• Contemporary reconstructive microsurgery was introduced by an American plastic surgeon, Dr. Harry J. Buncke. (wikipedia.org)
  • Our thirty years of experience and strong presence in top-level Greek microsurgery practices have led to the establishment of the Metropolitan Hospital Upper Limb Surgery and Reconstructive Microsurgery Team. (metropolitan-hospital.gr)
  • Dr. Jon Ver Halen is a board-certified plastic surgeon with a passion for reconstructive microsurgery. (drjonverhalen.org)
  • If you are considering reconstructive microsurgery, Dr. Ver Halen is here to help. (drjonverhalen.org)
  • Reconstructive microsurgery is for anyone who has suffered a complex wound or injury that has resulted in the loss of tissue or function. (drjonverhalen.org)
  • Reconstructive microsurgery can also be used to restore function after an injury or illness. (drjonverhalen.org)
  • Dr. Ver Halen is a member of numerous professional organizations, including the Plastic Surgery Research Council, the American Society for Reconstructive Microsurgery, and the American Society of Plastic Surgeons. (drjonverhalen.org)
  • Reconstructive microsurgery is a complex and specialized type of surgery that uses a microscope to repair and reconstruct damaged or missing tissue. (drjonverhalen.org)
  • How does reconstructive microsurgery work? (drjonverhalen.org)
  • Reconstructive microsurgery uses a microscope to allow the surgeon to see and repair very small blood vessels and nerves. (drjonverhalen.org)
  • What are the benefits of reconstructive microsurgery? (drjonverhalen.org)
  • A Groundbreaking Medical First Norris' doctors say that the two-day operation is the world's first full-face transplant performed by a team of plastic and reconstructive surgeons with specialized training and expertise in craniofacial surgery and reconstructive microsurgery. (drsaum.com)
  • Though, most men and women who want or receive beauty surgical procedure have a specific goal to reshape, remove or appropriate imperfect regions of their physique, plastic surgical procedure also engulfs extra types of surgical treatment this kind of as reconstructive, microsurgery, melt away remedies and hand surgical treatment. (chototvinhlong.com)
  • Subsequently, Dr Ch'ng went to the premier cancer hospital in USA, The University of Texas MD Anderson Cancer Center in Houston, as an internationalfellow on the highly competitive American Society of Reconstructive Microsurgery Program. (streamly.video)
  • Another is that tissue-based reconstruction lends itself to a new type of microsurgery that can restore sensation to the chest after mastectomy. (curetoday.com)
  • Endoscopic sinus Surgery (ESS): ESS is an innovative type of microsurgery that uses a tiny camera and surgical tools to treat problems inside the nose, such as blocked sinuses or tumors. (ehealthhut.com)
  • Leading the charge in this evolution is the DIEP flap procedure, a technique that has revolutionized the way surgeons approach autologous tissue-based breast reconstruction. (plasticsurgery.org)
  • Dr. Michael Howard specializes in breast reconstruction microsurgery and has helped thousands of women restore their contours and confidence. (drmichaelhoward.com)
  • His comprehensive training and compassionate approach make him a trusted choice for procedures such as breast reconstruction, microsurgery, and skin cancer reconstruction. (n-bol.com)
  • Breast reconstruction plays a pivotal role in restoring a sense of wholeness and identity for individuals who have undergone mastectomy due to breast cancer. (drgregmackay.com)
  • Microvascular surgery or microsurgery is a surgical technique for joining or repairing the damaged blood vessels and nerves during reconstructive surgery of body parts. (xaviersimcockmd.com)
  • By developing new techniques in sutureless microsurgery, Sanduk made it possible to perform large numbers of high-quality cataract surgeries in remote locations. (aru.ac.uk)
  • Reconstructive Surgeries - We specialize in reconstructive procedures to restore functionality and aesthetics following trauma, birth defects, or cancer treatments. (n-bol.com)
  • In these types of surgeries correcting or restoring form and function to a specific portion of the entire body is essential. (chototvinhlong.com)
  • In a feature article in this special issue, we describe the techniques that connect nerves in transplanted tissue to those in the area being reconstructed, bringing sensation back. (curetoday.com)
  • While the approach has traditionally involved some compromise with muscle tissue, newer techniques like the APEX flap - introduced by the NOLA group - ensure minimal to no muscle damage. (plasticsurgery.org)
  • One of the main benefits of microsurgery is that it is often able to achieve precise results without causing any major damage to the surrounding tissue. (ehealthhut.com)
  • Other flap procedures used for autologous breast reconstructions use similar techniques, resulting in a healthy new breast that moves and feels like authentic breast tissue. (drmichaelhoward.com)
  • Because these techniques use the patient's own tissue, there's no risk of the body rejecting the new breast, or long-term side effects. (drmichaelhoward.com)
  • This technique permits the detection and repair of very small anatomical structures of the body, such as anastomosis of very small vessels and nerves (typically around 1mm in diameter), transfer of tissue from one part of the body to another, and replantation of amputated limb parts. (metropolitan-hospital.gr)
  • This technique is usually performed for soft tissue defects caused by tumor surgery or following a trauma. (xaviersimcockmd.com)
  • It is the same process as the free-tissue transfer, but in this technique, the bone along with its blood vessels are removed and transferred. (xaviersimcockmd.com)
  • These techniques mean that tissue from distant parts of the body, such as the intestine, arm muscle, abdominal muscle, or even lower leg bone, may be used to replace parts of the mouth, throat or jawbone. (cancercenter.com)
  • The doctor may repair a blocked fallopian tube with microsurgery (where tiny surgical tools are used to gently handle tissue). (gailmillerobgyn.com)
  • This decreases the pressure, lets the muscle tissue swell, and restores blood flow. (icloudhospital.com)
  • Using advanced techniques that often take many hours and may require the use of an operating microscope, plastic surgeons can now replant amputated fingers or transplant large sections of tissue, muscle or bone from one area of the body to another with the original blood supply intact. (sassonplasticsurgery.com)
  • The tissue is either transposed or rotated locally as a pedicled flap or detached from his vascular bed and reattached by the use of very precise small instruments and microsurgical techniques. (drhellers.com)
  • A technique enabling an extremely low impact of tissue is mandatory for the conservation of these small anatomical structures. (drhellers.com)
  • Free tissue transfer is a surgical reconstructive procedure using microsurgery. (drhellers.com)
  • Facial reconstruction techniques address fractures, soft tissue injuries, and complex facial trauma, aiming to restore normal facial structure and function. (drgregmackay.com)
  • Hand surgery focuses on repairing injuries to the hand, including fractures, tendon and nerve damage, and tissue loss to restore optimal hand functionality. (drgregmackay.com)
  • Trauma reconstructive surgery often involves repair of complex bony or soft tissue injuries and defects, as well as microvascular reconstruction, requiring the use of microsurgery techniques. (leica-microsystems.com)
  • Your surgeon will use skills with tissue rearrangement, microsurgery, and bony fixation to optimize your recovery. (stlukesonline.org)
  • However, the ideal scenario would be to improve the benefits offered by the MTA with the aid of other techniques that promote tissue regeneration. (bvsalud.org)
  • So whether you're thinking about getting a minor procedure done or dealing with a life-threatening disease, read on to learn all about the world of microsurgery. (ehealthhut.com)
  • This procedure is used to reshape the ears by restoring their shape and position. (ehealthhut.com)
  • In this procedure, the surgeon inflates a small balloon within the fractured vertebra and inserts bone cement to restore the original size and shape of the vertebrae. (baycare.org)
  • Lumbar disc microsurgery - This procedure is used to treat herniated discs of the lower back. (baycare.org)
  • In this procedure, the damaged disc is removed and a spacer is placed between the vertebrae to help restore alignment and relieve pain. (baycare.org)
  • I will discuss the procedure in detail, including where the surgery will be performed, the anesthesia and surgical techniques that will be used, possible risks and complications, the recovery and rehabilitation period, and the probable outcome in terms of function and appearance. (dralanweiss.com)
  • We use microsurgery for this procedure to rejoin the cut ends of the vas. (northeasternurology.com.au)
  • In all, more than 150 doctors, nurses, and medical staffers were involved in the groundbreaking procedure, which used innovative surgical and computerized techniques to "precisely transplant the mid-face, maxilla and mandible including teeth, and a portion of the tongue," as well as underlying muscles and nerves, said Dr. Rodriquez in a news release. (drsaum.com)
  • The artery and veins are reconnected to the blood vessels to restore blood circulation. (xaviersimcockmd.com)
  • Dr. Roof is skilled in the use of minimally invasive surgical techniques, such as transoral robotic surgery and transoral laser microsurgery. (mountsinai.org)
  • There she learnt the latest techniques in cancer surgery such asadvanced microsurgery, robotic surgery, and lymphoedema surgery. (streamly.video)
  • For those with longstanding facial paralysis, surgeons can transplant muscles to the face with microsurgery techniques. (orlandohealth.com)
  • Our surgeons utilize minimally invasive options whenever possible, but when traditional techniques offer the best solution, our specialists have the training and expertise to perform even the most complex procedures, including spinal reconstructive surgery, revision surgery (to correct previous operations), and surgery to correct curvature of the spine (scoliosis). (baycare.org)
  • Plastic surgeons undergo intensive training in hand surgery, and microsurgery. (dralanweiss.com)
  • Hand surgeons aim to restore hand and finger function. (icloudhospital.com)
  • In the past, surgeons usually waited till the time Cataract becomes mature or ripe, but modern technique an advances have now made possible to perform Cataract removal at early stage. (amdavadeyelaser.org)
  • Plastic surgeons help individuals regain their sense of belonging and restore their ability to become a contributing member of society. (drgregmackay.com)
  • In 1966, Buncke used microsurgery to transplant a primate's great toe to its hand. (wikipedia.org)
  • NeoGraft utilizes advanced hair transplant technology to restore patients' hair. (northeasternplasticsurgery.com)
  • The process requires microsurgery to transplant active hair follicles. (northeasternplasticsurgery.com)
  • NeoGraft uses a modern FUE microsurgical technique to take hair follicles from a donor site and transplant it. (northeasternplasticsurgery.com)
  • Therefore, it is crucial to choose a reputable and experienced hair transplant specialist who can assess your unique situation and recommend the most suitable technique for you. (transplantecapilar.com)
  • Consultation with a qualified hair transplant specialist is essential to determine the best approach for achieving natural-looking results and restoring your confidence. (transplantecapilar.com)
  • Skin grafting is a crucial technique used in hair transplant procedures in Turkey . (transplantecapilar.com)
  • At the Nova Medical Hair Transplant Clinic , we offer the latest NJ hair transplant methods to help effectively restore your hairline and put the confident swagger back in your step. (newjerseyhairtransplantclinic.com)
  • At the Nova Medical Hair Transplant Clinic , our team works hard to ensure that every patient who visits with a goal to restore their hairline with a NJ hair transplant can get the very best design and result possible. (newjerseyhairtransplantclinic.com)
  • He also specializes in complex reconstructive surgery, including microvascular free flaps, to restore form and function after cancer treatment. (mountsinai.org)
  • Advances in the techniques and technology that popularized microsurgery began in the early 1960s to involve other medical areas. (wikipedia.org)
  • The treatment of lesions of the brachial plexus has changed from shoulder fusion, elbow bone block, and finger tenodesis following World War II to far greater functional restoration made possible by advances in nerve repair and microsurgery. (medscape.com)
  • Both procedures restore patients' ability to better express emotions through the natural movements of their faces. (orlandohealth.com)
  • From small procedures such as fixing piercings to more complicated procedures such as removing cancerous tumors, microsurgery is an essential tool in the medical arsenal. (ehealthhut.com)
  • Microsurgery procedures are performed on a daily basis with great success. (ehealthhut.com)
  • Procedures such as dilation and evacuation (D&E), resection of tumor, excision of cyst, and repair of lacerations can all be done using microsurgery techniques. (ehealthhut.com)
  • Most hand surgery procedures will require follow-up with caring for the wound and physical therapy to restore normal hand movement. (drbramkaufman.com)
  • In addition to his skills and expertise with many popular aesthetic enhancement procedures, including breast augmentation , tummy tuck surgery, and liposuction , our board-certified plastic surgeon has extensive experience in facial reconstruction after skin cancer removal and other treatments designed to restore both physical function and cosmetic appearance. (plasticsurgerysne.com)
  • Dr. Tyler Clark is a board-certified plastic surgeon who is dedicated to helping patients restore form and function through reconstructive procedures. (n-bol.com)
  • With new techniques and breakthroughs in surgical instruments the variety of cosmetic surgical procedures is developing each and every year. (chototvinhlong.com)
  • Plastic surgery is a medical specialty that encompasses both reconstructive and aesthetic procedures aimed at enhancing appearance and restoring functionality to an individual. (drgregmackay.com)
  • These procedures not only restore physical appearance but also contribute to the psychological healing of patients, enabling them to return to normal function. (drgregmackay.com)
  • He is highly skilled in various techniques such as finger reconstruction to restore grasp function, bone grafting for congenital finger amputations, brachial plexus surgery finger separation, and hand rehabilitation. (fvhospital.com)
  • Furthermore, microsurgery is also known for its ability to help restore function and dignity to damaged tissues. (ehealthhut.com)
  • There was also no need for neurotization or microsurgery techniques to restore sphincteric function to the anus. (bvsalud.org)
  • Special tendon transmission and neurotransmission techniques can help paralytic hand or foot function, even in patients with quadriplegia. (metropolitan-hospital.gr)
  • Modern techniques have greatly improved the surgeon's ability to restore function and appearance, even in severe injuries. (dralanweiss.com)
  • In many cases, surgery can restore a significant degree of feeling and function to injured hands. (dralanweiss.com)
  • Reconstructive hand surgery can help restore the function as well as appearance of your hands and enable you to return to your normal lifestyle. (drbramkaufman.com)
  • Flap surgery can restore form and function to areas of the body that have lost skin, fat, muscle movement, and/or skeletal support. (sassonplasticsurgery.com)
  • I employ the latest 3-D imaging technology to optimize the reconstructive plans and am trained to use muscle-sparing techniques called perforator flaps to provide each patient the most ideal reconstruction to restore appearance and function. (weillcornell.org)
  • Although appearance is enhanced, the main goal of the surgery is to restore function. (drcappuccino.com)
  • He has extensive experience in repairing complex wounds and restoring function and form to patients who have suffered injuries or illnesses. (drjonverhalen.org)
  • For example, it can be used to reattach a severed limb or to restore the function of a damaged nerve. (drjonverhalen.org)
  • It can restore function after an injury or illness. (drjonverhalen.org)
  • Our goal is to restore function as well as have aesthetically pleasing results. (drsaum.com)
  • Unlike conventional reconstruction, facial transplantation seeks to transform severely deformed features to a near-normal appearance and function that conventional reconstructive plastic surgical techniques cannot match," NEJM study author Dr. Bohdan Pomahac, director of the plastic surgery transplantation program at BWH, reported last year. (drsaum.com)
  • Drs. Kim, Yoshinoya, Böcker and colleagues emphasize that their experiments are "solely descriptive," and that more research is needed to move the new technique out of the laboratory and into the operating room - to see how well hyperbaric-oxygen treated, fat-derived stem cells work to restore form and function. (plasticsurgery.org)
  • Her interests include facial skin cancers (especially those involving the ear, nose, eyelids and lips),advanced skin cancers requiring complex reconstruction following resection with a focus on obtaining the best cosmetic outcome and restoring function,surgery for parotid tumours (including nerve integrity monitoring and mini-facelift incisions), facelift, neck lift and blepharoplasty (eyelid surgery). (streamly.video)
  • The surgery mainly helps to restore the function of the tissues. (indicure.com)
  • When you have cancer, an injury, or another condition that affects the appearance or function of your face, skull, scalp, or neck, you may need a plastic and reconstructive surgeon to restore a natural appearance and function. (stlukesonline.org)
  • For example, microsurgical techniques are often used to repair spinal cord injuries or facial disfigurements. (ehealthhut.com)
  • This team aims to provide the most comprehensive and timely treatment of upper limb and peripheral nerve injuries and conditions, using traditional and innovative surgical techniques, while at the same time showing kindness and compassion towards patients and working closely with other health professionals. (metropolitan-hospital.gr)
  • Surgical investigation of such injuries using a surgical microscope reveals the extent of damage and leads to a decision about immediate or subsequent microsurgery repair, minimizing the complications and optimizing the results. (metropolitan-hospital.gr)
  • Microsurgery is performed in patients with head and neck cancer, nerve injuries and fractured limb. (xaviersimcockmd.com)
  • Hand microsurgery can be performed for a variety of causes, including hand injuries, rheumatic disorders that alter and harm the structures of the hand, such as osteoarthritis and rheumatoid arthritis , degenerative alterations to the hand's structures, hand problems or deformities that are present at birth, known as congenital & hand infections are common. (icloudhospital.com)
  • Dr. Nelson has advanced experience in wrist arthroscopy, microsurgery and the treatment of injuries among athletes. (oklahomahand.com)
  • As a New Zealand otolaryngologist working in London, he developed many of the techniques used in modern facial surgery to care for soldiers who suffered disfiguring facial injuries during World War 1. (essentialfeeling.co.uk)
  • Newer techniques such as endoscopic carpal tunnel surgery, neurotransmission, use of nerve conductors and allografts are appropriately used and indicated by experienced microsurgeons. (metropolitan-hospital.gr)
  • He developed the middle fossa approach and perfected the translabyrinthine approach and began to use these techniques to remove acoustic nerve tumors. (wikipedia.org)
  • Follicular Unit Transplantation (FUT) is a traditional hair transplantation technique that involves removing a thin strip of hair-bearing scalp from the donor area. (transplantecapilar.com)
  • This involves the collection of sperm directly from the testis or epididymis, and it is injected directly into an egg collected by IVF techniques. (northeasternurology.com.au)
  • Plastic surgery is a surgical specialty that involves restoring, rebuilding or altering the human body. (essentialfeeling.co.uk)
  • Oncologic reconstructive surgery involves repairing, reconstructing and restoring physical deformities or defects caused by cancer or its treatment. (leica-microsystems.com)
  • Rather than harvesting bone from the patient's pelvic bone, which can be a significant source of post-operative pain, this technique uses bone graft substitutes (osteobiologics) to enhance healing. (baycare.org)
  • Though success will largely depend on the extent of a patient's injury, flap surgery and microsurgery have vastly improved a plastic surgeon's ability to help a severely injured or disfigured patient. (sassonplasticsurgery.com)
  • Using the most advanced surgical techniques with technical precision and attention to detail, I strive to provide the highest quality reconstructive and aesthetic surgery that will enhance each patient's quality of life. (weillcornell.org)
  • I use various massage techniques, which are matched to each patient's needs. (jaszkiewiczphysioclinic.com)
  • Otolaryngologists were the first physicians to use microsurgical techniques. (wikipedia.org)
  • She also offers aesthetic surgery for the face and body with the goal to enhance appearance with a natural un-operated look using the most advanced surgical techniques available. (weillcornell.org)
  • Further delving into the procedure's intricacies, he highlighted the emphasis on muscle and nerve consideration, the restoration of sensation and the crucial role of proficiency in microsurgery. (plasticsurgery.org)
  • In this technique, either the epineurium layer or perineurium layer or both the layers of the nerve are sutured. (xaviersimcockmd.com)
  • In this technique, a piece of nerve from one part of the body is transferred to the damaged area using anastomosis techniques. (xaviersimcockmd.com)
  • She went on to complete a fellowship in microsurgery for reconstruction of oncologic and traumatic defects at NYU Langone Medical Center and at Memorial Sloan Kettering Cancer Center. (weillcornell.org)
  • Microsurgery is a general term for surgery requiring an operating microscope. (wikipedia.org)
  • The revival of the stapes mobilization operation by Rosen, in 1953, made the use of the microscope mandatory, although it was not used by the originators of the technique, Kessel (1878), Boucheron (1888) and Miot (1890). (wikipedia.org)
  • Mastoidectomies began to be performed with the surgical microscope and so were the tympanoplasty techniques that became known in the early 1950s. (wikipedia.org)
  • Using an operating microscope, he performed coupling of vessels as small as 1.4 mm and coined the term microsurgery. (wikipedia.org)
  • The term "microsurgery" refers to the surgical technique that uses a surgical microscope. (metropolitan-hospital.gr)
  • A microscope having a magnification of 5 to 40 times is used for microsurgery. (xaviersimcockmd.com)
  • This technique allows for the transplantation of healthy hair follicles from a donor site to the recipient area, resulting in permanent hair growth. (transplantecapilar.com)
  • Only surgeon with expertise in microsurgery and experience in calculating the best possible outcomes, post-surgery, are able to perform this type of operation. (fvhospital.com)
  • Known as Nepal's miracle eye doctor Dr Sanduk Ruit, an eminent eye-surgeon, has restored the sight of more than 120,000 people across Nepal and beyond. (australiaawardsnepal.org)
  • Early in his career, through his friendship and collaboration, he was inspired by Dr Fred Hollows, a trailblazing Australian eye-surgeon with whom he shared the vision that all people with treatable blindness have the right to restored eyesight. (australiaawardsnepal.org)
  • Hand surgery is a sophisticated technique to restore functionality to hands that have deformities that were present at birth or caused by accidents. (fvhospital.com)
  • On the other hand , Follicular Unit Extraction (FUE) is a more advanced and minimally invasive technique. (transplantecapilar.com)
  • What are the Different Types of Hand Microsurgery? (icloudhospital.com)
  • Skin grafts for the hand include restoring or connecting skin to a missing area of the hand. (icloudhospital.com)
  • Hand surgery became a part of the plastic surgery training mostly by providing an atraumatic surgical technique. (drhellers.com)
  • After completing extensive education and training at some of the most prestigious institutions in Massachusetts, Dr. Babbitt obtained a fellowship focused on microsurgery, human anatomy, abdominal and limb reconstruction, and wound healing. (plasticsurgerysne.com)
  • The vessels that supply the free flap are anastomosed with microsurgery to matching vessels (artery and vein) in the reconstructive site. (drhellers.com)
  • We bring back, refashion and restore to wholeness the features that nature gave but chance destroyed, not that they may be an advantage to the living soul, not as a mean artifice but as an alleviation of illness, not as becomes charlatans but as becomes good physicians and followers of the great Hippocrates. (drcappuccino.com)
  • It includes a wide variety of techniques, ranging from skin grafts and local flaps to pedicled and free flaps. (leica-microsystems.com)
  • The choice between the two techniques ultimately depends on the individual's specific needs, hair loss pattern, and donor area availability. (transplantecapilar.com)
  • The decision between the two techniques should be based on individual factors such as hair loss pattern, donor area availability, and personal preferences. (transplantecapilar.com)
  • Rather than the labour-intensive manual microsurgery of FUT methods, theNeoGraft system is automated to extract individual hair follicular units from the donor site and then implant them into a recipient area of the scalp. (newjerseyhairtransplantclinic.com)
  • Plastic surgery can help in restoring dignity in these individual, giving them the chance to heal and offering them a fresh start. (drgregmackay.com)
  • Our most innovative and advanced technology utilizes the Neograft system to carry out the precision follicular unit extraction (FUE) technique. (newjerseyhairtransplantclinic.com)
  • In this blog post, we will introduce you to microsurgery and discuss some of the benefits it offers patients. (ehealthhut.com)
  • Dr. Ver Halen is dedicated to helping his patients achieve their desired outcomes, using the safest and most effective techniques. (drjonverhalen.org)
  • We utilize the latest surgical techniques and employ state-of-the-art technology to ensure optimal results and minimal downtime for our patients. (n-bol.com)
  • After the war, Gillies developed a private practice with Rainsford Mowlem, including many famous patients, and traveled extensively to promote his advanced techniques around the world. (essentialfeeling.co.uk)
  • Sanduk went to study with Doctor Hollows at the Prince of Wales Hospital in Sydney, and it was here that he applied a surgical technique using implanted intraocular lenses, which he had finetuned in Nepal. (aru.ac.uk)
  • While in Australia, Dr Ruit learned about a cataract micro-surgery technique using implanted intraocular lenses. (australiaawardsnepal.org)
  • The technique aims at enhancing the quality and quantity of new bone and accelerating bone growth around the bone cavity 17 . (bvsalud.org)
  • The pair quickly formed a close bond, and Doctor Hollows took on the role of mentor, helping Sanduk find his true path - to restore eyesight to people who are unnecessarily blind. (aru.ac.uk)
  • When you decide which massage technique to use, it is crucial to ask yourself what results you expect - temporary relaxation or removing sources of pain and achieve deep muscle regeneration. (jaszkiewiczphysioclinic.com)
  • Blood vessel reconstruction has successful outcomes, and helps to restore blood flow to the affected regions and keeps them alive. (drbramkaufman.com)
  • Reconstructive plastic surgery serves a critical role in restoring form and functionality to individuals who have experienced physical trauma or have been diagnosed with congenital abnormalities or serious medical conditions, such as breast cancer. (drgregmackay.com)