Sunday, June 30, 2013

Asiatic Aesthetic Series 48:Demonstrating stage one levator repositioning

In this present Baadan cleft camp, I will be demonstrating newer methods of stage one soft palate repair to some  trainees from Yemen and Uzbekistan:
The soft palate is distended with 1:500,000 saline adrenaline which makes the surgery a lot less bloody.
Using a 15# blade, I stab the mucosa medial to the maxillary tuberosity;this identifies the hook of hamulus and tensor tendon very easily .
The tensor tendon is incised and the hook of hamulus fractured with a palatal dissector.
The entire muscle bundle shifts medially as a result of this ,making it easy for me to detach the levators and retroposition them for about 7-9 mm caudally.
The suction test done after the procedure shows that the levators are functioning well ,pulling the soft palate up towards the posterior pharyngeal wall.
The second stage hard palate closure is done after 6-10 months.

stage one closure of the soft palate with levator retropositioning

below(stage 2 on another patient shows how hard palate closure is done in a routine Langenbeck type of fashion)

Saturday, June 29, 2013

Asiatic Aesthetic Series 49: clearing waitlisted surgeries in Baadan governorate, Ibb

Clearing the waitlisted cleft lip and palate surgeries at Baadan governorate Ibb along with my Yemeni friends who are so supportive; we are working hard ,doing as many as 7 surgeries a day
With the upcoming Ramadan festive season,patients are eager to get their plastic surgeries done before the Eid feast
We will stay here for a few more days and try to operate as many as we possibly can with our team here at the govt hospital
Many thanks to Abdul Karim Hasan and team for looking after us so well!

Wednesday, June 26, 2013

Asiatic Aesthetic Series 50:Teaching the art of mission aesthetic medicine and plastic surgery

A successful mission aesthetic and plastic mission teaching programme was conducted over ten years by our network of medical and aesthetic professionals from Singapore. Special thanks to Prof KO Lee  of the National University of Singapore, Dr.Yeap CL of Yeap Plastic Surgery Mount Elizabeth,Rodney Lim of Laser Acupuncture Centre and others for their valuable contributions in this mission to poor plastic surgery and aesthetic medicine patients.
Many units have been equipped and several medical personnel trained in useful techniques over the years.

Asiatic Aesthetic Series 51:The Academy of Aesthetic Cleft Surgery

The benefits for local cleft surgeons

As an international plastic surgical charity registered with the Ministry of Planning and International Cooperation of the Republic of Yemen, one of our commitments to the government is to provide advanced training to selected Yemeni surgeons who are able to prove themselves in the sub speciality. The Academy of Aesthetic Cleft Surgery provides state of the art training in cleft lip, palate and related deformities. The candidate receives an initial certificate after successfully demonstrating a few cleft lip surgeries. The trainee is then able to independently perform these surgeries at the hospital or private clinic. Later, as the trainee learns more advanced methods of palate and nose repair, a multiple choice test, several slides and hands on demos are held after a period of 10-12 months. If successful, the surgeon receives a Diploma in Aesthetic Cleft Surgery and is able to take referral cleft surgeries from one's region, and also train other local doctors with the help of the charity. The offer is open only to local Yemeni cleft surgeons who have had some experience in cleft surgeries under the charity over the years. Two of our trainees have already successfully performed over a hundred cleft lip surgeries each in the last 4-5 years.Most of their surgeries are done at their own private clinics for a reasonable rate and they are able to earn a decent income as a result of their successful training.

Tuesday, June 25, 2013

Asiatic Aesthetic Series 52:Passing on the mantle to safe hands

Passing on secrets to trustworthy specialists of the profession is one of the means to provide advanced solutions to  problem cases. Not all are able to learn the correct techniques , and some learn the methods only to misuse them later.This dilemma in providing safe delivery of advanced techniques will always plague the system because not everyone feels the need to be loyal.
One of the goals of any charitable mission work is to ensure long term sustainability by training selected candidates for the job. We have had some measure of success in the area of training.
The sincere and trustworthy candidate will always learn newer and improved techniques for the benefit of others ,and later on train others to do the same.

Sunday, June 23, 2013

Asiatic Aesthetic Series 53:Improving health care delivery across Yemeni governorates

From 2003 - 2013 the charity was involved in improving health care delivery across the entire country of Yemen by improving existing operation theatres,sterilization rooms,recovery rooms,Intensive Care Units,out patient clinics and wards

That way,safer and more reliable services are provided to all poor local patients from across the nation.

The improvements in health delivery systems through donation of medical equipment,training of medical personnel,workshops and camps were made across the country at the following zones:

f. Taiz

Asiatic Aesthetic Series 54:Compassionate Overseas US Missions

Many thanks to US Embassy leaders of 2009, HE Amb Stephen Seche ,Susan Canning and friends in Yemen for supporting the programmes for poor plastic surgery patients.As a result of this act of kindness in 2009 July,more than 1500 patients have benefited from our free plastic surgery workshops and camps across this nation.
July 15, 2009
On July 15, U.S. Ambassador to Yemen Stephen A. Seche and representatives of Yemen's business community presented a donation of $37,000 to Yemen Smile Foundation, a local charity working health issues affecting Yemeni youth.
Speaking at the event, Ambassador Seche praised Yemen Smile for, "rising to the challenge of providing much needed treatment options to Yemeni children suffering from cleft palate and lip deformities. We are very proud that the Embassy and all of the corporate sponsors represented here tonight have come together to support such a worthy cause." Ambassador Seche also thanked the representatives of the Yemeni companies that contributed to the donation; MTN, YLNG, Sabafon, the Al-Khamery Group, YESCO, the Universal Group, the Fahem group, The Coffee Trader, Abu Rejal Trading Corporation, the Sheraton Hotel and the al-Thor Group.
For more information about Yemen Smile, please visit their website at
(the site has since been removed due to security reasons)

Asiatic Aesthetic Series 55:Giving hope to cleft children

Sometimes you may be the only person or group befriending poor cleft children;it is a window of opportunity for all of us to lend a helping hand to these cleft children who come from very poor backgrounds.

Thursday, June 20, 2013

Asiatic Aesthetic Series 56:Web lessons in poor nations

Web lessons in poor nations are best achieved  with simpler methods like adobe reader pdf lessons,powerpoint  presentations,simpler animation graphics,basic html programmes and short mpeg files which show only the most important steps of a procedure.
It is impossible for regions with bad bandwidths to access hi tech lessons and videos from rich nations. Good intentions may not always deliver the desired results.
Very often, a simpler solution like the whiteboard projector with a laptop achieves far more results than a hi tech virtual reality classroom .
Medical technology has advanced considerably over the last decade.However,what is relevant in hi tech countries  may not be feasible in poor nations which struggle to provide internet services.

Asiatic Aesthetic Series 57:Asianization of smile missions

Singapore is fast becoming a global centre for smile missions with some of the world's largest smile missions setting up offices in the city state. With its hi tech industry, excellent infrastructure and clean government,the country is today the most sought after destination for business and missions alike.
The reason is because unlike many other countries,the govt makes it easy for expats to do business and set up work in the country. With this new development,many cleft children in the Asian regions and beyond will benefit from this important new strategy.

Wednesday, June 19, 2013

Asiatic Aesthetic Series 58:US Smile Train outreach to Yemeni cleft children

The United States Smile Train cleft lip and palate charity has been helping Yemeni cleft children through its Yemen Smile partnership programmes since January 2010.
The charity camps are conducted at government hospitals with the cooperation of the Ministry of Health offices as well as the Ministry of Planning and International Cooperation.
Announcements about the free cleft lip and palate charities are made throughout the nation of Yemen and cleft patients can register at designated camp zones so that they can receive much needed plastic surgery for their deformities.
Over the last three years, 905 cleft children have been treated this way. The training of selected senior cleft surgeons  continues across the nation and some are able to do the easier surgeries confidently.
Yemen is one of the countries where government hospital participation has been a success because of the well planned activities of some honest leaders in the regions. Every Yemeni cleft child is screened for fitness before surgery and a database of the cleft children is readily available to future reference at these government units.

Asiatic Aesthetic Series 59:Drying the tears of Sheba's cleft children

"..better to bring the gift of  life, instead of death and destruction"

The cleft children of Sheba often come from faraway villages which are inaccessible to health facilities;most of the rural folk live in villages without electricity ,roads or clean drinking water.As a result these Yemeni children are often underweight and suffer from a host of other medical problems like protein energy malnutrition,low birth weight,anemia and respiratory illnesses.
In our recent interview with Hadramout Al Yom (Hadramout Today) ,we highlighted the needs of the cleft children across poor Yemeni villages and rural towns.
Our small Yemeni cleft and plastic surgery team along with well wishers in some expat nations will  sponsor every Yemeni child born with a cleft lip and palate. Yemeni families with cleft children  can hope for a better future for every cleft child . The cleft children from impoverished Yemeni families are given the exact same state of the art  treatment as cleft children from richer and more privileged backgrounds . Somali UNHCR refugees are given the same level of hi tech care by our team. We do not differentiate between class , race or religion.
So far over 2500 cleft children have received free plastic surgery across the nation.
Our vision is to give abundant life and happiness to every Yemeni family with cleft children.

Monday, June 17, 2013

Asiatic Aesthetic Series 60:Cleft Trainee Performance

Cleft trainee performance has been increasing steadily over the last few years in Yemen.
Some more experienced trainees are able to produce good results for different cleft lip presentations, and help several poor patients through their own government hospitals.
It is encouraging to see cleft trainees doing a good job across several counties of Yemen these days.With expat presence on the decline because of the unstable security situation , this is a welcome addition to the task force on palate solutions in poor nations.

pic: cleft lip surgery done by trainee surgeon Dr.Alawi Aidaroos Mohammed @ Seiyun General Hospital

Wednesday, June 12, 2013

Asiatic Aesthetic Series 61:skill providers in plastic surgery missions

Various workshops and hands on operating sessions are necessary before other providers can learn and master the art of plastic surgery
The resources include-
a.workshop materials for hands on training
b.aesthetic and plastic surgery journals for ready reference
3.specific medical items and operating instruments through donor companies resources for web based learning to improve existing skills

In our situation, we use all the above methods for passing on skills to local and expat providers who in turn do the same in their respective zones. This method of mission delivery is effective and always works in developing nations where resources are sparse.