Thursday, May 29, 2014

So what's the blues got to do with smileathons?



Many of you ask us how we got the smileathons done in a relatively short period of time. When we started out in June 2003 ,all we had at the British Embassy Club was a cool Ambassador- HMA Frances Guy,a handful of wellwishers,very little money,thousands of plastic surgery patients and lots of good ideas.
The only way we could launch a charity for these cleft kids was through an impromptu blues concert using the 12 bar blues progressions over and over again.It worked.
Today over 6,500 plastic surgery patients have been helped,including the latest number of over 1200 cleft children under the US Smile Train.
I absolutely love the simple 12 bar progressions and use it as an inspiration to design all my cleft surgeries.The lines are kept simple,meaningful and are generally repetitive.But the results are fantastic and pleasing to the eyes.There is so much room for improvisation and many new techniques can be developed over this ordinary progression.
If you live the blues,make sure you use the blues and play them blues :-).



Monday, May 26, 2014

REAL solutions to REAL problems

The Smile Train charity programme in Yemen this month  sponsored free smiles  for 85 new cleft lip and palate children from  villages across Yemen.
As a plastic surgeon for the US Smile Train programmes, I appreciate what the Smile Train US family does for underprivileged  cleft children from remote villages,who have no access to proper health care.
We do not live in a world of images and fantasy but in a world that is facing REAL problems of alienation ,social rejection and pain. Only REAL solutions and decisive action will work. It is a tough job to go into remote zones,but well worth the inconveniences  and hardships.More often than not,there is a power cut during my operations.One gets used to such hiccups and tries one's best under the given circumstances.Something unheard of in sophisticated hi tech units  where most of us have studied earlier for many years,before launching into the boondocks where the real needs are.

We can get involved in others lives merely through the media and not in reality,as is common in today's world. Real people do not need just sympathy or good reporting,but a quick response to a call for immediate action.
There is a real world out there in need of solutions for real problems. I personally like what the Smile Train does for people who would otherwise never have a second chance at life.
The challenges are huge,but we keep plodding on and on,hoping one day to see many more smile again for life.Hundreds of cleft kids are stranded in remote villages this month across Yemen because of the petrol crisis,where hoarders and greedy traders are refusing to sell at normal rates and creating a huge blackmarket across the nation. Many poor people cannot travel to our camps.This is the harsh reality here.
Since January 2010,when the first few smiles were launched here by the Smile Train,over 1200 cleft kids are now smiling again and several have gone back to school. Thanks to my friends in New York and here who made this happen for the kids.There were several serious attempts by some corrupt officials and doctors here to prevent the US Smile Train from helping the poor cleft children,for reasons best known to the perpetrators of such acts.The work continued against all odds and today we can look back and say it was worth taking the risk for Yemeni cleft children.


Thursday, May 22, 2014

curved line ? an easy flap for large volume unilateral cleft lip surgery

Over the years, I have changed my unilateral cleft lip design to a very simple curved line flap which is easy to perform.The results are not different from the other fancier flaps.In my earlier days, I spent a lot of time designing fancy flaps but apart from the long operating time,the results were not so glamorous.Using a simpler flap could address the problems in an equally effective manner.
My reason for designing this innovative flap is mainly the large volume cleft lip surgeries at the charity camps for cleft children under the Smile Train USA.
Simple things in life often give rewarding results.

I always say ,follow the KISS principle in aesthetic surgery  :-)
K keep
I it
S simple
S straightforward


using a very simple curved line for cleft lip closure

Wednesday, May 21, 2014

The prolonged learning curve in aesthetic cleft surgery?

Looking at the thousands of deformed cleft children , as an aesthetic medicine and cleft surgeon I often wonder what the outcome would be if there was not the element of aesthetics in cleft lip surgery.The functional aspect of the surgery involves good approximation of the orbicularis oris muscles and that enable the child to have normal oral function. Many surgeons are good at this, but need more practice to improve on the aesthetic aspects of cleft management.
Excellence in aesthetic procedures  takes years to achieve and one has to keep on working at it to get improved results.
Reaching the desired goal in aesthetic surgery for cleft lip problems needs a lot of fine tuning,patience and practice.
The rewards are well worth the time and effort spent in this pursuit of  excellence and happiness for oneself and others.
Change has to be slow,elegant and beautiful.





Saturday, May 17, 2014

I wanna smile with somebody ...@Smile Train:-)

(Smiles Paraphrased..:-) short clip made by Arabwood Productions ,Sana'a )

Smile: What is you name, little girl?

Rahiba: "Hi ya'll, my handle is Rahiba and I am a cute 'lil 8 year old Yemeni gal from a one horse village in Ibb."

Smile: Cool,do you attend a school?

Rahiba: Are you kiddin' me?The boys at school tease me and call me funny names.No way am I going to school...I will go to that school after my smile operation

Smile: So,you will go to school after your smile operation this week?That is so beautiful..Rahiba,what is your dream?


Rahiba: I wanna smile with somebody one day:-) "

Smile: Okee dokee..you will smile tomorrow

a day with Rahiba @ Yarim hospital 2014 May

41 Madison Ave NY where it all happened..
500 registrations a week..are you crazy? you caint do it..sez who?:-)

powering up from the Lhasa connection Queens NY with red red wine to take on smileathons :-)


Thursday, May 15, 2014

Inspiration from Pachabel's Canon in D in aesthetic surgery?


A magical score with an angelic soft touch.And much more as one discovers the slow and beautiful progressions. The rhythmic soft notes with perfect harmony between the lead and bass continues gently before the fantastic middle melody riffs of the violin accompanied by alto on the guitar.Forever music.
 Pachabel's Canon in D is not a very difficult score but one has to study the progressions well to understand how a beautiful melody can be constructed from basic notes.

Aesthetic procedures on the face can be life changing ,using simple designs without too many complicated patterns. A right design in the right place is all that is needed for a life changing experience.
This child has an incomplete bilateral cleft lip with an upper lip that needs staged correction in order to get the desired results. The first procedure corrects the philtral segment and adjusts the lip deformity.The 2nd procedure after three months will realign the Cupids bow and fine tune the entire lip complex so that the end result is a work of art and beauty.






Sunday, May 4, 2014

Large volume smileathons

Large volume smileathons where many cleft children are registered for surgeries can be done only by plastic surgeons and anesthetists who have been doing this sort of work regularly.
In our experience, we have  found it useful to choose only those cases which are not too difficult to handle. Complicated surgical procedures are reserved for later dates when numbers are not large.
This way, our team is able to clear the large waitlist of  smile surgeries in a relatively short period.
I normally operate about 9-11 cleft lips and palates in a single day's list. This is possible because I have changed some of the plastic surgical techniques ,using shorter innovative procedures, with equally good results. To be realistic however, palates do take more time, unless of course,the ops include stage one soft palate mucosal adhesions.
We have smiles and smiles to go ,even after our initial Smile Train list of 1200 ops in a little over 290 working days!