[Gynécomastia. Management of diagnosis and therapy. Apropos of 148 cases].

Gynecomastia is the most frequently breast lesion in males. 148 patients (mean age 24,7 years) operated in our department were reviewed with a mean follow-up of five years. Gynecomastia occurred most frequently during puberty (77,7 %), was bilateral (86,5%) and idiopathic (89,9%).

[Nipple-areola complex malformations].

THE NIPPLE-AREOLA COMPLEX, ALSO KNOWN AS THE NIPPLE-AREOLA PLATE, IS AN ESSENTIAL VISUAL FEATURE OF THE BREAST.THIS COMPLEX CAN BE AFFECTED BY VARIOUS MALFORMATIONS, BOTH CONGENITAL AND ACQUIRED. ALTHOUGH THESE ANOMALIES OFTEN HAVE A MODERATE IMPACT ON THE FUNCTIONALITY OF THIS COMPLEX, THE RESULTING PSYCHOLOGICAL CONSEQUENCES CAN BE SIGNIFICANT.

[Is it legitimate to propose surgery of the breast area before the end of puberty?].

Breast surgery is usually recommended for women who have completed puberty. Indeed, during adolescence the breast is constantly changing, the patient's weight is often unstable, the risk of inflammatory scars (hypertrophic or keloid) is higher and disturbances of areolar sensitivity can affect the patient's quality of sexual life. In addition, the risk of infection is not negligible, especially during an acne outbreak.

Evaluation of satisfaction and the quality of life after bilateral breast reconstruction using the BREAST-Q questionnaire.

Background: The demand of breast reconstruction is growing, the purpose of this study is to evaluate the satisfaction and quality of life of patients who underwent bilateral breast reconstruction.

Methods: In this cohort retrospective study, patients who underwent bilateral breast reconstruction in our department between September 2009 and December 2019 were asked to complete BREAST-Q questionnaire based on the timing of the reconstruction received following mastectomy, thus dividing them into three groups: (1) bilateral immediate breast reconstruction(BIBR), (2) immediate breast reconstruction in one side and delayed reconstruction on the other side (mixed group), (3) bilateral delayed breast reconstruction(BDBR). Surgical techniques were divided into prosthesthetic (permanent implant and expander), flaps (pedicle or free), mixed technique (associating flap and prosthesis).

[Buccinator muscle: A new target for botulinum toxin injections in the treatment of facial paralysis sequelae].

Aim Of The Study: Facial paralysis can cause aesthetic and functional sequelae such as spasms and synkinesis. Botulinum toxin injection is one of the key treatments for these sequelae. Its use is widely reported in the literature for many muscles of the face but little for the buccinator muscle.

[Not Available].

The recreational consumption of nitrous oxide has steadily increased in recent years. Before being inhaled, the nitrous oxide is contained in a gas cylinder held firmly between the thighs and then the gas is transferred to a rubber balloon. During the deconditioning steps, the cylinder cools down and causes frostbite.

Free flap for lower limb salvage in infectious purpura fulminans.

Background: Infectious purpura fulminans is a disabling disease often leading to amputations. Free flaps preserve limb length, covering exposed areas. We examined the efficacy of free flaps for lower limb salvage in infectious purpura fulminans survivors by evaluating surgical management, walking ability and quality of life.

The interest of "ortho-plastic" collaboration in management of complex limb injury.

Constantly evolving knowledge on fracture management, soft tissue coverage, microsurgery and vasculo-nervous repair now permits salvage of limbs that previously would have had to be amputated. Management of complex limb injuries of which the severity inevitably entails functional and esthetic sequelae calls for mastery of the full spectrum of bone and soft tissue reconstruction. Such mastery is rarely attainable by a single surgical specialty; individually and isolatedly, an orthopedic or plastic surgeon cannot ensure optimal management of the above-mentioned patients.

[New surgical strategy in breast reconstruction with implants for bilateral prophylactic mastectomies with BRCA gene mutation].

Background: For the past decades, number of prophylactic bilateral mastectomies using reconstruction with implants increases. We describe a new surgical strategy and analyse its safety and feasability.

Method: It is a retrospective, descriptive and monocentric study.

Benefits of cryopreserved human amniotic membranes in association with conventional treatments in the management of full-thickness burns.

The use of split-thickness skin autografts (STSA) with dermal substitutes is the gold standard treatment for third-degree burn patients. In this article, we tested whether cryopreserved amniotic membranes could be beneficial to the current treatments for full-thickness burns. Swines were subjected to standardised full-thickness burn injuries, and then were randomly assigned to treatments: (a) STSA alone; (b) STSA associated with the dermal substitute, Matriderm; (c) STSA plus human amniotic membrane (HAM); and (d) STSA associated with Matriderm plus HAM.

[Gluteal flap harvest for breast reconstruction].

The lower gluteal flap is an autologous microsurgical breast reconstruction procedure using the soft tissue of the region of the gluteal sulcus. The perineal extension increases the volume of the sample. The pedicle with one artery and two large veins extends up the ischial notch and can reach 8 to 12cm.

[Emergency management of extravasation in children].

The subcutaneous diffusion of intravenous drips, or extravasation, is a frequent iatrogenic complication in children, mainly in the neonatal period. This potentially severe pathology can lead to local ischemia that sometimes mimics compartment syndrome. It can also evolve towards vast soft-tissue necrosis.

[Burn child specificity].

Burn is still a frequent accident in children and particularly occurs in young children under 4years. The majority were caused by hot liquids (scalds) with mixed-dermal burns and is commonly treated conservatively with surgery performed at 10-15 days post-injury after healing of superficial burn. Patients with burns greater than 10% need early fluid resuscitation and adequate nutritional support to avoid deepening with infection, improve healing and survival.

[Features of skin graft in pediatric plastic surgery].

Skin graft is a skin tissue fragment transferred from a donor site to a receiving site with a spontaneous revascularization. Basic process of plastic surgery, skin graft known in children, specific, warnings and refinements. It finds its indication in many pediatric cases: integumental diseases (neavus, hamartoma), acute burns and scars, traumatic loss of substance or surgically induced, congenital malformations of the hands and feet, etc.

[Palpebral malformations in children].

Palpebral malformations can be isolated or associated with a craniofacial disorder. Their assessment is based on clinical examination; additional investigations are mainly done to characterize craniofacial syndromes. In case of extrapalpebral lesions or complex craniofacial pathology, genetic testing must be performed.

[Aplasia cutis congenita: Update and management].

Congenital skin aplasia, or aplasia cutis congenita (ACC) is a rare congenital disease. It is characterized by the absence of skin at birth, localized or widespread, of one or several areas. This condition commonly involve the scalp but can also involve more rarely the trunk or limbs.

[Non syndromic craniosynostosis].

Craniosynostosis are rare congenital malformations of the skull resulting from the premature fusion of one or several cranial sutures. Prevalence is considered in approximately 1 on 2000 births. Non syndromic craniosynostosis (NSC) or isolated form are the most frequent forms (85 % of the cases).

[The unsightly chest: Analysis and anomaly. Curative or palliative approach?].

Anterior chest wall deformity are mostly represented by pectus excavatum, which is a depression of the chondrosternal plastron from the 3rd to the 7th pairs of the costal cartilages, then by pectus carinatum which conversely represents a protrusion of this plastron. The major esthetic and psychosocial impact is not to be demonstrated anymore whereas the cardiopulmonary functional impact remains still highly debated. Regarding the management, curative surgical techniques such as Wurtz's sub-perichondrial simplified sternochondroplasty or Nuss' minimaly invasive technique are opposed to palliative filling technique such as customized silicone implant, lipostructure and flaps.

[Indications of the expansion in pediatric surgery. Experience of 30years and literature review].

The expansion of soft tissue, especially skin, is an old and physiological process to increase the skin reserve allowing excision while coveraging of the resulting loss of substance. Easy in principle, this process is subjected to constraints in children requiring precise planning and rigorous technical procedure. Between 1990 and 2016, we performed 293 expansion protocols with 411 implants in 244 children.

[Breast asymmetry of the teenager and the young adult. Stability of the result in time. About 144 patients].

Introduction: Breast asymmetry is defined by a difference in breast shape and/or volume. The goal of this study was to assess the stability of the surgical results and to highlight predictive factors for deterioration in results.

Materials And Methods: This retrospective and monocentric study included all patients presenting constitutional isolated asymmetry, Poland's syndrome, asymmetric tuberous breast or pectus excavatum treated between 1980 and 2015.

[Scar revision in children: Clinical situations and solutions].

The scar of soft tissues is a permanent stigma of a trauma but it can sometimes be improved. It is more or less accepted by the patient and may be the source of a significant physical and psychosocial impact that leads to a request for a scar revision. Even if the child presents generally an excellent ability to heal, the quality of the scar depends on many factors such as the age, the type of scar or trauma and the affected body area.