In Togo, reconstructive management has been based on local and regional flaps. In some severe cases and in cases of failure, only a cross leg flap (if possible) or an amputation would save the patient. It has become vital to move forward in the reconstructive ladder in our setting. We report our first case of free gracilis muscle flap for the reconstruction of a foot defect in a 21-year-old male patient who was presented with a foot laceration due to a road traffic accident. The plastic surgeon had training in microsurgery. For other members of the operative team, this was the first microsurgery procedure. The gracilis muscle was harvested from the contralateral thigh and inset in the defect by microsurgical vascular anastomosis. The flap’s monitoring was done clinically. The post-operative course was uneventful. The muscle flap was resurfaced on day 5 using a split thickness skin graft. The patient was discharged on day 12. Total healing was seen on day 21. The patient was very satisfied with the procedure. The success of this first case represents an optimal motivation to build up a microsurgery team and the debut of microsurgery procedures for patients with difficult defects in Togo.

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Introduction: Gynaecomastia is the commonest aesthetic problem in men. Treatment in our environment is mainly by open surgical excision. The practice of liposuction is still developing in our region. We present our experience in the use of liposuction in the management of bilateral gynaecomastia in Alex Ekwueme Federal University Teaching Hospital Abakaliki with a satisfactory outcome. Method: We report a case of 33-year old male with idiopathic bilateral gynaecomastia (Simon grade IIb) and resultant aesthetic concern. Treatment was by suction-assisted liposuction with satisfactory outcome. Results: The lipoaspirate from the left breast was 900 mls and 600 mls from the right breast. Male chest contour was regained several weeks post-surgery with good patient satisfaction. Conclusion: Liposuction alone offered a satisfactory outcome in the management in this case.

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Context: Perforator flaps is now a very versatile tool for the reconstruction of challenging tissue defects. The beauty of the tool lies in the minimization of morbidity in comparison to conventional pedicled flaps surgery. Also the inherent property of ease of rotation through 180° gives it excellent versatility in repair of defects that would have been difficult with conventional pedicled flaps. Aims: This article discusses our experience and encourages more plastic surgeons to develop the skill and use it in solving complex reconstructive challenges. Methods and Material: This a case series involving 16 cases of complex wounds (chronic and acute) that presented at our unit. Results: A total of 16 cases were selected for surgical treatment. It involved 12 males and four females. The average age of the patients was 42.4 years. The most common site of reconstruction was in the lower limb with the left being more frequent. Posterior tibia artery was the most common axial vessel that the perforators were based. The most common complication in our series was superficial epidermolysis. There was no flap loss. Conclusions: Perforator flaps are indispensable tools in managing complex defects. This is the next available option to free flap transfer as long a perforator vessel can be identified in a skin tissue just large enough to cover a defect. Due to poor development of free flap surgery, we are encouraging surgeons − old and new − to pick up the skill. We have opened opportunities for training in our institution.

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Objective: As the country becomes increasingly ethnically and racially diverse, it is important for surgeons with an interest in eyelid anatomy to have an appreciation and understanding of eyelash and eye width variations that exist in order to plan for and execute ethnically congruent procedures. The eyelash and eye width analysis is an important aspect of patient assessment for plastic surgeons to identify variations from the normal anatomy. The aim of this study is to inform on anatomical variations that exist between selected ethnic groups as a guide for describing the status of the eyelash and eye width. Enlightenment on these variations will help instruct on important cultural aesthetics, which can be used to plan for blepharoplasty [A1] in a diverse patient population. Materials and Methods: Morphometry of eyelashes and eye width was conducted on 389 healthy volunteers comprising of 193 males and 196 females with no eyelash abnormalities and no eyelash extension participated in the study. The Yoruba tribe consisted of 274, the Igbo tribe were 78 and the Hausa tribe were 37 volunteers respectively. Result: The result showed that the Hausa tribe had the longest lashes with mean values in millimeters of 7.80±1.03, 9.35±1.13 and 8.29±1.19 followed by the Yoruba tribe with mean values of 7.40±3.14, 8.58±1.16 and 7.67±1.12 and then the Igbo tribe with mean values of 7.24±0.93, 8.65±0.89 and 7.72±0.83 on the medial, middle and lateral regions respectively. Further analysis also revealed that males had longer upper eyelid eyelashes in the three regions compared to females. With respect to age, volunteers between the ages of 0–19 years had longer eyelashes than those that were between the ages 20–39 years. The ratio of their mean eye width compared to the mean upper eyelash length was at least 5:1 or more across the three tribes. Conclusion: Morphometric analysis of the eyelashes and eye width provides baseline anatomic data relevant in the performance of cultural background sensitive procedures.

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