A fantastic lecture was given by Prof. Michel StCyr, Plastic Surgeon at the Mayo Clinic, USA. He introduced the concept of perforsomes for raising flaps i.e. the blood supply patterns by which a surgeon can lift living tissue and transfer it to another part of the body. It was great to meet up with Michel- we were surgical fellows at the Kleinert Institute of Hand and Micro-surgery, Louisville in 2004. For QVH, it was a new take on an old association- Sir Archibald McIndoe worked with the Mayo brothers in Rochester for 8 years in the 1930s before he came to the UK at the behest of Lord Moynihan. He eventually set up the Queen Victoria Hospital, East Grinstead.