Innovations in plastic surgery

21st March 2012


I think that the media interest in breast implants, with the current controversy regarding the French PIP implants, will focus increased attention on alternative methods of breast augmentation and reconstruction, particularly lipofilling. There will be increased efforts to refine and streamline these techniques to make them realistic alternatives to current prosthetic implants.

Elsewhere, collagenase injections for the treatment of dupuytren's contractures [a fixed flexion contracture of the hand] has highlighted the pharmaceutical approaches to some surgical diseases. The care that must be taken to ensure the correct location of the injection, requires detailed anatomical and surgical knowledge, ensuring that this pharmaceutical approach still requires a specialist interventional perspective. I think collagenase will find other uses over the course of 2012 in the management of other fibrotic conditions, including plantar fibromatoses and peyronie's disease.  

Other hand innovations that are likely to be news in 2012, include further progress in hand transplants and perhaps indeed in other composite tissue transplantation.  Professor Simon Kay is leading a team hoping to progress hand transplantation in the United Kingdom and is currently seeking potential patients. Other composite tissue transplants may also come to the public's attention during 2012.  

The above three examples are also good examples of how research translates into clinical developments.  As such, I think it is essential that research is encouraged and I would like to see how further translational research can clinically benefit plastic surgery in the coming year.  These research developments should add to the continuous surgical innovation that occurs, even at a minor level, on a daily basis amongst plastic surgeons.

I think that, luckily, plastic surgery is not hugely dependent on expensive technology, instrumentation or prosthetic implantation, for its innovation. Unlike some other surgical specialties, our innovations tend to be based on creative techniques, adapting and utilising existing resources.  Due to this, I think the current NHS budget constrictions are less likely to limit innovation of plastic surgery, compared to other specialties. On the other hand, budget constrictions with increased emphasis on productivity and efficiency mean that there is less time for reflective practice and innovation.

Henk Giele
Consultant plastic surgeon and Full Member of BAPRAS


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