Reflections on the IPRAS world congress

I was awarded a travel bursary by BAPRAS to present a paper on ‘Versatility of reverse sural artery neurocutaneous flap for distal lower limb reconstruction: a meta-analysis and case series’, which made it possible for me to attend the congress.

Highlights were numerous, but included new insights as well as updates on breast reconstruction, hands, burns, lower limb reconstruction, craniofacial surgery and facial transplantation, skin cancer, fat grafting, aesthetic surgery and post-bariatric body contouring surgery. In addition to multiple concurrent presentations, there were 10 ‘round table’ sessions, where 3-5 experts discussed a particular topic from different perspectives. There were also 7 master-classes each evening covering a wide range of topics from fat grafting to vascular malformations.

One particular highlight was the keynote lecture given by Dr Luis Vasconez (Birmingham, USA), looking back at the past fifty years of plastic surgery advances. This session reminded both young trainees and established surgeons of the tremendous strides that our specialty has taken, and reinforced that, for the specialty to progress, we cannot not be complacent, but to continue striving for excellence.

The future of plastic surgery depends on the ability to train high-caliber trainees, who will innovate and bring the specialty forward. Therefore, the ‘round table’ session on Training in Plastic Surgery, where training programme directors from a number of countries (Canada, Brazil, Russia, Italy) presented their current training structure together with the pearls and pitfalls of each, was particularly fascinating. A lively discussion followed where a number of issues were raised, including how to deal with failing trainees and the advantages and disadvantages of a standardised exit exam, especially across the Europe.

Continuing with the theme of training, the recently founded IPRAS trainees association (IPRAS-TA) invited all trainees to a business meeting, which was attended by trainees from 23 different countries. The main aim of IPRAS-TA is to create opportunity for trainees to share their experience and to encourage exchange of trainees internationally. It has launched a survey to evaluate the structure of plastic surgical training among IPRAS member countries, and the outcome of this survey will no doubt be of great interest.

The congress provided several tantalising glimpses into the future of plastic surgery and its challenges across a range of seminars. Cell-based therapies for both reconstructive and aesthetic applications or tissue engineering of whole organs, although enticing, appear a long way off. Composite tissue allotransplants (CTA), however, have become a viable treatment option in many countries, as evidenced by the presentations from China and the USA. With the first CTA (hand transplant) successfully carried out in 1998, medium- and long-term functional outcomes have now begun to emerge, which will undoubtedly dictate its future direction.


All in all, I was impressed with the breadth of topics presented as well as with the diversity of the presenters. However, I noted that most of the presentations reported level 3 – 4 evidence, with very few presenters reporting results of controlled studies. I also observed the paucity of reports from basic science plastic surgical research.

I was also surprised to find that a number of presenters (and even a few chair persons!) did not attend their respective sessions.

So was it worth attending, as a trainee? Yes. Although the scientific scrutiny could have been more stringent, the overall learning experience was enjoyable. I particularly relished learning the training experiences around the world and the opportunity to meet my peers across the globe. It was also humbling to meet the plastic surgery greats from all over.

As the sun went down over the Andes mountains on the final evening of the congress, I reflected on the lectures that I attended, the people that I met, and perhaps most importantly, the friends that I made, and toasted on a thoroughly enjoyable trip.

Thet Su Win
Plastic Surgery Trainee