In this week's edition
- ✍️ Letter from P'Fella
Trust us, we’re growing. - 🤓 The Sunday Quiz
How well do you know fasciocutaneous flaps? - 🖼️ Image of the Week
Mathes and Nahai muscle flap classification. - 🚑 Technique Tip
Keystone design perforator island flap. - 🎈 Upcoming Events
Your events deserve a spot here too! - 🎓 The Fellow's Corner
Visual guide to fat grafting. - 📖 JPRAS Journal Club
Sub-internship cost: The numbers speak for themselves - 🔥 Articles of the Week
Original Mathes and Nahai, Cormack & Lamberty foundational system for fasciocutaneous flaps, & original angiosomes publication: with 1-sentence summaries. - 💕 Feedback
Suggest ideas & give feedback!
A Letter from P'Fella
Trust Us, We’re Growing
We came in second. Just saw the results from this week’s PlasticsPaper poll — rank your most trusted sources for plastic surgery. And to be totally honest? I was surprised.
Because four years ago, this platform didn’t really exist. There was no reason to trust us. No reason to even notice us.
We Didn’t Set Out to Be Trusted — We Just Wanted Less Noise
Let’s be real. Most plastic surgery education feels like a bad algorithm: Paywalls, recycled abstracts, and PDFs so dense they make you feel dumber.
That’s why we started this — to cut through the noise.
It wasn’t about being “the best.” It was about being useful.
Something you could read between cases. Listen to on the commute. Share with your team.
And slowly, it turns out… that builds trust. Not because we asked for it — but because we showed up. Every week. No clickbait. No sponsorships. No fluff.
So What Now?
This poll isn’t a victory lap. It’s a mirror. If people trust us, it means we’ve got a responsibility to keep earning it. And if we're not at the top? That’s fair too. There’s still room to grow — and a lot of ground left to cover.
That’s why over the next 12 months, The Plastics Fella will be investing over $100,000 into plastic surgery education.
We’re here for the long game. But first — I want to hear from you.
No trophies. Just trust.
P’Fella ❤️
The Sunday Quiz
How Well Do You Know Fasciocutaneous Flaps?
Welcome to the next round of The Weekly Quiz.
Each edition of thePlasticsPaper includes a quiz question designed to challenge and engage our readers. Keep your wits about you and join in every week — the winner at the end of six rounds will earn you a one-year subscription to thePlasticsPro.
❗You asked, we listened: The quiz now runs on a fixed time limit, not a countdown.
Image of the Week
Mathes and Nahai Muscle Flap Classification
In this section, we feature an anatomical illustration. This week’s image illustrates the five types of muscle vascular supply, as described in the original 1981 classification by Mathes and Nahai.
A foundational concept in flap planning, this system categorises muscles based on the number & dominance of vascular pedicles, which is critical when selecting flaps for reconstruction.
Technique Tip
Keystone Design Perforator Island Flap
This week’s tip highlights the original Keystone Design Perforator Island Flap. The flap is trapezoidal, based on perforators, and positioned adjacent to an elliptical defect. The key features include,
- A 1:1 flap-to-defect width ratio
- 90° angled lateral borders
- V–Y advancement at each end for tension redistribution
This simple yet effective design allows great coverage without the need for grafts in most cases.
Upcoming Events
Your Events Deserve a Spot Here Too!
Got something worth sharing? Submit your event and get it featured on our events page!
the Fellows' Corner
Visual Guide to Fat grafting
The video walks through the key steps in harvesting, processing, and injecting fat for optimal graft survival. Watch below for a quick reference for anyone in theatre ▶️
Fat Grafting - Video Guide
JPRAS Journal Club
Sub-Internship Cost in the US: The Numbers Speak for Themselves
P’Fella’s educational fellow, Hatan Mortada breaks down a powerful JPRAS study that exposes the stark financial disparities in plastic surgery sub-internships.
The Numbers Speak:
- IMGs face 17x higher costs than US peers.
- Median cost for ~4.5 away rotations: $9,114 for IMGs vs $410 for US students.
- IMGs also have 80% fewer programs available to them.
Articles of the Week
3 Interesting Articles with One-Sentence Summaries
Mathes and Nahai propose a five-type classification of muscle blood supply, linking vascular anatomy with surgical flap design.
This study defines four distinct vascular patterns in fasciocutaneous flaps, laying the anatomical and conceptual foundation for designing reliable and versatile flaps in reconstructive surgery.
This foundational work introduces angiosomes through cadaveric dissection and radiographic analysis, defining the 3D vascular territories of source arteries and setting the stage for flap planning.
