The progress of surgery has been utterly dependent on continuing innovations by surgeon innovators, largely because surgeons work in an environment that is very conducive to innovating. Of all clinicians surgeons excel at improvisations and innovations. The aim of this review is to outline some of my innovations, the circumstances leading to their origin, and to explain some of the fundamental concepts behind those innovations, with a view to inviting and encouraging younger surgeons to consider breaking away - sensibly - from convention at times, and embark on a journey towards innovation. The context and the qualities required of a would-be innovator are explained and the process of innovation itself is analysed. Rigid adherence to prevailing assumptions and practices stifles originality, while adopting a questioning attitude with a smidgen of irreverence facilitates innovation. That an innovation has resulted purely by a chance observation or occurrence - serendipity - may render it less glamorous but never less useful. Innovations in surgical techniques necessitate adoption of a novel pragmatic surgical philosophy. Confined as they are to Oculoplasty, the concepts of innovations cited and illustrated in this review, are equally valid for Plastic surgery and indeed for Surgery in general. Working in a small hospital or an isolated Institution need not be a hindrance to a would-be innovator.
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