Pub Date : 2026-01-01DOI: 10.1016/j.anplas.2025.09.004
A. Vergnet , E. Zanchetta-Balint , P. Sohier , J. Chanal , V. Pozzo , A. Chansavang , L. Lantieri
Background
A 57-year old woman presented with a 18-month history of a vertex lesion. The first excisional biopsy showed an histopathology dermal proliferation of epithelioid splinded cells, arranged in nests or trabeculae, suggesting a tumoral pathology such as sarcoma or melanoma, without a definitive diagnosis. Further surgical treatment was realised. The definitive diagnosis is a clear cell tumor with melanocytic differentiation and MITF::CREM translocation. It is a recently described rare tumor, with less than 5 cases reported. This article addresses the management of a rare tumor in a plastic surgery ward.
Une patiente de 57 ans s’est présentée avec une lésion du vertex évoluant depuis 18 mois. La première biopsie-exérèse a révélé une prolifération dermique de cellules épithélioïdes fusiformes, disposées en amas ou en travées, évoquant une pathologie tumorale de type sarcome ou mélanome, sans qu’un diagnostic définitif ne puisse être posé. Un traitement chirurgical complémentaire a été réalisé. Le diagnostic final est une tumeur à cellules claires avec différenciation mélanocytaire et translocation MITF::CREM. Il s’agit d’une tumeur rare récemment décrite, avec moins de cinq cas rapportés dans la littérature. Cet article traite de la prise en charge d’une tumeur rare dans un service de chirurgie plastique.
{"title":"Management of exceptional tumor: MITF::CREM-rearranged tumor on the scalp","authors":"A. Vergnet , E. Zanchetta-Balint , P. Sohier , J. Chanal , V. Pozzo , A. Chansavang , L. Lantieri","doi":"10.1016/j.anplas.2025.09.004","DOIUrl":"10.1016/j.anplas.2025.09.004","url":null,"abstract":"<div><h3>Background</h3><div>A 57-year old woman presented with a 18-month history of a vertex lesion. The first excisional biopsy showed an histopathology dermal proliferation of epithelioid splinded cells, arranged in nests or trabeculae, suggesting a tumoral pathology such as sarcoma or melanoma, without a definitive diagnosis. Further surgical treatment was realised. The definitive diagnosis is a clear cell tumor with melanocytic differentiation and MITF::CREM translocation. It is a recently described rare tumor, with less than 5 cases reported. This article addresses the management of a rare tumor in a plastic surgery ward.</div></div><div><div>Une patiente de 57 ans s’est présentée avec une lésion du vertex évoluant depuis 18 mois. La première biopsie-exérèse a révélé une prolifération dermique de cellules épithélioïdes fusiformes, disposées en amas ou en travées, évoquant une pathologie tumorale de type sarcome ou mélanome, sans qu’un diagnostic définitif ne puisse être posé. Un traitement chirurgical complémentaire a été réalisé. Le diagnostic final est une tumeur à cellules claires avec différenciation mélanocytaire et translocation MITF::CREM. Il s’agit d’une tumeur rare récemment décrite, avec moins de cinq cas rapportés dans la littérature. Cet article traite de la prise en charge d’une tumeur rare dans un service de chirurgie plastique.</div></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"71 1","pages":"Pages 3-6"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.anplas.2025.10.001
O. Mathieu , J.P. Foy , A. Revel , D. Boccara , T. Schouman , C. Bertolus , J. Bouaoud
<div><h3>Background</h3><div>Road traffic accidents are a leading cause of injury and death globally. Airbags are critical safety systems designed to protect vehicle occupants during collisions. Despite their benefits, concerns about airbag safety arose following the Takata Corporation scandal, which resulted in significant recalls due to defective airbags linked to serious injuries, including maxillofacial trauma.</div></div><div><h3>Methods</h3><div>This case series reports on adults with penetrating head and neck injuries caused by airbag malfunctions, treated at a maxillofacial trauma center in Paris, France, from November 2021 to September 2024. We also performed a literature review of cases published from 1992 to 2024, focusing on similar penetrating injuries.</div></div><div><h3>Results</h3><div>Three cases of penetrating trauma were analyzed, highlighting complex facial injuries requiring extensive surgical interventions, including reconstructions with free flaps. The literature review revealed seven reported cases, predominantly affecting young males, with high mortality rates due to vascular injuries from foreign bodies.</div></div><div><h3>Conclusions</h3><div>The findings underscore the severe consequences of airbag malfunctions, emphasizing the need for urgent medical interventions and reconstructive surgeries. This case series calls for a reevaluation of airbag safety standards to prevent future injuries and ensure enhanced training for healthcare providers managing such trauma.</div></div><div><h3>Contexte</h3><div>Les accidents de la route sont une cause majeure de traumatismes et de décès dans le monde. Les airbags sont des dispositifs de sécurité essentiels conçus pour protéger les occupants des véhicules lors de collisions. Malgré leurs avantages, des préoccupations concernant leur sécurité ont émergé après le scandale de la société Takata, qui a conduit à d’importants rappels en raison d’airbags défectueux associés à des lésions graves, notamment au niveau cervico-facial.</div></div><div><h3>Méthodes</h3><div>Cette série rapporte des traumatismes pénétrants cervico-faciaux survenus chez des adultes à la suite de dysfonctionnements d’airbags, pris en charge dans un centre de traumatologie français entre novembre 2021 et septembre 2024. Une revue de la littérature a également été réalisée, portant sur les cas publiés entre 1992 et 2024.</div></div><div><h3>Résultats</h3><div>Trois cas de traumatismes pénétrants ont été analysés, mettant en évidence des lésions faciales complexes nécessitant des interventions chirurgicales lourdes, dont des reconstructions par lambeaux libres. La revue de la littérature a identifié sept cas similaires, touchant majoritairement des hommes jeunes, avec des taux de mortalité élevés liés à des lésions vasculaires causées par des corps étrangers.</div></div><div><h3>Conclusions</h3><div>Ces résultats soulignent la gravité des traumatismes associés dysfonctionnements d’airbags, mettant en avant la néce
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Pub Date : 2026-01-01DOI: 10.1016/j.anplas.2025.10.002
V. David , J. Obeida , C. Joliot , R. Van Damme , R. Chauvet , L. Cussinet , J. Usseglio , J. Tricard , J. Laloze
Soft tissue sarcomas are rare tumors requiring wide surgical excision to ensure local control. When located in complex anatomical areas such as the cervico-thoracic junction, these resections can involve vital structures that require immediate and reliable reconstruction. We report the case of a 63-year-old woman with a large radiation-induced sarcoma involving the right cervico-thoracic region. A wide excision was performed by a multidisciplinary team, followed by immediate reconstruction using a pedicled latissimus dorsi flap (LD) and an internal mammary artery perforator (IMAP) flap. These two flaps provided effective coverage of the exposed vital structures and allowed early initiation of adjuvant chemoradiotherapy. This clinical case illustrates how the involvement of a plastic surgeon within a multidisciplinary team facilitates extended resections of soft tissue sarcomas involving critical structures, which would otherwise be unresectable without reconstruction.
Les sarcomes des tissus mous sont des tumeurs rares nécessitant une exérèse chirurgicale large afin d’assurer un contrôle local de la maladie. Lorsqu’ils sont situés dans des zones anatomiques complexes, comme la région cervico-thoracique, ces résections peuvent exposer des structures vitales, nécessitant une reconstruction immédiate et fiable. Nous rapportons le cas d’une patiente de 63 ans présentant un volumineux sarcome radio-induit de la région cervico-thoracique droite. Une exérèse large a été réalisée par une équipe multidisciplinaire, suivie d’une reconstruction immédiate à l’aide d’un lambeau pédiculé de grand dorsal (LD) et d’un lambeau perforant de l’artère mammaire interne (IMAP). Ces deux lambeaux ont permis une couverture efficace des structures vitales exposées et l’instauration rapide d’un traitement adjuvant par chimio-radiothérapie. Ce cas clinique illustre l’importance de l’implication du chirurgien plasticien au sein d’une équipe multidisciplinaire pour permettre la réalisation de résections étendues de sarcomes des tissus mous au contact de structures vitales. Ce type d’exérèse ne serait pas possible sans geste associé de reconstruction.
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Pub Date : 2026-01-01DOI: 10.1016/j.anplas.2025.11.004
R. Bosc , T.H. Dao , C. Haioun
Cet article vise à proposer des recommandations sur le lymphome anaplasique à grandes cellules associé aux implants mammaires (LACG-AIM), causé par les implants mammaires texturés, LAGC-AIM en se fondant, d’une part sur les données actualisées de la littérature, d’autre part sur l’expérience acquise dans la prise en charge et le traitement des patientes au sein du groupe francophone d’études des lymphomes de l’adulte, le Lymphoma Study association (LYSA), sur le LACG-AIM. Les études publiées et indexées dans Pubmed, portant sur la chirurgie mammaire et le lymphome associé aux implants mammaires ont été incluses entre 2006 et 2024. Les articles les plus probants ont été intégrés pour synthétiser les recommandations et déterminer l’incidence, la présentation clinique, les facteurs de risque, les différentes approches thérapeutiques et les modalités de surveillance. Les chirurgiens « poseurs » de prothèses mammaires doivent prendre conscience des risques spécifiques liés à ces dispositifs médicaux. Les risques à court terme sont à considérer de manière aussi attentive que les risques à plus long terme. Les modifications techniques apportées par les industriels sur les dispositifs médicaux peuvent engendrer des risques inattendus. Au-delà des procédures habituelles de sécurisation et d’agrément lors de l’introduction sur le marché d’un dispositif médical, la mise en place d’une surveillance appropriée des patients et les déclarations des évènements indésirables constituent le préalable indispensable à la mise en œuvre des enquêtes d’imputabilité et des éventuelles mesures correctives.
This article aims to provide recommendations on breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), caused by textured breast implants. These recommendations are based on both updated data from the literature and the experience gained in the management and treatment of patients by the French-speaking Adult Lymphoma Study Group, Lymphoma Study Association (LYSA), regarding BIA-ALCL. Studies indexed in PubMed, focusing on breast surgery and breast implant–associated lymphoma, published between 2006 and 2024, were included. The most relevant articles were analyzed to synthesize recommendations and determine the incidence, clinical presentation, risk factors, various therapeutic approaches, and follow-up strategies. Surgeons who implant breast prostheses must be aware of the specific risks associated with these medical devices. Short-term risks must be considered just as carefully as long-term risks. Technical modifications made by manufacturers to medical devices may introduce unexpected risks. Beyond the usual safety and regulatory procedures for introducing a medical device to the market, appropriate patient monitoring and the reporting of adverse events are essential prerequisites for causality investigations and potential corrective measures.
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Pub Date : 2026-01-01DOI: 10.1016/j.anplas.2025.09.007
K. Al Tabaa , F.M. Leclere , B. Faucon
<div><h3>Introduction</h3><div>Les premières descriptions de la septoplastie remontent au XVIII<sup>e</sup> siècle. Les techniques modernes, dont la septoplastie par désarticulation, visent à corriger les déformations septales complexes tout en préservant la fonction et l’esthétique nasales. Notre étude évalue les résultats fonctionnels et esthétiques de cette approche innovante.</div></div><div><h3>Matériel et méthodes</h3><div>Nous avons mené une étude rétrospective monocentrique incluant 7 patients opérés entre 2024 et 2025 pour obstruction nasale unilatérale avec déviation septale caractéristique en « verre de montre ». La technique chirurgicale reposait sur trois principes fondamentaux : une dissection bilatérale minutieuse du lambeau fibromuqueux sous repères ethmoïdo-vomériens, une désarticulation complète du cartilage quadrangulaire incluant sa libération caudale, vomérienne et ethmoïdale, suivie d’un repositionnement anatomique stabilisé par des attelles en silicone. L’évaluation des résultats a comparé les scores NOSE et NAFEQ en préopératoire et à 3 mois postopératoire à l’aide de tests de Wilcoxon (logiciel R v4.1.3).</div></div><div><h3>Résultats</h3><div>L’analyse des résultats a révélé une amélioration fonctionnelle significative, avec un score NOSE moyen passant de 15,4<!--> <!-->±<!--> <!-->2,4 en préopératoire à 6,0<!--> <!-->±<!--> <!-->5,9 en postopératoire (<em>p</em> <!-->=<!--> <!-->0,022). Sur le plan esthétique, les scores NAFEQ ont montré une progression globale de 38,75<!--> <!-->±<!--> <!-->8,1 à 58,1<!--> <!-->±<!--> <!-->8,1 (<em>p</em> <!-->=<!--> <!-->0,014), avec des améliorations significatives tant pour le sous-score fonctionnel (<em>p</em> <!-->=<!--> <!-->0,025) qu’esthétique (<em>p</em> <!-->=<!--> <!-->0,03). Aucune complication majeure telle que perforation septale ou ensellure nasale n’a été observée dans notre série.</div></div><div><h3>Conclusion</h3><div>La septoplastie par désarticulation du cartilage quadrangulaire représente une avancée significative dans la prise en charge des déviations septales complexes. Elle combine une résolution efficace des obstructions nasales (réduction de 61 % du score NOSE), une correction esthétique satisfaisante des déviations columellaires (amélioration de 50 % du score NAFEQ) et un profil de sécurité démontré à court terme. Ces résultats encourageants méritent d’être confirmés par des études comparatives randomisées avec un suivi à plus long terme.</div></div><div><h3>Introduction</h3><div>The earliest descriptions of septoplasty date back to the 18th century. Modern techniques, including disarticulation septoplasty, aim to correct complex septal deformities while preserving nasal function and aesthetics. Our study evaluates the functional and aesthetic outcomes of this innovative approach.</div></div><div><h3>Materials and methods</h3><div>We conducted a single-center retrospective study including 7 patients who underwent surgery between 2024 and 2025 for unilateral
{"title":"Septoplastie par désarticulation du cartilage quadrangulaire – Note technique à propos de 7 cas","authors":"K. Al Tabaa , F.M. Leclere , B. Faucon","doi":"10.1016/j.anplas.2025.09.007","DOIUrl":"10.1016/j.anplas.2025.09.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Les premières descriptions de la septoplastie remontent au XVIII<sup>e</sup> siècle. Les techniques modernes, dont la septoplastie par désarticulation, visent à corriger les déformations septales complexes tout en préservant la fonction et l’esthétique nasales. Notre étude évalue les résultats fonctionnels et esthétiques de cette approche innovante.</div></div><div><h3>Matériel et méthodes</h3><div>Nous avons mené une étude rétrospective monocentrique incluant 7 patients opérés entre 2024 et 2025 pour obstruction nasale unilatérale avec déviation septale caractéristique en « verre de montre ». La technique chirurgicale reposait sur trois principes fondamentaux : une dissection bilatérale minutieuse du lambeau fibromuqueux sous repères ethmoïdo-vomériens, une désarticulation complète du cartilage quadrangulaire incluant sa libération caudale, vomérienne et ethmoïdale, suivie d’un repositionnement anatomique stabilisé par des attelles en silicone. L’évaluation des résultats a comparé les scores NOSE et NAFEQ en préopératoire et à 3 mois postopératoire à l’aide de tests de Wilcoxon (logiciel R v4.1.3).</div></div><div><h3>Résultats</h3><div>L’analyse des résultats a révélé une amélioration fonctionnelle significative, avec un score NOSE moyen passant de 15,4<!--> <!-->±<!--> <!-->2,4 en préopératoire à 6,0<!--> <!-->±<!--> <!-->5,9 en postopératoire (<em>p</em> <!-->=<!--> <!-->0,022). Sur le plan esthétique, les scores NAFEQ ont montré une progression globale de 38,75<!--> <!-->±<!--> <!-->8,1 à 58,1<!--> <!-->±<!--> <!-->8,1 (<em>p</em> <!-->=<!--> <!-->0,014), avec des améliorations significatives tant pour le sous-score fonctionnel (<em>p</em> <!-->=<!--> <!-->0,025) qu’esthétique (<em>p</em> <!-->=<!--> <!-->0,03). Aucune complication majeure telle que perforation septale ou ensellure nasale n’a été observée dans notre série.</div></div><div><h3>Conclusion</h3><div>La septoplastie par désarticulation du cartilage quadrangulaire représente une avancée significative dans la prise en charge des déviations septales complexes. Elle combine une résolution efficace des obstructions nasales (réduction de 61 % du score NOSE), une correction esthétique satisfaisante des déviations columellaires (amélioration de 50 % du score NAFEQ) et un profil de sécurité démontré à court terme. Ces résultats encourageants méritent d’être confirmés par des études comparatives randomisées avec un suivi à plus long terme.</div></div><div><h3>Introduction</h3><div>The earliest descriptions of septoplasty date back to the 18th century. Modern techniques, including disarticulation septoplasty, aim to correct complex septal deformities while preserving nasal function and aesthetics. Our study evaluates the functional and aesthetic outcomes of this innovative approach.</div></div><div><h3>Materials and methods</h3><div>We conducted a single-center retrospective study including 7 patients who underwent surgery between 2024 and 2025 for unilateral ","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"71 1","pages":"Pages 80-86"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-30DOI: 10.1016/j.anplas.2025.11.001
V Mitz
Lip augmentation is a procedure frequently performed by cosmetic physicians, as well as cosmetic and reconstructive surgeons. Atrophy of the lips and the surrounding areas or even in the perioral region is often the result of malformations related to insufficient development of structures during embryogenesis, but also the consequence of tissue aging, which affects patients unequally. The general principle of lip and midfacial augmentation involves injections using needles or cannulas that directly puncture the skin at certain strategic points, in order to correctly position the substance intended to increase tissue thickness. One of the adverse consequences of this approach is sometimes excessive augmentation, which occurs even unintentionally, as it is difficult to precisely control the amount to be injected, even with extensive experience. This is why an alternative approach, which is not new, consists of performing these injections, in certain indications, not transcutaneously but rather intraorally. This approach has already been used for around thirty years by a number of surgeons, notably by a French school of aesthetic surgery and medicine. The depth of the injection is therefore of some interest because it allows for less transformation of the face, since the product will be deposited in contact with the periosteum or soft tissues but relatively far from the skin or labial mucosa. In this technical note, the principles of this deep intraoral injection are detailed, and results are presented as well as rare complications.
{"title":"[Intraoral lip augmentation].","authors":"V Mitz","doi":"10.1016/j.anplas.2025.11.001","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.11.001","url":null,"abstract":"<p><p>Lip augmentation is a procedure frequently performed by cosmetic physicians, as well as cosmetic and reconstructive surgeons. Atrophy of the lips and the surrounding areas or even in the perioral region is often the result of malformations related to insufficient development of structures during embryogenesis, but also the consequence of tissue aging, which affects patients unequally. The general principle of lip and midfacial augmentation involves injections using needles or cannulas that directly puncture the skin at certain strategic points, in order to correctly position the substance intended to increase tissue thickness. One of the adverse consequences of this approach is sometimes excessive augmentation, which occurs even unintentionally, as it is difficult to precisely control the amount to be injected, even with extensive experience. This is why an alternative approach, which is not new, consists of performing these injections, in certain indications, not transcutaneously but rather intraorally. This approach has already been used for around thirty years by a number of surgeons, notably by a French school of aesthetic surgery and medicine. The depth of the injection is therefore of some interest because it allows for less transformation of the face, since the product will be deposited in contact with the periosteum or soft tissues but relatively far from the skin or labial mucosa. In this technical note, the principles of this deep intraoral injection are detailed, and results are presented as well as rare complications.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.anplas.2025.11.002
V Vaz, A Anantharaju, V G Doddawad
Background: Evidence suggests that altering the surface roughness significantly improves implant osseointegration. Enhancing the hydrophilicity of the implants is a similar strategy as hydrophilic surfaces encourage early osseointegration at 14 and 21 days and hasten the bone-healing process after implant placement. Hence, we evaluate and compare the marginal bone level of hydrophilic and non-hydrophilic implants in mandibular implant overdenture.
Methods and material: The study was a non-randomized, prospective split-mouth design with ten patients, each receiving a hydrophilic implant (Group A) and a non-hydrophilic implant (Group B) on opposite sides of the mandibular arch. An implant-supported overdenture was fitted and monitored at baseline, one month, three months, and six months. Marginal bone loss for the early-loaded hydrophilic implant and conventionally loaded non-hydrophilic implant was measured on each side of the mandibular ridge using an XCP holder and RVG radiographs at each interval. Data was obtained and subjected to statistical analysis using the Wilcoxon signed-rank test and Mann-Whitney U test.
Results: Although there was no statistically significant difference in marginal bone loss between the two implants, the hydrophilic implant achieved similar success with a faster healing time compared to the non-hydrophilic implant.
Conclusions: Hydrophilic implants offer a faster-healing alternative to conventional implants for mandibular overdentures.
{"title":"Non-randomized clinical trial in aesthetic dentistry to evaluate marginal bone level in hydrophilic vs. non-hydrophilic implants for mandibular implant overdentures: A split-mouth design.","authors":"V Vaz, A Anantharaju, V G Doddawad","doi":"10.1016/j.anplas.2025.11.002","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.11.002","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that altering the surface roughness significantly improves implant osseointegration. Enhancing the hydrophilicity of the implants is a similar strategy as hydrophilic surfaces encourage early osseointegration at 14 and 21 days and hasten the bone-healing process after implant placement. Hence, we evaluate and compare the marginal bone level of hydrophilic and non-hydrophilic implants in mandibular implant overdenture.</p><p><strong>Methods and material: </strong>The study was a non-randomized, prospective split-mouth design with ten patients, each receiving a hydrophilic implant (Group A) and a non-hydrophilic implant (Group B) on opposite sides of the mandibular arch. An implant-supported overdenture was fitted and monitored at baseline, one month, three months, and six months. Marginal bone loss for the early-loaded hydrophilic implant and conventionally loaded non-hydrophilic implant was measured on each side of the mandibular ridge using an XCP holder and RVG radiographs at each interval. Data was obtained and subjected to statistical analysis using the Wilcoxon signed-rank test and Mann-Whitney U test.</p><p><strong>Results: </strong>Although there was no statistically significant difference in marginal bone loss between the two implants, the hydrophilic implant achieved similar success with a faster healing time compared to the non-hydrophilic implant.</p><p><strong>Conclusions: </strong>Hydrophilic implants offer a faster-healing alternative to conventional implants for mandibular overdentures.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-13DOI: 10.1016/j.anplas.2025.06.015
T Daoulas, P Liverneaux, N Bigorre
Introduction: Microsurgery is becoming increasingly important in many surgical specialities. In France, it is taught as part of university certificates (UC), which are organised in different ways. A previous study carried out in 2014 highlighted several challenges, particularly in terms of finance and structure. This study aims to update this data ten years later to analyse the evolution of microsurgery teaching in France and identify future challenges related to new practices and constraints.
Methods: A descriptive observational survey was performed between January and March 2025 at 28 French university hospitals. The educational referents of the microsurgery university certificates were interviewed using a standardised questionnaire covering teaching methods, hours, assessment methods, registration costs and difficulties encountered. The data collected was compared with that of the 2014 study.
Results: Seventeen centres offered a university certificate in microsurgery, including 14 that already existed in 2014. The average number of hours per year decreased by 24%, while the total number of places offered increased by 86%. Assessment methods remained heterogeneous. The average cost of enrolment in initial training increased by 292 euros. The main challenges identified concerned access to animal models, economic constraints and lack of supervision.
Conclusions: Despite a growing interest in microsurgery training, major disparities persist between university certificates. Standardising programmes, optimising resources and introducing a progressive training pathway could help harmonise practices, while addressing current ethical and logistical issues. We therefore suggest a three-stage model (inert materials, living models, advanced training) to structure learning.
{"title":"State of microsurgery teaching in France in 2025.","authors":"T Daoulas, P Liverneaux, N Bigorre","doi":"10.1016/j.anplas.2025.06.015","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.06.015","url":null,"abstract":"<p><strong>Introduction: </strong>Microsurgery is becoming increasingly important in many surgical specialities. In France, it is taught as part of university certificates (UC), which are organised in different ways. A previous study carried out in 2014 highlighted several challenges, particularly in terms of finance and structure. This study aims to update this data ten years later to analyse the evolution of microsurgery teaching in France and identify future challenges related to new practices and constraints.</p><p><strong>Methods: </strong>A descriptive observational survey was performed between January and March 2025 at 28 French university hospitals. The educational referents of the microsurgery university certificates were interviewed using a standardised questionnaire covering teaching methods, hours, assessment methods, registration costs and difficulties encountered. The data collected was compared with that of the 2014 study.</p><p><strong>Results: </strong>Seventeen centres offered a university certificate in microsurgery, including 14 that already existed in 2014. The average number of hours per year decreased by 24%, while the total number of places offered increased by 86%. Assessment methods remained heterogeneous. The average cost of enrolment in initial training increased by 292 euros. The main challenges identified concerned access to animal models, economic constraints and lack of supervision.</p><p><strong>Conclusions: </strong>Despite a growing interest in microsurgery training, major disparities persist between university certificates. Standardising programmes, optimising resources and introducing a progressive training pathway could help harmonise practices, while addressing current ethical and logistical issues. We therefore suggest a three-stage model (inert materials, living models, advanced training) to structure learning.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-24DOI: 10.1016/j.anplas.2025.10.003
V Commenge, C Berthier, D Gangloff, T Meresse, J Fraisse
To reconstruct a lower eyelid defect involving two aesthetic cutaneous subunits, we propose the use of bilateral upper eyelid dermatochalasis. A homolateral heteropalpebral flap combined with a contralateral upper eyelid skin graft is our first-line option for cutaneous coverage. In the case of full-thickness defects, a composite tarsoconjunctival graft harvested from the three healthy eyelids provides satisfactory and functionally competent tissue reconstruction.
{"title":"[Two-subunit lower eyelid reconstruction in oncology].","authors":"V Commenge, C Berthier, D Gangloff, T Meresse, J Fraisse","doi":"10.1016/j.anplas.2025.10.003","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.10.003","url":null,"abstract":"<p><p>To reconstruct a lower eyelid defect involving two aesthetic cutaneous subunits, we propose the use of bilateral upper eyelid dermatochalasis. A homolateral heteropalpebral flap combined with a contralateral upper eyelid skin graft is our first-line option for cutaneous coverage. In the case of full-thickness defects, a composite tarsoconjunctival graft harvested from the three healthy eyelids provides satisfactory and functionally competent tissue reconstruction.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-12DOI: 10.1016/j.anplas.2025.10.004
Pierre Maincourt, Thomas Daoulas, Jimmy Pecheur, Anne-Sophie Henry, Yoann David, Marc-Pierre Henry
Introduction: Ballistic injuries to the knee present a complex reconstructive challenge due to associated bone, tendon, and soft tissue loss. Early coordinated management between orthopedic and plastic surgery teams is essential to optimize functional outcomes.
Case report: We report the case of a 22-year-old male who sustained a Gustilo IIIb open fracture of the proximal tibia following a gunshot wound, with avulsion of the tibial tuberosity and complete patellar tendon rupture. Initial debridement and negative pressure therapy were followed, 48hours later, by anatomical reconstruction of the extensor apparatus using an iliac cortico-cancellous graft in continuity with a gluteal fascia strip, reinforced with pedicled semitendinosus and synthetic tape. Skin coverage was achieved with a pedicled lateral genicular artery perforator (LGAP) flap. Rehabilitation included immobilization in extension and progressive physiotherapy-assisted knee flexion.
Discussion: At 18months, the patient presented complete wound healing, no pain at rest, and partial recovery of function (extension deficit 10°, flexion limited to 80°). The Knee injury and Osteoarthritis Outcome Score (KOOS) was 47. Early pedicled perforator flap coverage provided reliable soft tissue reconstruction while avoiding the complexity of microsurgical free flaps in this anatomically challenging region. The composite reconstruction restored mechanical continuity of the extensor apparatus, enabling stable joint function.
Conclusion: This case illustrates the feasibility and functional benefit of early, coordinated orthopedic-plastic reconstruction for complex ballistic knee injuries, combining bone-tendon reconstruction with local perforator flap coverage. Pedicled perforator flaps are a valuable option for small to medium-sized skin defects in the knee region.
{"title":"Anatomical reconstruction of the patellar tendon with coverage using a perforator LGAP flap in ballistic trauma: The importance of interdisciplinary collaboration.","authors":"Pierre Maincourt, Thomas Daoulas, Jimmy Pecheur, Anne-Sophie Henry, Yoann David, Marc-Pierre Henry","doi":"10.1016/j.anplas.2025.10.004","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.10.004","url":null,"abstract":"<p><strong>Introduction: </strong>Ballistic injuries to the knee present a complex reconstructive challenge due to associated bone, tendon, and soft tissue loss. Early coordinated management between orthopedic and plastic surgery teams is essential to optimize functional outcomes.</p><p><strong>Case report: </strong>We report the case of a 22-year-old male who sustained a Gustilo IIIb open fracture of the proximal tibia following a gunshot wound, with avulsion of the tibial tuberosity and complete patellar tendon rupture. Initial debridement and negative pressure therapy were followed, 48hours later, by anatomical reconstruction of the extensor apparatus using an iliac cortico-cancellous graft in continuity with a gluteal fascia strip, reinforced with pedicled semitendinosus and synthetic tape. Skin coverage was achieved with a pedicled lateral genicular artery perforator (LGAP) flap. Rehabilitation included immobilization in extension and progressive physiotherapy-assisted knee flexion.</p><p><strong>Discussion: </strong>At 18months, the patient presented complete wound healing, no pain at rest, and partial recovery of function (extension deficit 10°, flexion limited to 80°). The Knee injury and Osteoarthritis Outcome Score (KOOS) was 47. Early pedicled perforator flap coverage provided reliable soft tissue reconstruction while avoiding the complexity of microsurgical free flaps in this anatomically challenging region. The composite reconstruction restored mechanical continuity of the extensor apparatus, enabling stable joint function.</p><p><strong>Conclusion: </strong>This case illustrates the feasibility and functional benefit of early, coordinated orthopedic-plastic reconstruction for complex ballistic knee injuries, combining bone-tendon reconstruction with local perforator flap coverage. Pedicled perforator flaps are a valuable option for small to medium-sized skin defects in the knee region.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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