Thursday, January 29, 2015

Ala base shape in bilateral cleft lip deformity

Maintaining the shape of the alar bases or improving their appearance is one of the goals of a good bilateral lip repair.

The first stage adhesion for any bilateral cleft lip repair aligns the new philtral position more accurately and makes subsequent adjustment much easier.
The intention is not to make a picture perfect repair in the first stage of the surgery but to do a functional adhesion which aligns the anatomy to a more accurate level.
Maintaining the alar base shape make the second aesthetic surgery  more accurate .
I have found this approach a useful method for correcting different presentations of bilateral cleft lip.

Friday, January 23, 2015 Queens, New York City this week 2015

News: Shandong  to NYC

Hello New York City..I am Smilemaker and I hope to make  cleft kids smile  .I was designed to help many more cleft children smile again. 2015 designer classical-jazz telecaster fender hybrid with mp3 backing tracks in the body has finally reached 4172 Elmhurst NYC all the way from Shandong city Fender factory! It took me a lifetime to design this babe :-).

She has some jetlag and is now resting  at  my bro Namgyal's pad in Queens. Can't wait to check out the features and sound this year.:-)
The first copy will stay with me-- later models will be auctioned for smile kids who just might need help with new smiles  :-) 

The mp3 in the body holds the tracks and sounds something like this played together:

Advantage: one man band and also saves money on BEER :-) 

Wednesday, January 14, 2015

Encouraging clinical trials of Mini Home Spa

This season's clinical outcomes for Mini Home Spa products have been encouraging.
Several clients used the skin conditioning and rejuvenation products of Mini Home Spa.

A client from France who had used the micro crystal palm abrasion method and skin care product for over four months noted the following:
1. improvement in skin tone and texture
2.less fine lines
3.overall clearer complexion and brighter and softer skin

The 30% acid application TCA after superficial applications of LA 10% also showed encouraging results:
1. younger and healthier skin
2.less fine lines
3.lightening of age and sun spots

Overall,the Mini Home Spa skin care products are reliable,cost effective and show very good outcomes.
The products will be launched through a reputable US company sometime this year.

Tuesday, January 13, 2015

Early SMILEMAKER Reviews and notes from the LA ,MA pop world

Smilemaker is almost ready-as the workmen at the Fender unit in Shandong give some finishing touches before they ship it to New York City soon,several comments from wellwishers in the pop scene across US -LA ,MA and others are coming in for this designer classical-jazz blues hybrid in aid of cleft children.

1.          Boston
Very cool! Did you make it? What pickups, body wood, neck profile etc? Thx! P  .. Tres cool! Can't wait to see....Good cause as well. Nice gtr there brother! P  

2.      California LA  Sounds really nice. Good name… Bruce Guynn and Big Rain   

3.      Florida   That's awesome! It's gonna look beautiful Congrats! When are you expecting it to     be completed?

4.        Colorado

That is an amazing, highly creative way of impacting the life of others. 
 Dr.Ren Merry PhD(classical guitar), Guitar/choral/AP Music teacher at Frontier Academy,Denver

more later......:-)

Monday, January 12, 2015

SMILE networks to facilitate cleft care across countries

Smile networks across regions and countries make the job of helping cleft lip and palate children easier for plastic surgeons and others who are involved in helping cleft children.
One of the ways to reach out to more cleft populations is through blogging,using social networks.
Many patients as well as trainee surgeons have benefited from such programmes.
Thousands of patients have been helped even in remote regions because of networks between the public and local government health facilities.
Doctors from different regions and countries have also benefited immensely through networking and training in more advanced methods of training at specialist centres.
Thousands of our cleft patients were helped through local networks which included newspapers,GSM messages,local councils,TV and radio.

Thursday, January 8, 2015

Isolated Cleft children in remote Myanmar villages

Imagine living as a cleft child in a remote village where there are no roads,water supply or electricity because of neglect for hundreds of years?
Some of my friends had visited a remote region of Myanmar,also known as Burma on a medical project and came across several cleft children who were completely isolated from any specialist care.
This young boy's parents had never heard of  such services and he has not had any opportunity to get a free operation. There are many more like him who live in those regions.
The nearest centre for getting such help is the north eastern border states of India where smile surgeons can help them  through local medical teams.
The villages have no roads,power supply or water supply. There is no surgical facility within the region ,let alone a centre for smile surgery.
Some of us are studying the possibilities of reaching out in such areas with much needed smile programmes at a nearest cleft facility.

SMILEMAKER ..a designer guitar in aid of underprivileged cleft children

With love from our first team in Singapore SPC..who would have believed it then?

The wait is  over. SMILEMAKER has finally coming together inside a Fender guitar factory in Shandong province by a group of excellent Chinese workmen.It is now in Queens NYC.

This is a guitar I had designed after helping thousands of cleft children from very poor backgrounds.
A guitar that tells the story of a Smilemaker :-)

Many years ago, I found myself with thousands of cleft lip and palate children who had no one else to help them. So I played a few guitar riffs at the local Brit Embassy Pub in Hadda,Sana Yemen. Good people,including the Queen's Ambassadors befriended me and offered to help me start a charity for cleft children. The rest is history. Together, we did something no group anywhere else had even done. Thousands of plastic surgery patients,including thousands of cleft children were operated for free across the entire nation.
Today, the US Smile Train continues the work for cleft children across the entire MENA region.
My earlier blogs tell the story of Her Majesty's Amabssadors Frances Guy, Trish Gifford with HMA Mike Gifford and several others.

I will use the first model,and the other pieces  will be sold to donors of our smile work for cleft children from very poor backgrounds. Look forward to the finished product!
picture in the workshop 1.

Picture 2 shows the progress today-a beautiful masterpiece

Pic: My designer SMILEMAKER the making @Shandong Fender factory- a classical-jazz blues hybrid telecaster with an mp3 backing slot behind the body.Looks classical but is electric. I like fingerstyle and designed this hybrid since i can play classical, jazz ,gospel fingerstyle as well as blues using the same model. Wood- mahogany and spruce,jazz tone pickups,medium fretboard and light action.

Jan2015: It is now in NYC!

pics: early years 2003...June onwards

Singapore is where we first started with Shin Yong ,James and the rest of the smile gangnam styles:-)
@James place Singapore...jest guitarists :-)..the Jesters

Her Majesty's Ambassador  Frances Guy Patron of our smile charity 

Smilemakers:France TOTAL,Norway DNO Y A&S, UK Embassy

The best of America and Yemen- US Embassy, an Occasion to SMILE in aid of cleft kids

Trish Gifford of the UK residence Sana
21 Madison Avenue NYC

Thanks for the smiles...SMILEMAKER

Monday, January 5, 2015

People help spread the smiles through visits to unknown lands

Most of the support for smile missions comes from people from all walks of life.Some are business  owners,professionals, housewives,students,media folks and so on- kind folks who make smiles happen for cleft children in their communities or overseas. Hundreds of thousands of cleft children are helped as a result.
When we first started our smile campaigns,most of the folks involved were not medical folks but from other professions.Their unwavering commitment to the smile work led to smile programmes for thousands of children.

Often folks who visit  remote regions, come in contact with cleft children who are  hidden from society and later they inform specialists who are able to visit those regions or transport the children to well established smile units. Many families have been helped this way. Even those in far flung regions can now have hope because people everywhere are spreading the smiles.

 Our pioneer visit to the Indian island of Socotra several years ago was because of expats who had visited the remote islands and met with families who had many cleft children.

local fishermen at Socotra island on the Indian Ocean near Somalia

Sunday, January 4, 2015

2014 one year clinical trial with some superficial and deep peels

The one year clinical trial of some superficial and deep peels
Skin types: for all skin types 1-6
Safety: skin conditioning 6 weeks prior to trial
1.superficial peels-very safe
2. deep peel-need specialist care to prevent complications;thorough understanding of mechanisms;TCA 30% is relatively safe in good hands.

1.fine lines
2.age and sun spots/melesma
3.some benefit for moderate eye bags without fat herniation/dark circles under eyes
4.improving the overall texture and tone of facial skin

Results: good and encouraging for all skin types

Pictures before and after the  30% TCA peel this week taken at days 3/4 and day 7;the light application,controlled peel ensures the level of peel is  upper dermis(above reticular layer)-neutralisation is after 5 mts with bicarbonate solution
Original pictures,no photoshop
patient: self

TCA 30%  effects: fine peeling in some areas appear as flakes(white),thinner skin areas like below eye and sides of forehead show dark scabs which fall off on day5/6.There will be intense peeling on days 2-4,and in some cases even oozing and some discomfort.The skin will appear crinkled for about 4-6 days and tighten after that.

day 7 shows improved appearance with better skin texture,colour,tone;note-it takes several sessions to lighten age/sun spots/melesma;the effect is not immediate,although there is significant improvement
The results will continue to improve over the next few days and weeks

Saturday, January 3, 2015

Focus 2015: The use of SMILE adverts in conflict zones

The use of SMILE adverts in conflict zones may not always be possible ,especially if an expat mission is at the helm of smile programmes. In our volatile ME situation, the most useful means of spreading the smiles are through GSM text messages and through local tribal councils. We might use some  before and after pictures of our local cleft patients,but only if absolutely necessary.
Mentioning big names may often be detrimental to smile campaigns because health workers are usually at the receiving end of radicals and other troublemakers. Sadly,this sort of irregular behaviour is quite common in many developing countries where everything might be considered a competition. What is routine and taken for granted in a developed nation,may well be considered competition in a poor developing country,where salaries are meagre and most medical facilities below average.

In more peaceful times however,smile ads with the official seal of a parent charity NGO is useful and brings in thousands of new registrations. This also acts as a deterrent for some unscrupulous members of the medical profession from falsely using the name of famous international charities to perform charitable work in regions where hospitals may not be aware of the hidden agendas of smile mongers (often surgeons and dental/oral max facial surgeons with some cleft surgery knowledge) who may later sell their patient records to other unscrupulous members who are involved with famous names. There is no foolproof system to check mega smile regions where thousands are operated every month,although every effort is being made to root out such practices.
The learning curve even for large smile charities is often long and complicated.

pic: a common flyer used in cleft surgery adverts in developing nation missions

Training sessions: User friendly cleft lip aesthetic surgery

Using minimal incisions,and an innovative curved line flap ,is one of the easiest ways of repairng the small to moderate unilateral cleft lip deformity.The technique is easy to learn and gives very good results.
It is not necessary to make complicated z flaps or C flaps for simpler presentations of unilateral cleft lip. The extra flaps may only increase the post op scarring, and do not have any significant advantage over this simplified modification which was done by us in over seven hundred cases.

Pic: before and after using a curved line flap and minimal (0.5- 5 mm muscle release )

Thursday, January 1, 2015

Sense of Wonder in Massachusetts

Sitting and palate chatting with one of the world's greatest cleft maestros,Prof John B Mulliken @ Harvard Childrens Craniofacial.He has spent a lifetime researching cleft anomalies and has so much to teach us latecomers in the smile business.
pic:Harvard Childrens Massachusetts

As a long time senior advisor of our work in Arabia,he has helped me with many important decisions in the field of cleft surgery.Many have benefited from his expertise.

Yemen was the first country to benefit from our latest training methods in aesthetic cleft surgery with the help of experts from Singapore,Taipei,UK and the US.Some of the most important foundations were already laid years ago by close friends and experts from Singapore,UK and Taipei .

John gifted me his entire lifework on cleft research papers-over fifteen years of research materials .I have kept them in three volumes of spiral bound packages.A priceless gift of smiles! I named it, "Sense of Wonder 1,2,and 3". I hope to share this with my cleft trainess across different nations later, when I have more time to arrange the teaching packages of the Free Academy of Aesthetic Cleft Surgery into:

1. Workshop topics on cleft lip and palate in a user friendly format
2. Multiple Choice Questions-only 50 pertinent topics are included for the benefit of primary cleft trainees
3. John Mulliken's 3 volumes on "Sense of Wonder"
4. Over 100 useful PDF journal articles on cleft lip and palate

Smiles and smiles to go in 2015

2015 is going to be another special year for cleft children worldwide as smile mission teams continue to register tens of thousands of newer patients for free surgeries. Having traveled extensively for cleft programmes across different regions,and after thousands of surgeries,I am happy that we still have the strength to help these underprivileged members of our societies.  
There are over 10 million cleft patients worldwide. Over one thousand are born everyday.Most of them come from impoverished homes and regions,where there are limited specialist services for cleft children.
Each cleft child needs at least 3 to 4  surgeries over several years.That makes the number approximately 20 to 30 million patients who need help!
We are smilemakers,who have smiles and smiles to go.... may God give us success as we join hands to help even more cleft children smile again for the first time in their lives.