Robert Choa1, Sukbhir Rayatt2, Kamal Mahtani3. 1. Department of Plastic Surgery Royal Stoke University Hospital, Stoke on Trent ST4 6QG, UK rob_choa@hotmail.com. 2. Department of Plastic Surgery Royal Stoke University Hospital, Stoke on Trent ST4 6QG, UK. 3. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.