IMA Journal – February 2023

Message from Team IMA Chennai Kauvery Alwarpet Branch

Dear colleagues,

Greetings from IMA Kauvery Alwarpet branch Chennai. This month kick started with our annual Kauvery family get together. We thank all our consultants who participated in the memorable fun filled event which brought nostalgic memories of our college days and rejuvenated us.

With the same enthusiasm, we are delighted to share an platter of interesting articles, contributed by the Department of Plastic surgery, a premier department at Kauvery hospital with very highly skilled plastic surgeons available round the clock.

The articles will definitely be a feast to our knowledge.

Our thanks to Prof. V. B. Narayana Murthy, Sushrutha Professorship Plastic Surgery/Senior Consultant Plastic Surgery and his team.

Long live IMA

Yours in IMA service,
Dr S Sivaram Kannan

Plastic surgery is about refinement, restoration, reconstruction and quality.

In life, not always we avoid plastics!!!

This month, we bring you articles illustrating the challenges and variety from the department of plastic surgery.

Long live IMA.

Yours in IMA service,
Dr. Bhuvaneshwari Rajendran

Dr. R. Balasubramaniyam

Dear friends

Happy to meet you all through this month’s IMA journal.

The contributions have come from the Department of Plastic and Reconstructive Surgery.

My sincere thanks to them.

Thanks to the Editorial and Branding team for getting the journal on time.

With regards
Dr. R. Balasubramaniyam

Plastic Surgeon and Family doctors

The role of plastic surgeons to family doctors is a critical one as they work together to provide comprehensive care to their patients.

There are several first to this article.

1. Endeavours of Kauvery hospital, a new age hospital, to involve and provide an opportunity for plastic surgical team to share their views on the relationship they have with the family doctors. A very vital aspect and opportunity to further excel in the delivery of quality plastic surgical services in a collaborative manner.
2. Plastic surgical team share the knowledge in the form of case studies and also will make the varied and complex services of plastic surgeons easy to understand for every doctor.
3. This is also the first attempt to collaborate with Chat GPT. This has given me a new paradigm in preparing a document.

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Why Plastic Surgeon, Why Plastic Surgery - I say Pour Quoi Pas. KKK syndrome

In the continuing series on what I wonder to the question Why Plastic surgeon, Why Plastic Surgery – for a particular condition, I say Pour Quoi  Pas.?, WHY NOT ?. I have the pleasure of sharing yet another interesting set of conditions which I have treated. We are in an era where EBM (evidence based medicine) rules supreme and other EBMs, namely Eminence Based Medicine or Experience Based Medicine is generally given a cold shoulder and has a bad name. However, most do believe that EBM in whatever form can be useful to discuss and make some sense of it. Today, I am going to discuss the “KKK syndrome” which every medical student in Tamil Nadu would have heard in his lifetime. To me it is almost synonymous with the OPD’s we do in medicine in medical collages as house surgeons. Much talked about and ridiculed but never taken serioulsly.

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Neglected Pulp Space Infections


A Felon is a subcutaneous abscess of the distal pulp of a finger or thumb. Superficial infections of the most distal part of the pulp skin are known as apical infections. Apical infections are different from felon in that the palmar pad is not involved. The term Felon should be reserved for those infections involving multiple septal compartments and causing compartment syndrome of the distal phalangeal pulp. The most common organism grown from felons is S. aureus. Gram negative infections have also been reported. Though this condition is uncommon, it is typically seen in immunocompromised.

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Post Mastectomy Breast Reconstruction


Post mastectomy breast reconstruction is an integral part of breast cancer management. The breast is an important organ for a woman’s body image. Despite the benefits of psychosocial well-being, positive body image, and improved quality of life, very few women in India undergo breast reconstruction after mastectomy. Only one percent of women undergoing mastectomies receive breast reconstruction although breast cancer is the most common cancer accounting for 14% of all new cases of malignancies.

Case History and Management

A 50-year-old postmenopausal woman presented with a history of lump in upper outer quadrant of left breast

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Fat Grafting – A Novel Technique for Contour Correction


Fat grafting is a procedure, where excess fat from one part of the body is removed by aspiration and injected into another area for correction of contour deformity and improved aesthesis. This was first introduced by Dr Coleman in 1986, but the technique got universal acceptable and application much later. The technique has been experimented and perfected in the last decade by many surgeons and evolved into a unique method for augmenting the volume in contour deficient areas of the body. It is used to correct deformity in face, augmentation of the breast, correction of post injury deformities in limbs and to improve appearance of the old scars.

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Not An Uncommon Complication Of Diabetes Mellitus

Necrotizing fasciitis (NF) is an aggressive skin and soft tissue infection (SSTI) that cause necrosis of the muscle fascia and subcutaneous tissues. This infection typically travels along the fascial plane, which has a poor blood supply, leaving the overlying tissues initially unaffected, potentially delaying diagnosis and surgical intervention. Consequently early recognition of symptoms is crucial and patients have to be rushed into surgery immediately where a thorough debridement needs to be performed. Diabetic patients exhibit impaired cutaneous wound healing with increased susceptibility to infection and it is therefore reasonable to speculate that this chronic, debilitating disease contributes to a more serious nature of NF.
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