In this week's edition
- ✍️ Letter from P'Fella
Research or marketing? The industry cash behind nerve allografts. - 🤓 The Sunday Quiz
New winners top the leaderboard! - 🖼️ Image of the Week
Clinical insights on vascular tumours. - 📘 Foundations Textbook
Calling plastic surgery experts to contribute! - 🎙️ Behind the 'Fella
What should we ask Rod Rohrich? - 📖 What Does the Evidence Say
What is the optimal dose of oral propranolol? - 🔥 Articles of the Week
Vascular malformations, ISSVA classification, & The original 1982 classification of hemangiomas: with 1-sentence summaries. - 💕 Feedback
Suggest ideas & give feedback!
A Letter from P'Fella
Research or Marketing? The Industry Cash Behind Nerve Allografts
Let's call it what it is: Nerve allograft research is a tangled web of academia and industry cash. It’s a snapshot of a bigger struggle — clinical integrity versus commercial pressure.
The Dirty Truth
A recent publication in the PRS journal caught my eye. Nearly 80% of the top nerve allograft researchers have pocketed industry cash, totaling over $14 million in the past decade. We're not just talking lunch money — some pulled in hundreds of thousands. If that doesn’t raise your eyebrows, you’re not paying attention.
Yes, industry dollars can drive innovation, but when funding dictates research outcomes, the integrity of the science takes a hit. Positive spin often overshadows solid, comparative evidence — leaving clinicians and patients to wonder what’s real innovation and what's just clever marketing.
Real Winners or Real Risks?
Sure, nerve allografts offer appealing perks — shorter operations and no donor-site complications. But without robust, comparative evidence, we're left wondering: Are we truly advancing care, or simply buying into flashy marketing?
Beyond the Allograft
This isn't just about nerve grafts — it's a microcosm of medicine’s broader conflict-of-interest dilemma. Without clear, standardized disclosures, clinicians risk confusing genuine breakthroughs with industry sales pitches. Transparency isn’t optional — it’s essential.
With love,
P’Fella ❤️
The Sunday Quiz
*Drumroll🥁* New Winners Top the Leaderboard!
We're thrilled to announce the winners of this edition's quiz. After six rounds of questions on plastic surgery, our top scorers are Cher, AL, Manolo, and Alexander L.
Winners, please reply to this newsletter or reach out to us!
Thank you to everyone who participated and stay tuned for more fun quizzes in future editions!
Here's the rest of the leaderboard
tk - we can probably remove the question this week
Welcome to the first 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.
Image of the Week
Clinical Insights on Vascular Tumours
In this section, we feature an anatomical illustration. This week’s image shows a rapidly growing vascular lesion on the left cheek. Infantile hemangiomas are common benign tumors, often self-resolving but sometimes requiring treatment, such as oral propranolol, based on size, location, and complications.
You can explore vascular tumours in detail in our clinical case.
Vascular Tumour - Clinical Case
- Clinical diagnosis of a vascular malformation.
- Create and justify a differential diagnosis.
- Describe the natural history and aetiology of this condition.
- Identify and treat complications and associated conditions.
- Order relevant investigations.
- Treat this condition in the short and long term.
- Learn novel techniques and indications for surgery.
Foundations Textbook
Calling Plastic Surgery Experts!
We're seeking plastic surgery experts to contribute to the final review of our Plastic Surgery Student Guide. If you're interested in joining us, sign up below!
Behind the 'Fella
What Should We Ask Rod Rohrich?
tk - hyperlink for this section isn't working for both web and email versions
To kick off season two of our podcast, we've invited Rod Rohrich as a guest for our first episode.
Got a question for him? Submit yours below.
What Does the Evidence Say?
What Is the Optimal Dose of Oral Propranolol?
The recommended dosage is 2-3 mg/kg/day, typically administered for 6-12 months (Léauté-Labrèze et al., 2015; Solman et al., 2014). Early initiation of treatment, preferably before 5 months of age, has been associated with better outcomes (Andersen et al., 2014). Propranolol effectively stops IH growth, reduces volume, and improves color and elevation (Hogeling et al., 2011; Sans et al., 2009). It has shown efficacy in treating various IH complications, including vision compromise, ulceration, and airway obstruction (Solman et al., 2014; Haider et al., 2010).
Adverse effects are generally mild and infrequent, with no significant differences compared to placebo (Léauté-Labrèze et al., 2015; Price et al., 2011). However, careful monitoring is recommended, especially during treatment initiation.
Articles of the Week
3 Interesting Articles with One-Sentence Summaries
Vascular malformations differ from hemangiomas in their endothelial characteristics and require a multidisciplinary approach, with treatment strategies varying based on whether the lesion is capillary, venous, lymphatic, or arteriovenous.
The ISSVA classification distinguishes vascular anomalies into vascular tumors and vascular malformations, categorizing malformations as simple (capillary, lymphatic, venous, arteriovenous), combined, of major named vessels, or associated with other anomalies.
Mulliken and Glowacki's 1982 classification distinguishes hemangiomas, which exhibit endothelial proliferation and spontaneous regression, from vascular malformations, which are present at birth, grow proportionally, and lack proliferative endothelial activity.
