Advertise on podcast: The Plastic Surgery Room

The child walks in with ears that stick out, and the family has been waiting years for someone to fix them. One operation, one suture pattern, and one decision about cartilage may decide whether the ear stays put or springs back. The anatomy of the conchal bowl and antihelix, the auricular angle and concha-mastoid distance, Mustardé and Furnas cartilage-sparing techniques, cartilage scoring and its trade-offs, the posterior auricular incision and skin closure, the complications of recurrence, suture extrusion, hematoma, and over-correction, and the principle that the ear you correct must still look like an ear.

She does not want bigger breasts. She wants them back where they were before three pregnancies, and she asks you to lift them “as high as you can.” Put her nipple 2 cm too low and a small revision fixes it — put it 2 cm too high and nothing ever brings it back down. The Cooper’s ligaments and the inframammary fold, the internal mammary perforators that keep the superomedial pedicle alive, the 4th intercostal nerve and the inferolateral danger zone, Regnault grading and why pseudoptosis is a lower pole problem, Pitanguy’s point and marking the patient standing, crescent, Benelli and periareolar limits, vertical mastopexy and the pillars that actually lift the breast, the Wise pattern and the T-junction, auto-augmentation with the patient’s own lower pole tissue, single-stage versus staged augmentation-mastopexy and the 6 cm vertical excess rule, mesh and the internal bra, NAC congestion, bottoming out, the star-gazing nipple and the waterfall deformity, and the principle that when in doubt, the nipple goes lower.

The boy has no black eye. But every time he looks up, he vomits and his heart rate drops to 48. The CT says “minimal fracture” — and his inferior rectus is being strangled in a trapdoor of bone. The bones of the orbital floor and its lazy-S shape, the posterior ledge and the posteromedial bulge, the infraorbital nerve and the numb upper incisor, hydraulic versus buckling mechanisms, trapdoor versus open-door fractures, the white-eyed blowout and the oculocardiac reflex, visual acuity first and the forced duction test, Hertel and the 2 mm rule, Burnstine’s indications and the 2-week window, transconjunctival versus subciliary approaches, titanium, porous polyethylene, resorbable and patient-specific implants, retrobulbar haemorrhage and the bedside canthotomy, late enophthalmos and lid malposition, and the principle that where you put the implant matters more than what it is made of.

The cut is 2 cm long. The patient can still almost make a fist. But one finger lies perfectly straight while the others curl — and that straight finger means both tendons are gone, in the one place surgeons called no man's land for 80 years.

The reconstructed breast looks like a breast. It feels like a foreign object. One intercostal nerve, one nerve coaptation, and 12 months of patience might give her back sensation — or might not. The intercostal nerve anatomy from T2 to T6, why mastectomy destroys sensation, the DIEP flap's thoracodorsal nerve and why it does not naturally innervate the breast, direct coaptation versus nerve graft versus nerve transfer, the sural nerve harvest and permanent calf numbness, the 3–6 month delay before sensation returns, monofilament testing and sensory recovery quantification, neuroma formation at coaptation sites, patient expectations and realistic outcomes, and the 12–24 month timeline before sensory plateau.

The scar looks terrible now. But give it 12 months and it may look acceptable. And if you revise it at 2 months, you will have two scars instead of one — the original and the revision.The healing timeline and collagen remodeling, red versus white scars, hypertrophic versus atrophic versus contracture scars, when conservative measures work and when they do not, silicone sheeting and steroid injection, pulsed dye laser for vascularity reduction, Z-plasty for contractures, W-plasty for long linear scars, subcision for atrophic scars, and the principle that revision surgery trades one scar for another — so the new scar must be better

he ulcer is not just a wound — it is a symptom of a patient who cannot move. Closing it with a flap does not solve the mobility problem, so the patient gets another ulcer somewhere else unless something changes fundamentally about how they manage their pressure.Superior gluteal flap anatomy and pedicle, tensor fasciae latae as an alternative, why flap reconstruction must provide padding not just coverage, the recurrence that results from inadequate post-operative pressure relief, donor site morbidity from gluteal muscle loss, and the prevention principle that begins before the ulcer develops.

Filler is not a simple aesthetic injection — it is intravascular surgery without the operating room. One inadvertent arterial puncture in the wrong zone, and the patient loses her vision.The five danger zones where intra-arterial injection causes retinal occlusion and blindness, the supratrochlear artery in the glabella, the angular artery in the nasolabial fold, blunt cannulae versus sharp needles and why cannulae cannot pierce vessel walls, hyaluronic acid reversibility with hyaluronidase, calcium hydroxyapatite longevity, PLLA's collagen-stimulating mechanism, Tyndall effect in superficial hyaluronic acid, granulomas from PLLA, and the blanching and pain that signal immediate vascular occlusion requiring emergency hyaluronidase injection.

The hairline is not where you think it is. The temporal branch is exactly where you forgot it was. And the brow that looked perfect in the OR is resting at the eyebrow level at one month.Brow ptosis patterns, frontalis muscle anatomy, temporal branch danger zones, the middle temporal vein as a depth guide, trichophytic versus coronal versus endoscopic techniques, the hairline elevation that devastates patients with hair loss, and the asymmetry that requires revision.

kin removal seems simple — until the patient cannot close her eye and is facing corneal scarring.The nine layers of the eyelid, the orbital septum barrier that fails with age, the levator palpebrae and its aponeurosis, the tear trough and orbitomalar ligament, Müller's muscle and sympathetic tone, the lacrimal system in the medial lower lid, the difference between transconjunctival and transcutaneous approaches, and the corneal exposure that is preventable and catastrophic when it is not. Episode 42 — blepharoplasty, from the pinch test to the eyelid that closes.

The tissue is not supposed to be there. It grew because of hormones, maybe stopped growing, maybe didn't. And surgery removes it — but only if you can distinguish it from the normal breast tissue the man is supposed to keep.True gynecomastia versus lipomastia, the Tanner-Bostwick grades, why puberty gynecomastia regresses in most but not all adolescents, anabolic steroids and aromatisation, suction-assisted lipectomy with direct glandular excision, the conservative principle that prevents over-correction, and the asymmetry that reveals inadequate surgery.

The tissue is not supposed to be there. It grew because of hormones, maybe stopped growing, maybe didn't. And surgery removes it — but only if you can distinguish it from the normal breast tissue the man is supposed to keep.True gynecomastia versus lipomastia, the Tanner-Bostwick grades, why puberty gynecomastia regresses in most but not all adolescents, anabolic steroids and aromatisation, suction-assisted lipectomy with direct glandular excision, the conservative principle that prevents over-correction, and the asymmetry that reveals inadequate surgery.

Master the complete clinical continuum of burn care, from emergency resuscitation to long-term reconstruction. This brief, high-yield episode breaks down initial assessment using the Rule of 9s and the Lund-Browder chart, alongside fluid calculation with the Parkland formula. We discuss when to perform an emergent escharotomy, how to select appropriate topical creams and dressing choices, and when a burn requires skin grafts or skin substitutes. Finally, we cover the essentials of preventing infection and managing long-term scarring using pressure garments and silicone therapy. Perfect for students, interns, and residents looking to survive and thrive on the wards!

In this episode, we debunk the classic, outdated advice to "leave a wound open to the air". Grounded in modern medical evidence, we reveal the golden rule of wound care: a clean, moist wound actually heals faster and with less pain than a dry one.We walk you through the essential timeline for managing injuries, starting with the critical steps in the first 24 hours. You'll learn how to properly clean a wound using simple tap water or sterile saline, and why you should avoid routinely using hydrogen peroxide or alcohol, which can damage healthy, healing tissue. We also discuss why humble petroleum jelly is your best line of defence against scabs, how to select the right dressing for different types of wounds, and the clinical evidence behind using silicone gel for scar prevention once the skin has completely closed.If you found these clinical insights valuable, please follow the podcast, like this episode, and share it with your colleagues to help spread modern wound care practices!

In this episode, we review cleft lip and cleft palate from a plastic surgery resident’s perspective. We will cover embryology, anatomy, classification, associated syndromes, timing of repair, surgical principles, multidisciplinary care, and long-term follow-up. The episode focuses on how to think clinically and surgically about cleft patients, from newborn evaluation to lip repair, palate repair, speech outcomes, alveolar bone grafting, and secondary revisions.