Breast asymmetry and pectus excavatum improvement with fat grafting.

Background: In women, pectus excavatum malformation can cause modified breast morphology, resulting in mammary asymmetry, which can be increased by placing mammary implants alone. Fat transfer can be an elegant solution to increase the volume and projection of the breast.

Objectives: The authors discuss their experience treating pectus excavatum with fat transfer (lipomodeling) since 2000.

Factors associated with medicine use and self medication are different in adolescents.

Objective: To estimate the prevalence of medicine use among high school students (14-18 years old) living in an urban area in Southern Brazil and the proportion who self-medicate and to explore the association between medicine use and demographic, socioeconomic, and behavioral variables.

Methods: A school-based survey was conducted among high school students in the city of Maringá/PR, Brazil in 2007. The sample students were selected through two-stage random sampling.

Breast fat grafting (lipomodelling) after extended latissimus dorsi flap breast reconstruction: a preliminary report of 200 consecutive cases.

Background: The efficacy of fat grafting has long been a controversial issue. Breast lipomodelling after extended latissimus dorsi flap reconstruction was first attempted at the Plastic and Reconstructive Surgery unit of Leon Berard Cancer Centre in 1999. We present the results of a retrospective report of the first 200 consecutive patients treated at our institution from 1999 to 2003.

Lipomodeling of Poland's syndrome: a new treatment of the thoracic deformity.

Background: The severe forms of Poland's syndrome, with thoracic deformity, were until now very difficult to treat, with treatment involving complex surgery and implant insertion. Results were, in general, inadequate and the appearance unnatural. Our experience with fat transfer for breast reconstruction led us to propose reconstruction of the breast and thorax by serial fat transfer.

Patient information before aesthetic lipomodeling (lipoaugmentation): a French plastic surgeon's perspective.

Fat grafting to the breasts has long been controversial among aesthetic surgeons. We have developed a new, safe, effective, and reliable lipomodeling method to be used in breast augmentation. This method grew out of our clinical and radiologic experience acquired since 1998 with fat injections to the breast.

[Treatment by fat tissue transfer for radiation injury in childhood facial cancer].

The radiation treatment of malignant facial tumors in children may induce major functional and cosmetic sequelae, mainly due to uneven growth of the bones and soft tissues, resulting in facial asymmetry and hemihypotrophy at adult age. Although fat transfer has proven effective for facial cosmetic treatment, few studies have demonstrated the benefit of the technique in heavily irradiated tissues. The techniques generally used for the treatment of facial asymmetry or hypotrophy are ill-adapted to irradiated patients.

[Prevention of seroma by quilting suture after harvesting latissimus dorsi flap. The "Chippendale" technic].

Unlabelled: Seroma is the most frequent minor complication after harvesting latissimus dorsi flap for breast reconstruction. It induces patient's discomfort and multiple consultations for punctions. The dead space resulting from the harvest has to be closed by the "quilting suture" in order to prevent the seroma.

[Breast volume reconstruction by lipomodeling technique: about 15 consecutive cases].

Unlabelled: BACKGROUND OF STUDY: The purpose of this prospective study is to detail the preliminary results, the advantages and drawbacks of a new iterative fat transfer protocol in selected breast reconstructions.

Material And Methods: Fifteen patients had breast reconstruction following mastectomy for breast cancer by this iterative lipomodeling protocol, between 2002 and 2007. Clinical and technical aspects are described.

[Skin-sparing mastectomies: how to avoid skin necrosis?].

Skin-sparing mastectomy (SSM) has emerged as the surgical technique best adapted to the treatment of early breast cancers or breast cancer recurrences after conservative treatment; the technique is particularly appreciated by the patients who had been expecting the development of immediate, high-quality breast reconstruction for over 15 years. SSM preserves anatomical landmarks on the skin surface (notably the under-breast fold and the conical shape of the breast). The procedure must be performed by a skilled surgical team in order to maximize the quality of breast resection and reconstruction, particularly to avoid postoperative complications, notably damage to blood vessels within the skin flap and prosthesis infection.

[Post-treatment sequelae after breast cancer conservative surgery].

Thanks to the earlier detection of breast cancer, the advent of neoadjuvant therapy and the development of more effective surgical procedures reducing treatment sequelae, conservative treatment has dramatically expanded over the past 15 years. Several factors have recognized negative aesthetic consequences for breast cancer patients: being overweight, having voluminous or on the contrary, very small breasts, having a tumor located in the lower quadrant, having high breast-tumor: breast-volume ratio. Tissue injuries induced by radiotherapy and chemotherapy, such as shrinking, fibrosis or induration, maximize the deleterious impact of surgery.

[Efficacy of lipomodelling for the management of sequelae of breast cancer conservative treatment].

We report a study of 42 breast cancer patients undergoing lipomodelling, or fat transfer, for sequelae of conservative treatment. Detailed clinical and radiological data of the patients have been collected. These data demonstrate the feasibility of lipomodelling: the technique is simple but requires a learning curve to avoid cytosteatonecrotic lesions; the excellent results obtained in terms of shape and softness of the breast; no surgical implant or flap reconstruction is necessary; the reliability of the procedure: there is normal fat wasting within the first months after treatment, then results stabilize as the patient maintains a healthy weight; the small number of side-effects: only rare, predominantly infectious, rapidly resolving complications are induced.

[Radiological evaluation after lipomodelling for correction of breast conservative treatment sequelae].

Breast lipomodelling has been used in our unit since 2002 to correct the sequelae of conservative treatment of cancer. Morphologically, satisfactory results have been recorded and the method is likely to develop considerably. However, the technique has also been questioned because of the possible deleterious radiological impact of injecting fat into the breast.

[Extra-abdominal desmoid tumor in a scar of donor-site of a latissimus dorsi flap: case report].

Tumefaction arising lately after latissimus dorsi flap harvest are rare and observed in 1 or 2% of the cases. These lesions are frequently related to kystic sero-hematoma and are easily and efficiently treated with surgical excision. In some rare circumstances, a tumoral evolution can mimic a kystic sero-hematoma.

[Modified Texier mediodorsal transposition island skin flap of the nose. Report of four cases of ala nasi reconstruction].

First described by Texier in 1994, the mediodorsal transposition flap of the nose is an island flap. The paramedian dorsal arteries (anastomosed to the interdomal plexus) ensured the axial vascularisation in SMAS plane. The authors will discuss their personal approach to the surgical procedure for the improvement of final result, with four clinical cases.

Immediate nipple reconstruction during immediate autologous latissimus breast reconstruction.

Background: Creation of the nipple-areola complex is the final step in surgical restoration of the breast. Often considered as a secondary complement to breast reconstruction, nipple-areola reconstruction is usually done after an interval of several months and makes use of composite graft techniques involving the opposite nipple or local flaps.

Methods: Because the position of the nipple-areola complex is defined from the outset in skin-sparing mastectomy and because of the disappointing results obtained by classic nipple reconstruction techniques, the authors propose immediate nipple reconstruction using the skin paddle of the latissimus dorsi flap.

[Anaplastic thyroid carcinoma: aggressive radical resection and cervical reconstruction. A case report].

Study Aim: Anaplastic carcinoma of the thyroid is a rare but highly malignant tumor. The goal of this study was to present the case of a patient who underwent a multimodal treatment and to analyze prognosis factors.

Patient And Methods: We present the case of a patient treated in 1996 for an anaplasic thyroid carcinoma with cervical cutaneous invasion.

[Bilateral breast reconstruction with the autologous latissimus dorsi flap (a retrospective study of 31 consecutive cases)].

Purpose Of The Study: The purpose of this study was to analyse the advantages, disadvantages and results of bilateral breast reconstruction by autologous latissimus dorsi flap.

Material And Method: Thirty-one two-stage consecutive bilateral breast reconstructions were performed by the same operator between 1993 and 2001. All the reconstructions, in immediate or delayed manner, were indicated after radical or skin sparing mastectomy for breast cancer.

[Radiological evaluation of breasts reconstructed with lipomodeling].

We have been using the lipomodeling technique since 1999 in order to improve the form and the volume of the breasts reconstructed with latissimus dorsi flap. During several recent years this technique has known a considerable development and its results are quite attractive. At the same time, the breast imaging remains to be a fundamental mean of cancer control.

[3D evaluation and mammary augmentation surgery].

The medical application of the interferometry is valid now. The breast surgery works on the shape and the volume of the tissue. The Inspeck technology is now available and works well in our medical practice.

[Breast implant alternatives].

The use of implants is a basic technique in breast reconstruction after mastectomy, for the correction of breast abnormalities or even more in aesthetic breast augmentation. However, especially in difficult cases, implants can have inconveniences and insufficiencies (poor natural aspect, necessity of replacement, capsular contracture). To mitigate these, numerous alternatives were developed.

[Information of the patient: the characteristics of implant breast augmentation].

Delivering full information and obtaining enlightened assent is an unavoidable stage before each operation. This paper presents the different "rules" that defines this information duty in France. The assimilation of these different elements: sources, contents and the weight of the information can help the surgeon to carry out the consultation before breast augmentation with more efficiency and objectivity.

[3 D evaluation and breast plastic surgery: preliminary study].

Due to the development of the invasive technique of digital exam, the three-dimensional results are more and more precise, spectacular and helpful. The 3D surfacic model is for a medical approach and non invasive. Early in 2003, we have started a patient evaluation before and after surgery.

[An unusual risk of liposuction: liposuction of a malignant tumor. About 2 patients].

Liposuction is a simple and elegant way to treat fatty excess; it has been even used for the treatment of lipomas and some gynecomasties. The goal of this article is to present 2 patients with an unusual complication of this use: the liposuction of a malignant tumor. The first patient consulted following the liposuction of a "gynecomasty", which was in fact a breast cancer.

[Sports and facial injuries. Feasibility and limitations of an epidemiologic study].

Our aim was to conduct an epidemiological study in order to better assess the frequency of maxillo-facial sport injuries. Only those activities that are practised within a sport or game association are included in the study. A standard letter was sent to all French sport and game associations (Olympic or not) as well as to some major insurance companies (73 sport and game associations and 11 insurance companies).