgeons and nearly 300 residents for a 75-million
population. Unfortunately, some Plastic Surgeons are not
members of the Society. There are “Hand Miocrosurgery
Centers” in the large cities, mostly in the private sector and
in University Hospitals.There are “Burn Units” in different
centers, but not enough for the country.
We owe thanks to Cemil Topuzlu, Cafer Tayyar Kankat,
Halit Ziya Konuralp and Cihat Borçbakan who were
the leading Surgeons in the development of the Modern
Turkish Plastic Surgery.
Cemil Topuzlu
1866 – 1958
Halit Ziya Konuralp
1903 –2005
76 IPRAS Journal www.ipras.org Issue 7
Cafer Tayyar Kankat
1895 – 1955
Cihat Borçbakan
1912 – 1991
The distribution of Plastic Surgeons is, unfortunately, not
ideal in the country; they mostly try to stay in big cities.
In our field, the number of the Plastic Surgeons in Turkey
will be another problem in the near future.
References:
1. Arat, Reşid Rahmeti, Ord. Prof. Dr., Berlin Brandenburg
Academy of Science, Hand- written Collection,“Zur Heilkunde
der Uiguren” (SPAW, Phil. Hist. Klasse, 1930 XXIV, Berlin 1930,
page(451-473)
2. Sertkaya Osman Fikri, “Kurzer Überlick Über Die Uigurischen
Medizinischen Texte” Kitap: Festschrift für Arslan Terzioğlu, Prof.
Dr. Ing. Dr. med. habil., zum sechzigsten Geburtstag /sahife: s. s.
125-138
3. Uzel İlter; “Şerefeddin Sabuncuoğlu; Cerrahiyetü-l Haniyye”
Türk Tarih Kurumu Yayınları, III.Dizi-Sa.15,I. cilt, 495 sahife,
II. cilt 98+36 fasıl, 140 minyatür, Ankara 1992
4. Ağırakça. Ahmet; Prof. Dr., “İslam Tıp Tarihi; Başlangıçtan VII./
XIII. Yüzyıla Kadar, 399 sahife; FesanBasımevi, Derya Ciltevi,
İstanbul, 2004
5. McDowell, Frank, MD., Sc.D., “The Source Book of Plastic
Surgery”, Williams and Wilkins Company,Baltimore,1977; 509
pages
6. Horton, Charles E. MD. “Plastic and Reconstructive Surgery
of the Genital Area”, 695 sahife; Little Brown and Company;
Boston, 1973
7. Yıldırım İbrahim; “Plastic Surgical Training in Turkey, History,
present situation and future”, EuropeanJournal of Plastic Surgery
(Springer-Verlag), 16:115-117, 1993
8. Erdağı Binnur; “Anadolu’da Yazılmış İlk Türkçe Tıp Kitabı”,
Türkbilig-Türkoloji Araştırmaları, 2001-2002, sahife: 46-55,
TDV Matbaası, Ankara, Temmuz 2001
9. Terzioğlu Arslan Prof. Dr.; “İstanbul Tıp Fakültesi Tarihçesi 1”,
Türk Dünyası Tarih Kültür Dergisi, İstanbul, Ekim 2010, s: 286,
sahife 24-32
10. Terzioğlu Arslan Prof. Dr.; “İstanbul Tıp Fakültesi Tarihçesi 2”,
Türk Dünyası Tarih Kültür Dergisi, İstanbul, Kasım 2010, s: 287,
sahife 43-5
11. Terzioğlu Arslan, Prof. Dr., “Gülhane’nin Kuruluşunun 110.
Yıld.nümü Anısına, Son Araştırmalar Işığında Gülhane ve Türk
Tıbbının Gelişmesine Katkıları”, Türk Dünyası Tarih Kültür
Dergisi, Ocak 2009, sayı 265, sahife 13-22, İstanbul
12. Topuzlu, Cemil; “80 Yıllık Hatıralarım, (İstibdat-Meşrutiyet-
Cumhuriyet Devirlerinde) ‘Cemil Paşa’nınCerrahî Yayınları’
sahife 248-257, D.rdüncü Baskıya hazırlayan Dr. Cemalettin
Topuzlu, Topuzlu Yayınları, Üniform Matbaacılık, İstanbul 2002
13. Kankat, Cafer Tayyar; “Modern Cerrahî ve N.roşirürji Mecmuası”,
Ekspres Basımevi, Kader Basımevi,İstanbul 1936-1947 yılları
arasında 36 sayı çıkmıştır.
14. Kankat, Cafer Tayyar; “Plâstik, Reperatris ve Estetik Şirürjisi
Kitabı, 33 sahife, Kader Basımevi, İstanbul, 1946
15. Konuralp, Halit Ziya; “Plâstik Cerrahide Esas Prensipler”, 148
sahife, İsmail Akgün Matbaası, İstanbul, 1952
16. Kâhya, Esin; “Onbeşinci Yüzyılda Yaşamış Bir Bilim Adamımız,
Mümin B. Mukbil”, X. Türk Tarih Kongresi, Ankara 22-26 Eylül
1986, Türk Tarih Kurumu Yayınları, IX. Dizi-Sa.10d, V. Cilt,
sahife 2253- 2260, Türk Tarih Kurumu Basımevi, Ankara 1994
17. Sezer, Baha; “Plâstik Cerrahî”, Tıp Dallarındaki İlerlemelerin
Tarihi (Dünyada ve Türkiye’de 1850 yılından sonra), Cerrahpaşa
Tıp Fakültesi Vakfı Yayınları:4, Editör: Prof. Dr. Ekrem Kadri
Unat, sahife:362-372, Gürtaş Matbaası, İstanbul 1988
18. Konuralp, Halit Ziya; Anıları “Personal Communication”, 1990-
2005, İstanbul
19. Cihat Borçbakan’nın kendi sesinden Anıları, “Personal
Communication”, 1986 – 1990, Ankara

The First Meeting
The inaugural meeting of the British Association of Plastic
Surgeons was held at the Royal College of Surgeons of
England on 20 November 1946. It was chaired by Sir
Alfred Webb-Johnson (later Lord Webb-Johnson), who
was then the President of the Royal College of Surgeons
of England.
The next day, the Association’s first President, Sir Harold
Gillies, wrote the very first letter in the name of the
British Association of Plastic Surgeons, to Sir Alfred
Webb-Johnson:
Dear Alfred
I cannot let this opportunity go without putting on
paper the very deep appreciation of your mostly
kindly and helpful intervention last night. Your
handling of the inaugural meeting, your help to me
and to others in the later discussions were superb,
and I can assure you and the Council of the College
that our little association was happily started. We
now also feel that the Royal College is our home
and that the President and his team are our friends.
We trust that we shall be worthy members of this
surgical family.
HDG
BAPS had the objectives of relieving sickness and
protecting and preserving public health by the promotion
and development of Plastic Surgery. The Association
also undertook to advance education in all aspects of
Plastic Surgery.
The need for Plastic Surgery
A history of the British Association of Plastic,
Reconstructive and Aesthetic Surgeons
Previously: The British Association of Plastic Surgeons
A Plastic Surgery Planning Committee chaired by
Professor T Pomfret Kilner, and whose other members
were Sir Harold Gillies, Mr Wilfred Hynes, Mr Archibald
H McIndoe and Mr Rainsford Mowlem, had in fact met
on five previous occasions before the inaugural meeting.
They had found that the specialised war time units,
which were especially equipped for treating injuries of
the face and jaw, burns and soft tissues losses, had given
facilities for treatment and research greatly in advance
of those available in peace time. They also identified
civilian needs, such as some 700 cases of cleft lip and
palate each year, industrial injuries and many patients for
reconstruction and repair after surgery for cancer.
They noted that facilities in London and in the provinces
(Stoke-on-Trent, Manchester and Birmingham) had been
overwhelmed, and that even in November 1946 “the most
recently established centre at Sheffield, with 40 beds, had
only been open for five months, but already had a waiting
list of 70 cases and is compelled to refuse admission to
deserving cases from surrounding towns”.
The Committee was of the opinion that Plastic Surgery
units should be based in general teaching hospitals and
that they would function best in association with other
departments, but retain their own individuality, with
dedicated wards, operating theatres and offices, and
wherever possible they should also support research.
The First Presidents
The inaugural committee had faced a difficulty as to
who to put forward as the first President of the British
Association. The two main contenders were Sir Harold
Gillies, and Professor Kilner, (who was the holder of the
only chair in Plastic Surgery in the United Kingdom). The
initial committee vote split, half for Professor Kilner and
half for Sir Harold. A compromise solution of having two
presidents was rejected by both, and Archibald McIndoe
was definite in his advice that Sir Harold Gillies should
be put forward, and this prevailed.
Sir Harold was President from 1946-47, Professor Kilner
followed in 1947-48 (and was elected President again in
1955), and they were succeeded in 1949 by Archibald
McIndoe.
Harold Delf Gillies
Harold Gillies was born in New Zealand in 1882, the
youngest of eight children. His father died when he was
4 and he was sent to boarding school in England at the
age of 8. Four years later he returned to school in New
Zealand, and in 1901 came back to Gonville and Caius
College, Cambridge. He played the violin, developed
a love of fly-fishing, he rode and played golf (reaching
the semi-finals of the amateur golf championship at St
Andrews).
He graduated from St Bartholomew’s Hospital, London,
becoming a Fellow of the Royal College of Surgeons in
1910 and he became assistant to Sir Milsom Rees, the
senior ENT surgeon at St Bartholomew’s. When war
broke out in 1914, Gillies, then 32, volunteered to serve
with the Red Cross and was sent to France as a General
Surgeon in 1915. He was closely associated with Charles
Auguste Valadier and Varaztad H Kazanjian, who
Issue 7 www.ipras.org IPRAS Journal 77

stimulated his interested in maxillofacial injuries. He
visited Hippolyte Morestin at the Val-de-Grâce military
hospital in Paris and after watching him operate he wrote
“this was the one job in the world I wanted to do”.
Gillies transferred to the Royal Army Medical Corps
and with the backing of Sir William Arbuthnot-Lane, set
up a special unit at the Cambridge Military Hospital in
Aldershot, in 1916. From the Battle of the Somme (July
1916) 2000 casualties were referred. There were only
200 beds and the facilities were overwhelmed.
The Queen’s Hospital in Sidcup was established, with
an additional 200 beds and when the old hospital was
eventually knocked down many years later, a plaque was
placed in the entrance of the new Queen Mary’s Hospital,
Sidcup, to commemorate “Harold Delf Gillies, CBE,
FRCS 1882-1960, whose work at this hospital attracted
worldwide recognition and led to the foundation of Plastic
Surgery in Great Britain”.
BAPS Between the wars
After peace was declared in November 1918, American,
Canadian, Australian and New Zealand surgeons returned
to their home countries to develop Plastic Surgery and to
establish new units.
Most of England was covered by four Plastic Surgeons
in the 1930’s – Gillies, Kilner, McIndoe and Mowlem.
In 1936, Richard Battle was told “there are four Plastic
Surgeons in the country and there is no room for any
more”, but fortunately he was not put off. The only
other surgeon in formal Plastic Surgery training at that
time was David Matthews, later joined by Eric Peet and
J P Reidy.
The Royal Air Force was to recognise the importance
of the new specialty of Plastic Surgery, setting up
Plastic, Maxillofacial and Burns centres, including East
Grinstead and Halton. At the Queen Victoria Hospital,
East Grinstead, the Guinea Pig club was founded by
surviving burnt RAF crew members. The Royal Navy
and the Army also developed Plastic Surgery facilities.
From 1939, the period of the “phoney war” mass casualties
that had initially been expected did not materialise, but
the specialty developed by accepting civilian casualties
resulting from the blackouts, which increased the road
and domestic accident rate, and from those injured in
factories, which were depending on unskilled labour to
develop munitions (for example, women whose long hair
was caught in conveyor belts causing scalping injuries).
The British Association of Plastic Surgeons stimulated
the development of the specialty in many countries
around the world. At the outbreak of the Second World
War, medical officers from Australia, Canada, India,
Ireland, New Zealand and South Africa were allocated
to the four newly established Plastic Surgery units in the
United Kingdom for training.
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The Second World War and afterwards
On December 7, 1941 the Japanese bombed Pearl Harbour
and the next year large numbers of American forces began
to appear in Britain, together with their surgical hospitals
and field units. They brought with them specialised
Maxillofacial and Plastic Surgery teams, including pioneers
such as Aufricht, Converse, Ivy, Kazanjian and Webster.
The friendly co-operation during that time led to strong
trans-Atlantic friendships, including the collaboration of
Ralph Millard of Miami with Sir Harold Gillies, with whom
he became co-author of “The Principles and Art of Plastic
Surgery” (1957) being awarded an honorary FRCS(Ed).
After the end of the war, Loenneken (Oslo), Olsen
(Copenhagen), Ragnell (Stockholm), and Schjelderup
(Bergen) were amongst those who came to Britain to
train in the new specialty of Plastic Surgery, encouraged
by the inauguration of the Association in 1946 and of the
British Journal of Plastic Surgery in 1948.
Distinguished Visitors to Britain
Many pioneers of Plastic Surgery in Europe came to train
in Britain, including:
Holland: C Koch, C Honig
Belgium: J Polus, A de Coninck
France: D Morel-Fatio, C Dufourmentel,
R Tubiana
Spain: B Vilar-Sancho, J Planas, L Mir y Mir,
P Gabarro
Portugal: J Conde, A M Fernandes
Italy: S Rosselli, S Teich-Alasia, G Dogo
Austria: R Trauner, P Wilflingseder
Switzerland: H U Buff, H L Obwegeser
Yugoslavia: V Arneri, I Cupar, H Klemencic,
M Derganc, F Zdravic
Czechoslovakia: F Burian, S Demjen
Poland: J Szlazak
Denmark: P Fogh-Andersen
Sweden: T Skoog, B Johanson
International Meetings in Plastic Surgery
Surgeons from France, American and Britain, who had
been engaged in treating the wounded of the First World
War, attended a meeting held in Paris in June 1925.
Meetings were then held in Brussels in 1936 (“Le Premier
Congrès de Chirurgie Structive”) and this was followed
by the “Second European Congress of Structive Surgery”
in London, in October 1937. An international meeting

was planned under the presidency of Professor Sanvenero
Rosselli in Milan, in September 1938 and this had to be
abandoned midway, because of the Munich crisis. Dr Tord
Skoog was the Organising Secretary of the Scandinavian
Association of Plastic Surgeons International Congress,
which was held in Stockholm in August 1955, under the
presidency of Professor Erik Aschan of Finland, with Sir
Harold Gillies as its Honorary President.
The London International Congress was held at the
Royal College of Surgeons of England, on July 13th,
1959, under Mr Rainsford Mowlem, President of the
British Association of Plastic Surgeons and Professor
T P Kilner, Vice-President of the Association and of the
Congress. Appointed delegates of 29 national societies
of Plastic Surgery attended, each seated below their
national flag and receiving an address from His Royal
Highness, Prince Philip, Duke of Edinburgh, who had
consented to being the Patron of the Congress (and who
in November 1964 agreed to become the first patron of
the British Association of Plastic Surgeons), a role which
he continues to the present day.
BAPS Becomes BAPRAS
In 2004 the majority of the members of the British
Association of Plastic Surgeons (BAPS) voted to change
the name of the Association to the British Association
of Plastic, Reconstructive and Aesthetic Surgeons
(BAPRAS), in line with many European associations of
Plastic Surgery. http://www.bapras.org.uk
The Association’s new look and name came into being in
July 2006. This was associated with a change of brandidentity,
moving from the previous heraldic crest to a
new, contemporary logo, retaining one of the key motifs,
the salamander.
The salamander possesses natural powers of regeneration
and is able to restore lost or damaged tissue or limbs. In
mythology, the salamander was believed to be capable
of withstanding fire and was often depicted walking
unharmed through flames. Thus, this simple amphibian
is an enduring symbol of reconstruction, protection and
repair. Over the years, the salamander has also been
valuable in scientific research and this new emblem
provided a vital link with history as, moving forward
BAPS became BAPRAS and a new era began.
The British Association of Plastic, Reconstructive
and Aesthetic Surgeons is now “the voice of Plastic
Surgery” in the UK, advancing education in all aspects
of the specialty and promoting contemporary practice.
BAPRAS sees its role as increasing understanding of the
scope of the specialty of Plastic Surgery. It aims to raise
the profile of Plastic Surgeons, who are a crucial element
of surgical care teams which provide specialist care to
patients over a wide range of conditions. Continuing
the core objective of advancing education, BAPRAS
is always looking to promote innovation within the
speciality of Plastic Surgery.
The President in 2011, Tim Goodacre, set out ways in
which the Association looks to develop: enhancing its
research profile; increasing its presence in the regions
in support of its members; and collating accurate data
relating to the numbers of Plastic Surgeons, the focus of
their work and the impact created.
Members and Plastic Surgery Units
There are currently Plastic Surgery units in 56 centres
in the United Kingdom and 6 units in the Republic of
Ireland. Plastic Surgery clinics, however, are held in
many other hospitals throughout the country, each one
linked to a regional unit. There are 892 members of
the Association including honorary members, senior
members, full members, trainee and junior members, and
other categories of associated and overseas members.
Current Meetings, Courses, and Research
The Association, together with the Royal Colleges,
has appointed Plastic Surgery and Cosmetic Surgery
tutors. Each year, BAPRAS holds two 3- day Scientific
Meetings, and two 2-day Advanced Courses, covering the
spectrum of Plastic Surgery, which are open to colleagues
from the UK and abroad. In addition, there are two 1-
day meetings for medical students interested in Plastic
Surgery, and a 1-day breast care nurses’ course. There is
an active Education and Research subcommittee.
The Next BAPRAS instructional Course will be held
in Manchester on 18th and 19th April, 2012. Delivered
by renowned international experts, this course is aimed
at specialist trainees and established surgeons in Plastic
Surgery, breast oncology, and applied disciplines from
the UK and the wider international community and will
cover the latest innovations and techniques.
Examinations and Assessment
Members of BAPRAS have also been heavily involved
in mainstream teaching, training, and examinations. The
Intercollegiate Board in Plastic Surgery brings together the
four Royal Colleges and the examination structure, which
started with the FRCS (Plastic Surgery) in 1986 at the
instigation of Mr Ian McGregor, which includes written, oral
and clinical examinations. The FRCS (Plast) examination
is held in different centres throughout the UK.
The evolving structure of the Intercollegiate Examination
has helped to shape the course of other examinations
abroad, including those of the European Board, first held
in Brussels in 1994 under the encouragement of Mr Magdy
Saad, then President-Elect of BAPS, and Professor John
Ioannovich of Athens. The EBOPRAS European Board
Examination in Plastic Surgery currently has a British
Chairman, Mr John Boorman FRCS.
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BAPRAS and the Developing World
British Plastic Surgery has a long tradition of links with
the developing world. Through its Overseas Service and
Training Committee, BAPRAS continues to offer support
to developing countries, recognising the importance of
Reconstructive Plastic Surgery in the treatment of injury
and disease and helping to develop Plastic Surgery skills
in these environments.
BAPRAS is keen to provide sustained and effective help to
colleagues abroad. Some UK Plastic Surgery units already
have twinning arrangements with overseas hospitals and
departments and more links can be set up through the
BAPRAS Overseas Service and Training Subcommittee.
BAPRAS also has links with non-governmental
organisations, as well as the UK government, to provide
acute help, for example following natural disasters abroad,
such as earthquakes. Overseas activities include:
• Funding short visits for Surgeons to learn new
techniques in the UK
• Supporting Surgeons in countries as diverse as
Bangladesh, Ghana, India, Nepal, Pakistan, Sri Lanka
and Uganda
• Enabling BAPRAS members to visit many of these
countries to participate in meetings and to work in
collaboration with overseas colleagues
• Conducting teaching and training and workshops in
countries with limited plastic surgical infrastructure.
The Journal of Plastic, Reconstructive
and Aesthetic Surgery
An early proposal, after the foundation of the Association
in 1946, was to start a regular scientific communication on
Plastic Surgery and the British Journal of Plastic Surgery
was launched in March 1948, under the editorship of Mr
A B Wallace.
Lectures
THE GILLIES LECTURE
In 1961 the Council of the British Association of Plastic
Surgeons instituted the Gillies Lecture as a memorial
to Sir Harold Gillies. Distinguished Plastic Surgeons
from within the UK and abroad, are invited to lecture
to the Association and receive the Medal. The most
recent Gillies Lecture was given at the BAPRAS
Winter Scientific Meeting in December 2011 by Dr Sam
Noordhoff, a world leader in the field of cleft lip and
palate and Craniofacial Surgery, who practised for over
40 years in Taiwan and was instrumental in establishing
several hospitals and Plastic Surgery Departments in
Taipei, which have an international reputation.
80 IPRAS Journal www.ipras.org Issue 7
THE McINDOE LECTURE
In 1962, the Royal College of Surgeons of England
received a donation from the Royal Air Forces Association
which was to cover a Lectureship, awarded by the Council
of the College, on the recommendation of the President of
the College and the President and Honorary Secretary of
the BAPRAS, devoted to Plastic Surgery or another allied
subject, in the name of Sir Archibald McIndoe, the Third
President of the British Association of Plastic Surgeons.
HUNTERIAN LECTURES
Many Plastic Surgeons, and members of the Association,
have been awarded Hunterian Professorships by the Royal
College of Surgeons, at the invitation of the Council. The
most recent Hunterian lecture was given at the BAPRAS
Winter Scientific Meeting in December 2011 by Mr M
Schaverien whose ground-breaking work in the UK,
Australia and the USA was the basis of his lecture on “The
use of three-dimensional imaging for the investigation
of the microvascular arterial and venous anatomies and
perfusion of surgical flaps and the integument”.
The Organisation of BAPRAS
The Officers of BAPRAS are its President, Vice-
President, Honorary Secretary and Honorary Treasurer.
The other elected members of Council and the officers
are the Trustees of the Association and there has been a
strong move recently towards regional representation on
the Council.
A number of other colleagues are invited to attend
BAPRAS Council meetings, including the President
of the Irish Association of Plastic Surgeons, a patient
liaison representative, the editor of JPRAS, the Chairman
of the Overseas Service and Training Committee, the
Chairman of the Professional Standards Committee, the
Communications Officer, the chairman of the Specialist
Advisory Committee in Plastic Surgery, the President of
the British Association of Aesthetic Plastic Surgeons, and
the Chairman of the Education and Research Committee.
From 2012 the presidency will be extended to a two year
term of office. Recent Presidents:
• Mr Timothy Goodacre (Oxford) 2011
• Mr Richard Milner (Newcastle) 2012
• Mr Graeme Perks (Nottingham) 2013/2014
European and International
Representation
BAPRAS is proud to be represented on the European
Board of Plastic, Reconstructive and Aesthetic Surgery,
and the Union Européenne des Médecins Spécialistes.
BAPRAS is represented on the International Confederation
for Plastic, Reconstructive and Aesthetic Surgery by its
President.

ESPRAS, Edinburgh, 2014
BAPRAS is pleased to be able to host the 12th Quadrennial
meeting of ESPRAS in Edinburgh, in 2014. Earlier this
year, Mr Tim Goodacre, President of BAPRAS in 2011,
issued a warm invitation to colleagues throughout the
world to join their BAPRAS colleagues in Scotland in the
summer of 2014.
A.B. Wallace, M.C. Oldfield, W. Hynes, J.S. Tough
R.Mowlem, J.N. Barron, Prof. T.P. Kilner, R.P. Osbourne, Sir Harold Gillies
Given by I.A. McGregor
Sir Harold Gillies in uniform and when kligthed
Given by Lady Gillies
(from “The History of the British Association of Plastic Surgeons
THE FIRST FORTY YEARS” Churchill Livingstone 1987, and
other sources)
Chris Khoo
Previous President, BAPRAS
Member, Executive Committee of the European Board,
IPRAS Regional Representative
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Çistory of Plastic Surgery in the Republic of Armenia
The history of Plastic Surgery in the Republic of Armenia
begins in 1982. Since 1982, the “Initiative Group”, a
team of young surgeons, started experimental operations.
They derived from the ranks of a microsurgery fellowship
in Moscow. They worked in the Armenian branch of
the All-Union Scientific Center of Surgery. The first
successful clinical operation, was the replantation of
thumb in 1984.
In 1984 a division of microsurgery in the Armenian
branch of the All-Union Scientific Center of Surgery
was created by the initiative group. The first operations
were muscle, tendon, vessel and nerve reconstructions of
extremities.
In 1985 the first department of Microsurgery was
created and headed by Artavazd Sahakyan. Later in
1992, a second department, the Center of Plastic and
Reconstructive Surgery was organized and headed
by Gagik Stamboltsyan. All surgeons of the second
department completed their specialization period in Yale
University.
Since 1990 many aesthetic operations take place in the
Republic of Armenia.
In 1996 in Yerevan State Medical University and
National Health Institute, two new departments of
Plastic Surgery were organized. They also manage a
postgraduate education program. After graduating from
a 4 year residency in one of these departments you can
get a Plastic Surgeon’s diploma.
Armenian Association
of Plastic Reconstructive
and Aesthetic Surgeons
(ÁÁPRAS)
The Armenian Association of Plastic Reconstructive and
Aesthetic Surgeons (AAPRAS) was founded in 2005 by
the main Committee (The First RPesident was Armen
Hovhannisyan). The greatest part of the Armenian Plastic
Surgeons have decided to create this Society, giving
priority to issues like:
- coordination of the surgeons’ practical
and scientific work,
- promotion of postgraduate education,
- unification of educational programs,
- organization of International Congresses.
During the last period the Association organized four
International Congresses, the last of which took place
under the endorsement of IPRAS and ESPRAS. Our
Association is in close relationship with the Russian and
Georgian Societies. Our relationship with IPRAS and
ESPRAS is very productive and highly influential to our
young Plastic Surgeons’ education and training in famous
European clinics.
Nowadays, many Member Surgeons of our Association
work in aesthetic and reconstructive Surgery Units
worldwide.
In 2013 we are planning an International Multidisciplinary
Congress on Antiaging Medicine and we invite all our
colleagues to participate in it.
Dr. Armen Hovhannisyan
President of AAPRAS
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84 IPRAS Journal www.ipras.org Issue 7
World Health Organization
Dear colleagues,
WHO Patient Safety is pleased to share with you the results of the Latin American Study
of Adverse Events (IBEAS): on a given day, 1 in 10 patients admitted to the participating
hospitals were suffering from, or undergoing treatment for, a health care -related adverse
event. The risk of suffering adverse events doubled if the entire hospital stay was considered.
This evidence is a reflection of the reality of many other hospitals in transitional countries
across the globe and it highlights the importance of addressing patient safety globally.
The result of a collaborative effort between the governments of Argentina, Colombia,
Costa Rica, Mexico and Peru, as well as the Spanish Agency for Quality of the Ministry
of Health, Social Policy and Equality, the Pan-American Health Organization and WHO
Patient Safety, the IBEAS study is the first large scale study of this kind in Latin America.
For more information, click here
http://www.who.int/patientsafety/research/country_studies/en/index.html
To download the study results in English, click here
http://www.who.int/patientsafety/research/ibeas_report_en.pdf
To download the study results in Spanish, click here
http://www.who.int/patientsafety/research/ibeas_report_es.pdf
The WHO Patient Safety team

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Dear colleagues,
The IPRAS International Committee for Quality Assurance and Medical Devices in Plastic
Surgery (IQUAM) celebrates the 20-year anniversary from its foundation, in 1992. This
celebration will take place during the 10th Congress and Consensus Conference to be held
in Athens on Nov 1st – 4th, 2012.
The organization was founded as EQUAM by a group of Plastic Surgeons from various
European, Central and South American, African, Southeast Asian and Middle-Eastern
countries. Representatives participating in meetings are Plastic Surgeons, scientists,
manufacturers and delegates from governmental bodies involved in the development and
surveillance of advanced technologies, devices and techniques in the field of Plastic Surgery.
Consensus Conferences are held biennially. At the close of meetings, a Position Statement
is drawn up, summarizing the conclusions of the meeting. This statement is presented to the
health ministry and Plastic Surgery society of each member country, the industry and any
other interested party. Over the years, these statements acquired an important significance
in the practice of the Specialty and proved helpful for all.
No doubt, this type of meeting is unique in its purpose and, besides clinical practice, it also
focuses on evaluating technology and methodology. Among others, topics like Fat Grafting,
Stem cells and Growth Factors will be addressed, as well as results from recent and older
procedures like breast augmentation and ALCL, quality of silicone implants, injectable
fillers, Botulinum toxin A, suturing materials, wound dressings, medical equipment,
instruments, LASER apparatuses and so many others. The recent issue regarding PIP,
which alarmed Plastic Surgeons and the public worldwide, will be particularly discussed
in detail.
Besides science, a rich social program is planned, including a guided evening tour at the
illuminated Acropolis. Most of all please be assured that the organizing committee shall
spare no effort in putting together a successful congress.
108 IPRAS Journal www.ipras.org Issue 7
A cordial invitation to all,
C. Neuhann-Lorenz
IQUAM President
Jan Poëll
Congress President
Daniel Marchac
Chair Organizing Co.
Andreas Yiacoumettis
Chair Scientific Co.

For the FIRST time…
The 1st IPRAS
INTERNATIONAL TRAINEES’
MEETING
will take place in Athens on November 1st, 2012.
This meeting will make history as the first of its kind in the world. It is expected that
Trainees from many countries will participate, as well as representatives from Trainees’
organizations.
The program will include the following:
1. Scientific Presentations
2. Training and accreditation
3. International co-operation
4. Official participation of trainees in IPRAS
The Faculty of this meeting will include respected and well known teachers, Heads of
training programs, Trainees and members from the IPRAS leadership.
More information will soon be uploaded on the IPRAS website www.ipras.org
Issue 7 www.ipras.org IPRAS Journal 109

SUPPORT LETTER FROM BOARD OF TRUSTEES MEMBER
Dear colleagues and friends of IPRAS,
I have always been certain that the only way forward is to have our eyes looking to the
future, confident that plastic surgery will carry on thriving, absorbing new technologies and
techniques. I have accompanied our society since its first steps, and I am glad to see visions
transformed to reality! It has been my hope that IPRAS and its national societies will
continue to be the forums where innovation will be presented, where the inquisitive mind
will find others equally curious, so that plastic surgery may evolve within the framework of
two principal objectives: to generously pass on knowledge to the next generation, and to
assure safety to our patients.
I am particularly happy that the upcoming IPRAS World Congress is to be held in beautiful
Chile, in our continent of South America, where plastic surgery has made giant steps of
development. I invite you all to add this important event to your plans for 2013 and to take
advantage of the opportunity to attend one of the most important scientific gatherings for
plastic surgery.
110 IPRAS Journal www.ipras.org Issue 7
Ivo PITANGUY
Head-Professor of the Plastic Surgery Departments of the Pontifical Catholic University
of Rio de Janeiro and the Carlos Chagas Institute of Post-Graduate Medical Studies
Member (and patron) of the Brazilian Society of Plastic Surgery, the National Academy
of Medicine, and the Brazilian Academy of Letters
Visiting Professor, I.S.A.P.S. FICS, FACS

NATIONAL & CO-OPTED SOCIETIES’ FUTURE EVENTS
17 - 19 February 2012
17th Annual Pakistan Association Of Plastic Surgeon Meeting
Location: Bahawalpur, Pakistan - Venue: Quaid-e-Azam Medical College - Contact: Dr M. Mughese Amin
E-mail: mughese@yahoo.com - URL: http://www.papscon2012.com
06 - 11 March 2012
XLIII National Congress of Plastic, Aesthetic and Reconstructive Surgery
Location: Merida, Yucatan, Mexico - Venue: Convention Center Merida
URL: http://www.cirugiaplastuca.org.mx
09 - 11 March 2012
1st Congress of the International Society of Plastic Regenerative Surgery (ISPRES)
Location: Rome, Italy - Venue: Hotel Columbus - Contact: Chrysa Kontololi
Telephone: +30 2111001783 - Fax: +30 2106642116
E-mail: chrysa.kontololi@zita-congress.gr - URL: http://www.ispresrome2012.com
11 - 14 March 2012
16th ASEAN Congress of Plastic Surgery
Location: Boracay Island, Aklan, Philippines - Venue: Boracay Regency Beach Resort & Convention Center
URL: http://www.papras.org/
17- 20 April 2012
42º Argentine Congress of Plastic Surgery
Location: Buenos Aires, Argentina - Venue: Sheraton Hotel - Telephone: (54) 114811-9103
E-mail: info@42congresoargentino.com - URL: http://www.42congresoargentino.com
03 - 05 May 2012
3rd Central Asian Plastic Surgery Conference
Location: Tashkent, Uzbekistan - Contact: George Koliopoulos
E-mail: george.koliopoulos@zita-congress.gr - URL: http://www.caps2012.com/
15 - 18 May 2012
11th SRBPRAS Congress
Location: Belgrade, Serbia - Venue: HYATT Regency Belgrade
E-mail: info@srbpras.rs - URL: http://www.srbpras2012.org
18 – 20 May 2012
Controversies, Art and Technology in Breast and Bodycontouring Aesthetic Surgery, CATBBAS I
Location: Ghen, Belgium - URL: www.coupureseminars.com - E-mail: seminars@coupurecentrum.be
22 - 26 May 2012
XIX International Meeting of FILACP
Location: Medellín (Colombia) - URL: http://www.filacp2012.com
29 - 31 May 2012
3rd European Congress on preventive, Regenerative & Aesthetic Medicine (ECOPRAM)
Location: Istanbul, Turkey - Venue: Harbyie Military Museum - Contact: Chrysa Kontololi
Telephone: +302111001783 - Fax: +302106642116
E-mail: chrysa.kontololi@zita-congress.gr - URL: http://www.ecopram2012.com/

NATIONAL & CO-OPTED SOCIETIES’ FUTURE EVENTS
05 - 07 June 2012
17th Meeting of the Euro-Mediterranean Council
for Burns and Fire Disasters (MBC) & 25th Anniversary Commemorative Meeting
Location: Palermo, Italy - Contact: Prof. Bishara Athiyeh - E-mail: batiyeh@terra.net.lb
16 - 17 June 2012
1st Seoul Rhinoplasty Forum
Location: Seoul, Korea - Venue: Seoul St. Mary’s Hospital
E-mail: psyskim@gmail.com - URL: http://www.srf2012.or.kr/conference/1st_html/
11-12 September 2012
The XIIth Congress of the Romanian Association of Plastic Surgeons with Participation of
Hungarian Association of Plastic, Reconstructive and Aesthetic Surgery
Location: Sinaia, Romania - Contact: Lefteris Aivaliotis - E-mail: e.ai@zita-congress.gr
12 – 15 September 2012
LaserInnsbruck 2012
Location: Innsbruck, Austria - Venue: Faculty of Catholic Theology of the University of Innsbruck
Contact: Chrysa Kontololi
E-mail: congress@laserinnsbruck.com - URL: http://laserinnsbruck.com/
13 - 15 September 2012
43. Jahrestagung der DGPRÄC / 17. Jahrestagung der VDÄPC
Location: Bremen, Germany - URL: http://www.dgpraec2012.de
10 - 13 October 2012
2nd World Congress of Plastic Surgeons of Lebanese Descent
Location: Cancun, Mexico - Venue: Convention Center Cancun
URL: http://www.congressmexico.com/LSPRAS2012
26 – 30 October 2012
Plastic Surgery THE MEETING
Location: New Orleans, USA - E-mail: registration@plasticsurgery.org
URL: http://www.plasticsurgerythemeeting.com/
1st November 2012
The 1st IPRAS International Trainees’ Meeting
Location: Athens, Greece - Venue: Royal Olympic Hotel
Contact: Mr Nikos Antonopoulos - E-mail: n.an@zita-congress.gr
01 - 04 November 2012
10th IQUAM CONSENSUS CONFERENCE
Location: Athens, Greece - Venue: Royal Olympic Hotel - Contact: Nikos Antonopoulos
Telephone: +302111001782 - Fax: +302106642116
E-mail: nikos.antonopoulos@zita-congress.gr - URL: www.iquam2012.com
14 – 18 November 2013
49th Brazilian Congress of Plastic Surgery
Location: Porto Alegre - URL: http://www.cirurgiaplastica.org.br/

JOIN YOUR COLLEAGUES
The first website that gives you the opportunity
to upload your scientific profile for free!!
www.ipras.org
116 IPRAS Journal www.ipras.org Issue 7
I P R A S W E B S I T E
Now it is very simple to upload your scientific
profile and gain the benefits of being under the
IPRAS umbrella.
Try it…!!
Sign up on www.ipras.org 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 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.
In conclusion, I want to emphasize the usefulness
of the IPRAS website FORUM. A section you
will gain access to, as soon as your profile has
been accepted and uploaded. Only verified
plastic surgeons can use it and read its contents.
Therefore, you will have the opportunity to
exchange ideas, news regarding plastic surgery
techniques, news from your National Association,
alerts and all other information you would like to
share with your peers.
Don’t miss the opportunity to make the IPRAS
website twice as useful to you!
If you face any difficulties please do not hesitate
to contact me at: maria.petsa@iprasmanagement.
com .
Always at your disposal!
Maria Petsa
IPRAS Assistant Executive Director

e-Stetix 3D
2011 has been the result of several important achievements,
among them:
- e-Stetix 3D progressed through versions 1 to 5, with a long
list of improvements and new functionalities. All updates
were provided for free to registered users, and the service
was continuously updated with the latest technology
following users’ feedback.
- e-Stetix was selected by IBM for its “Smarter Planet”
Some new developments available in version 5.2: complete set
of linear and surface measurements, 3D planning for implant
positioning and nipple orientation, and much more.
program due to its innovative cloud computing approach.
- A 24/7 support desk was implemented, to train and support
every e-Stetix user whenever necessary.
- A second research & development project was commissioned
by the Swiss National Fund of Research - CTI (Commission
of Innovation and Technology) in Switzerland, due to the
value e-Stetix unique technology brings to the field of plastic
surgery.
- e-Stetix reached the milestone of more than 1,500 active
users in more than 70 countries (see map below).
- The launch of its consumer website www.sublimma.com,
which today is already generating more than 30 enquiries
per day in 10 different languages from people interested in
plastic surgery with certified surgeons.
- Endorsements by the International confederation of Plastic
Reconstructive Aesthetic Surgery (IPRAS) and the Sociedad
Española de Cirugía Plástica Reconstructiva y Estética
(SECPRE). Both organizations support and share the same
objective as Crisalix; increasing patient satisfaction by
I N D U S T R Y N E W S
Crisalix 3D simulations are now used
in more than 70 countries
“Special offer for all IPRAS members and readers.
See end of the article for more details.”
answering the most common question from patients.
Dr. Serge Lê Huu (LaClinic, Montreux) has been using e-Stetix
since its first commercial release and recently announced that
in only 18 months, e-Stetix had contributed to increasing his
conversion rate from 57% to over 92%.
Aside from generating these impressive results, Dr Lê Huu also
noted that e-Stetix has been invaluable in optimizing the relationship
with patients, through educating them about their bodies, helping
them to select the desired implants, and helping to understand and
manage the patients’ expectations and aspirations.
SHOWCASE – Serge Lê Huu – Switzerland
“e-Stetix for Patient Education“
Dr Lê Huu specifically refers to using e-Stetix in order to
highlight asymmetries and distance between the breasts, as
well as to show how implant shapes and volumes can produce
varying results on different patients’ bodies. He maintains
that having this discussion prior to surgery has significantly
minimized potential disappointment, and even surgery
revisions, to the extent that he has not encountered a single
unsatisfied patient during these 18 months.
IPRAS members and readers have a special 10% discount
on e-Stetix annual subscriptions until March 15th 2011. To
benefit from this offer, please visit http://www.crisalix.com/en/
pricing and proceed to “sign up”. Use the following code in the
“Promotional Code” field: 41f282e1d8
Crisalix
PSE-A
1015 Lausanne
Switzerland
info@crisalix.com
Issue 7 www.ipras.org IPRAS Journal 117

I P R A S P A S T G E N E R A L S E C R E T A R I E S
Tord Skoog
(Sweden)
1955 - 1959
John Watson
(U.K.)
1971 - 1975
118 IPRAS Journal www.ipras.org Issue 7
David N. Matthews
(U.K.)
1959 - 1963
Roger Mouly
(France)
1975 - 1983
James G. Hoehn
(USA)
1999 - 2006
Thomas Ray Broadbent
(USA)
1963 - 1967
Jean-Paul Bossé"
(Canada)
1983 - 1992
Marita Eisemann-Klein
(Germany)
2006 - 2011
William M. Manchester
(N. Zealand)
1967 - 1971
Ulrich T. Hinderer
(Spain)
1992 - 1999

International Confederation
for Plastic Reconstuctive
and Aesthetic Surgery
IPRAS BENEFITS
FOR INDIVIDUAL MEMBERS
• 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 though the IPRAS website and
its FORUM section
• Certificate for Individual Members to
display their IPRAS Membership
• Regular updates on necessary information
and the 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
International Confederation
for Plastic Reconstuctive
and Aesthetic Surgery
IPRAS BENEFITS
FOR NATIONAL ASSOCIATIONS
• 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 events
through the official IPRAS management
office
• Promotion of local or regional news and
a Historical Account for the Association
through the IPRAS Journal
• Free shipment of copies and electronic
receipt of the IPRAS Journal
• Immediate information and advice 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
• Promotion of Patient Safety and Quality
Management (in cooperation with the
World Health Organization - WHO)
• Information regarding harmonization of
training
• Information regarding accreditation of
Plastic Surgery Units
• Protection of the Specialty and Promotion
of its image world-wide
• Information and reports about events
organized by other National Societies and
IPRAS

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: www.ipras.org • E-mail: zita@iprasmanagement.com
Executive Director: Zacharias Kaplanidis
E-mail: zacharias.kaplanidis@iprasmanagement.com
Assistant Executive Director: Maria Petsa
E-mail: maria.petsa@iprasmanagement.com
Accounting Director: George Panagiotou
E-mail: george.panagiotou@zita-congress.gr
Associations Management Director: Dimitris Synodinos
E-mail: dimitris.synodinos@zita-congress.gr
Commercial Director: Gerasimos Kouloumpis
E-mail: gerasimos.kouloumpis@zita-congress.gr
Next issue: April 2012
IPRAS Journal Management
Editor: IPRAS
Editor-in-Chief: Thomas Biggs, MD
Editorial Board: Marita Eisenmann - Klein, MD
Andreas Yiacoumettis, MD
Christian Echinard, MD
Constance Neuhann-Lorenz, MD
Zacharias Kaplanidis, Economist
Page Layout: Ioannis Karanasis
E-mail: jokaran@otenet.gr
Post Editing: Athena Spanou, MD
Photographer: Julian Klein
DISCLAIMER:
7th Issue January 2012
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.