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Plastic surgery residency programs often rely on a residents' aesthetic clinic to help train residents in aesthetic surgery. The television media may be used to help boost interest in such clinics. We report our experience with a local television station in helping to produce a "health segment" broadcast that chronicled the experience of an aesthetic patient in the residents' aesthetic clinic. As a result of this broadcast, approximately 150 people responded by telephone and subsequently attended a series of seminars designed to screen patients and educate the audience about the aesthetic clinic. A total of 121 patients (112 women and 9 men) signed up for personal consultations. The age distribution and requested procedures are presented. From the data, we conclude that there is a healthy demand for reduced-fee plastic surgery procedures performed by residents in plastic surgery. The number and variety of cases generated are sufficiently diverse to provide a well-rounded operative experience. The pursuit of media coverage of a not-for-profit clinic has the potential for generating large patient volume. Such efforts, although very attractive, are not without their own risks, which must be taken into consideration before engaging the media in the public interest arena.

The history of scalp avulsions is presented, and one case is reported. A treatment plan for scalped patients is outlined.

The cleft lip nasal deformity is a result of imbalance of the structures caused by a collapsed alar cartilage, a widened nostril floor, and a lowered nasal orifice. This deformity can be corrected most readily by repositioning and supporting the collapsed alar cartilage of the cleft side. A technique has been developed to achieve this by releasing the ala from the nasolabial fold, elevating and supporting the alar cartilage, and repositioning the alar rim on its new deepithelialized base. One- to two-year follow-up of seven patients who underwent such repair has demonstrated satisfactory correction of the deformity.

A questionnaire designed to determine the pattern of usage of prophylactic antibacterials, similar to one used a decade ago, was distributed to plastic surgeons, of whom 1718 responded. The pattern of antibacterial use in 8 major categories and 55 separate operations and circumstances was reviewed. The timing and the influence of various modifying factors was evaluated. The data present the pattern of antibacterial use by plastic surgeons at this point and time, that is, what is "usual and customary".

Our initial experience with the lower rectus abdominis procedure for breast reconstruction in 19 patients is presented. Anatomic considerations, surgical technique, and results are reviewed. Errors in flap design and execution resulted in a disproportionately high complication rate, which improved following certain technical refinements. The lower rectus flap has proved to be an alternative to conventional techniques of breast reconstruction. As more experience is gained with this flap, its particular role in the reconstructive armamentarium will be more clearly defined.

A questionnaire distributed to plastic surgeons to determine their patterns of usage of systemic prophylactic antibacterial agents was answered by 1,025 respondents (73.7 percent). The patterns of usage among the respondents were determined for 29 circumstances and operations for the time of administration, and as influenced by 11 modifying factors. The data present the patterns of antibacterial use by plastic surgeons at this time.

Dependent upon the age, the occupation, and the requisites of an individual patient, the less important ulnar fingers may be of great value; in these the philosophy of discriminate preservation should be given considerable weight in the choice of treatment. Revascularization of fingers injured by a ring avulsion, and restoration of tactile gnosis with esthetic coverage make salvage of the valued ulnar fingers feasible. Three illustrative cases are described.

Twenty-one mastoid-occiput-based shoulder flaps have been used to reconstruct patients with head and neck cancer. When the tip of the flap does not extend beyond the midclavicle, this flap can safely be elevated and transferred into its final position without delay procedures. Not requiring secondary sectioning and implantation, the Mütter flap can successfully be used to reconstruct multiple defects within its arch. Its utility thus rivals the more commonly used medially based deltopectoral flap and forehead flap.

George David Pollock, F.R.C.S., convinced the world of the efficacy of skin autografting and homografting. Previous studies on the priority of skin grafting are reviewed. The life of Pollock, including a glimpse of the surgical world of the Victorian era is described. A detailed analysis of the roles and relationships of Pollock, Reverdin, and Gosselin is given.