Pub Date : 2025-08-07DOI: 10.1016/j.anplas.2025.06.007
C Klein, M-C Plancq
{"title":"Commentary on\"Syndactyly release with full-thickness skin graft harvested from the wrist: About 24 webspaces\".","authors":"C Klein, M-C Plancq","doi":"10.1016/j.anplas.2025.06.007","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.06.007","url":null,"abstract":"","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805289","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 : 2025-08-05DOI: 10.1016/j.anplas.2025.05.010
F. Dupuy , H. Despert , H. Oubari , D. Beltramin , A. Mojallal , F. Boucher
<div><h3>Introduction</h3><div>Chest masculinization is often the first operation requested by patients with female-to-male gender dysphoria. Despite increasing demand for this procedure, no recommendation of care is unanimous. We present our experience with the use of a simple and effective algorithm based on periareolar and subcutaneous mastectomy with free nipple graft techniques and compare complication rates between techniques.</div></div><div><h3>Aims</h3><div>The main objective of this study was to compare the postoperative complications associated with these two techniques.</div></div><div><h3>Methods</h3><div>Patients who underwent chest masculinization between January 2018 and February 2023 at Croix-Rousse University Hospital (Lyon, France) were retrospectively reviewed. Data of the 71 patients were collected from medical records.</div></div><div><h3>Results</h3><div>Among the 71 patients, 32 (45%) were treated by periareolar mastectomy and 39 (55%) by double-incision mastectomy with free nipple graft. Twenty-one patients (30%) had minor postoperative complications, with no significant difference between the two groups. Five patients treated with the periareolar technique (16%) developed hematoma requiring emergency reoperation. In contrast, none of the patients treated by double-incision mastectomy had this complication (<em>P</em> <!-->=<!--> <!-->0.015).</div></div><div><h3>Conclusion</h3><div>The results of this study are in keeping with those in the literature, namely a higher rate of acute postoperative complications in patients treated by periareolar mastectomy. Hemostatic net has been used since March 2023 in these procedures to reduce the risk of postoperative bleeding complications. It is also a powerful procedure for better skin redraping.</div></div><div><h3>Introduction</h3><div>La masculinisation du thorax est souvent la première opération demandée par les patients souffrant de dysphorie de genre. Malgré la demande croissante pour cette procédure, aucune recommandation de prise en charge chirurgicale n’est unanime. Nous présentons nos résultats avec l’utilisation d’un algorithme simple et efficace basé sur deux techniques chirurgicales distinctes, la mastectomie par voie péri-aréolaire et la mastectomie à double incision avec greffe d’aréole.</div></div><div><h3>Objectifs</h3><div>L’objectif principal de cette étude est de comparer les complications postopératoires associées à ces deux techniques.</div></div><div><h3>Méthodes</h3><div>Les patients ayant bénéficié d’une masculinisation du thorax entre janvier 2018 et février 2023 à l’hôpital universitaire de la Croix-Rousse (Lyon, France) ont été revus rétrospectivement. Les données des 71 patients ont été recueillies à partir des dossiers médicaux.</div></div><div><h3>Résultats</h3><div>Parmi les 71 patients, 32 (45 %) ont été traités par mastectomie péri-aréolaire et 39 (55 %) par mastectomie double incision avec greffe d’aréole. Vingt et un patients (30 %) ont présenté d
{"title":"Chest wall contouring in female-to-male gender affirming surgery: Algorithm, surgical techniques and outcomes","authors":"F. Dupuy , H. Despert , H. Oubari , D. Beltramin , A. Mojallal , F. Boucher","doi":"10.1016/j.anplas.2025.05.010","DOIUrl":"10.1016/j.anplas.2025.05.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Chest masculinization is often the first operation requested by patients with female-to-male gender dysphoria. Despite increasing demand for this procedure, no recommendation of care is unanimous. We present our experience with the use of a simple and effective algorithm based on periareolar and subcutaneous mastectomy with free nipple graft techniques and compare complication rates between techniques.</div></div><div><h3>Aims</h3><div>The main objective of this study was to compare the postoperative complications associated with these two techniques.</div></div><div><h3>Methods</h3><div>Patients who underwent chest masculinization between January 2018 and February 2023 at Croix-Rousse University Hospital (Lyon, France) were retrospectively reviewed. Data of the 71 patients were collected from medical records.</div></div><div><h3>Results</h3><div>Among the 71 patients, 32 (45%) were treated by periareolar mastectomy and 39 (55%) by double-incision mastectomy with free nipple graft. Twenty-one patients (30%) had minor postoperative complications, with no significant difference between the two groups. Five patients treated with the periareolar technique (16%) developed hematoma requiring emergency reoperation. In contrast, none of the patients treated by double-incision mastectomy had this complication (<em>P</em> <!-->=<!--> <!-->0.015).</div></div><div><h3>Conclusion</h3><div>The results of this study are in keeping with those in the literature, namely a higher rate of acute postoperative complications in patients treated by periareolar mastectomy. Hemostatic net has been used since March 2023 in these procedures to reduce the risk of postoperative bleeding complications. It is also a powerful procedure for better skin redraping.</div></div><div><h3>Introduction</h3><div>La masculinisation du thorax est souvent la première opération demandée par les patients souffrant de dysphorie de genre. Malgré la demande croissante pour cette procédure, aucune recommandation de prise en charge chirurgicale n’est unanime. Nous présentons nos résultats avec l’utilisation d’un algorithme simple et efficace basé sur deux techniques chirurgicales distinctes, la mastectomie par voie péri-aréolaire et la mastectomie à double incision avec greffe d’aréole.</div></div><div><h3>Objectifs</h3><div>L’objectif principal de cette étude est de comparer les complications postopératoires associées à ces deux techniques.</div></div><div><h3>Méthodes</h3><div>Les patients ayant bénéficié d’une masculinisation du thorax entre janvier 2018 et février 2023 à l’hôpital universitaire de la Croix-Rousse (Lyon, France) ont été revus rétrospectivement. Les données des 71 patients ont été recueillies à partir des dossiers médicaux.</div></div><div><h3>Résultats</h3><div>Parmi les 71 patients, 32 (45 %) ont été traités par mastectomie péri-aréolaire et 39 (55 %) par mastectomie double incision avec greffe d’aréole. Vingt et un patients (30 %) ont présenté d","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 5","pages":"Pages 398-410"},"PeriodicalIF":0.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769341","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 : 2025-07-31DOI: 10.1016/j.anplas.2025.05.018
V Bourdon, C Barani, P Curings, M Vantomme, G Henry, R Bayoux, D Voulliaume
Introduction: Although surgical site infection is one of the classic complications of breast reduction surgery, since 2024 the Société française d'anesthésie réanimation (SFAR) no longer recommends the administration of preoperative antibiotic prophylaxis. This study presents the evolution of postoperative breast infection rates in our unit according to the application of this recommendation, by comparing surgical site infection rates between homogeneous groups of patients: with and without antibiotic prophylaxis.
Methods: This was a retrospective, single-center, comparative study. All patients who underwent breast reduction surgery between January and June 2024 were included. The primary outcome was surgical site infection rate. Secondary endpoints were the usual complications of this surgery: hematoma, areolar necrosis and delayed healing.
Results: One hundred and twenty-nine patients were included, of whom 66 received preoperative antibiotic prophylaxis (group 1) and 63 did not (group 2). Surgical site infection rates were 6.06% and 28.57% respectively in groups 1 and 2. There were significantly more surgical site infections in the group that did not receive antibiotic prophylaxis (P=0.001).
Discussion: The value of antibiotic prophylaxis in breast reduction surgery is debated in numerous publications in the literature, mainly Anglo-Saxon; the great heterogeneity of protocols prevents the emergence of a consensus, whereas almost all studies show results superposable to those obtained in this series.
Conclusion: This study confirms the role of antibiotic prophylaxis in the reduction of surgical site infections in breast surgery, and once again highlights the absence of consensus due to the lack of high-level studies. Larger prospective studies are needed to establish appropriate recommendations.
{"title":"[Preoperative antibiotic prophylaxis and breast reduction surgery: A call for new recommendations].","authors":"V Bourdon, C Barani, P Curings, M Vantomme, G Henry, R Bayoux, D Voulliaume","doi":"10.1016/j.anplas.2025.05.018","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.05.018","url":null,"abstract":"<p><strong>Introduction: </strong>Although surgical site infection is one of the classic complications of breast reduction surgery, since 2024 the Société française d'anesthésie réanimation (SFAR) no longer recommends the administration of preoperative antibiotic prophylaxis. This study presents the evolution of postoperative breast infection rates in our unit according to the application of this recommendation, by comparing surgical site infection rates between homogeneous groups of patients: with and without antibiotic prophylaxis.</p><p><strong>Methods: </strong>This was a retrospective, single-center, comparative study. All patients who underwent breast reduction surgery between January and June 2024 were included. The primary outcome was surgical site infection rate. Secondary endpoints were the usual complications of this surgery: hematoma, areolar necrosis and delayed healing.</p><p><strong>Results: </strong>One hundred and twenty-nine patients were included, of whom 66 received preoperative antibiotic prophylaxis (group 1) and 63 did not (group 2). Surgical site infection rates were 6.06% and 28.57% respectively in groups 1 and 2. There were significantly more surgical site infections in the group that did not receive antibiotic prophylaxis (P=0.001).</p><p><strong>Discussion: </strong>The value of antibiotic prophylaxis in breast reduction surgery is debated in numerous publications in the literature, mainly Anglo-Saxon; the great heterogeneity of protocols prevents the emergence of a consensus, whereas almost all studies show results superposable to those obtained in this series.</p><p><strong>Conclusion: </strong>This study confirms the role of antibiotic prophylaxis in the reduction of surgical site infections in breast surgery, and once again highlights the absence of consensus due to the lack of high-level studies. Larger prospective studies are needed to establish appropriate recommendations.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765828","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 : 2025-07-30DOI: 10.1016/j.anplas.2025.03.007
M. Crossouard , E. Delay , S. Perez , P. Frobert , R. Vaucher
Introduction
Le lambeau perforant épigastrique inférieur profond (DIEP) s’est imposé comme l’un des gold standards en reconstruction mammaire différée (RMD). Bien que la reconstruction avec palette cutanée soit couramment utilisée pour restaurer simultanément le volume et l’enveloppe cutanée, cette approche présente l’inconvénient esthétique d’un effet « patch ». Nous proposons une stratégie en trois étapes pour éviter cet effet : une RMD initiale par prothèse associée à un lambeau d’avancement abdominal et une symétrisation mammaire controlatérale, suivie d’une conversion par DIEP enfoui et un temps de retouches. Notre étude vise à étudier la faisabilité et l’efficacité de cette technique.
Matériel et méthodes
Une étude descriptive, monocentrique et rétrospective a été réalisée chez des patientes inclues de juillet 2019 à décembre 2023. Les complications et leur prise en charge ont été notées pour chaque étape.
Résultats
Quatre-vingt-deux procédures ont été initiées. Lors de la première étape, seize patientes (19,5 %) ont présenté une complication assimilable à un rejet de prothèse (inflammation cutanée ou sérome) nécessitant le plus souvent une prise en charge chirurgicale associée à une antibiothérapie. Soixante-douze patientes (87,8 %) ont bénéficié d’un DIEP avec enfouissement total, la moyenne de retouches par patiente était de 1,39. Cinq patientes (6,09 %) étaient satisfaites de leur reconstruction prothétique sans conversion.
Conclusion
La stratégie de RMD par DIEP avec enfouissement total est une alternative fiable et esthétique à la reconstruction avec palette cutanée. Cette étude montre la sécurité et la reproductibilité de cette technique avec une gestion efficace des complications.
Introduction
The deep inferior epigastric perforator (DIEP) flap has emerged as a gold standard in delayed breast reconstruction (DBR). Although the skin paddle technique is often employed to restore both volume and the skin envelope simultaneously. This procedure presents an aesthetic drawback, commonly referred to as a “patch” effect. We propose a three-stage approach to avoid this issue: initial reconstruction with a prosthesis combined with an abdominal advancement flap and contralateral breast symmetrization, followed by conversion to a buried DIEP flap with an option for further refinement. The objective of our study is to evaluate the security et efficiency of this method.
Material and methods
A monocentric, and retrospective study was conducted, encompassing patients who began this protocol between July 2019 and December 2023. Complications and their management were documented at each stage.
Results
A total of eighty-two procedures were initiated. In the first stage, sixteen patients (19.5%) experienced complications resembling prosthesis rejection, s
{"title":"Reconstruction mammaire différée par lambeau DIEP sans palette cutanée : technique et évaluation","authors":"M. Crossouard , E. Delay , S. Perez , P. Frobert , R. Vaucher","doi":"10.1016/j.anplas.2025.03.007","DOIUrl":"10.1016/j.anplas.2025.03.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Le lambeau perforant épigastrique inférieur profond (DIEP) s’est imposé comme l’un des <em>gold</em> standards en reconstruction mammaire différée (RMD). Bien que la reconstruction avec palette cutanée soit couramment utilisée pour restaurer simultanément le volume et l’enveloppe cutanée, cette approche présente l’inconvénient esthétique d’un effet « patch ». Nous proposons une stratégie en trois étapes pour éviter cet effet : une RMD initiale par prothèse associée à un lambeau d’avancement abdominal et une symétrisation mammaire controlatérale, suivie d’une conversion par DIEP enfoui et un temps de retouches. Notre étude vise à étudier la faisabilité et l’efficacité de cette technique.</div></div><div><h3>Matériel et méthodes</h3><div>Une étude descriptive, monocentrique et rétrospective a été réalisée chez des patientes inclues de juillet 2019 à décembre 2023. Les complications et leur prise en charge ont été notées pour chaque étape.</div></div><div><h3>Résultats</h3><div>Quatre-vingt-deux procédures ont été initiées. Lors de la première étape, seize patientes (19,5 %) ont présenté une complication assimilable à un rejet de prothèse (inflammation cutanée ou sérome) nécessitant le plus souvent une prise en charge chirurgicale associée à une antibiothérapie. Soixante-douze patientes (87,8 %) ont bénéficié d’un DIEP avec enfouissement total, la moyenne de retouches par patiente était de 1,39. Cinq patientes (6,09 %) étaient satisfaites de leur reconstruction prothétique sans conversion.</div></div><div><h3>Conclusion</h3><div>La stratégie de RMD par DIEP avec enfouissement total est une alternative fiable et esthétique à la reconstruction avec palette cutanée. Cette étude montre la sécurité et la reproductibilité de cette technique avec une gestion efficace des complications.</div></div><div><h3>Introduction</h3><div>The deep inferior epigastric perforator (DIEP) flap has emerged as a gold standard in delayed breast reconstruction (DBR). Although the skin paddle technique is often employed to restore both volume and the skin envelope simultaneously. This procedure presents an aesthetic drawback, commonly referred to as a “patch” effect. We propose a three-stage approach to avoid this issue: initial reconstruction with a prosthesis combined with an abdominal advancement flap and contralateral breast symmetrization, followed by conversion to a buried DIEP flap with an option for further refinement. The objective of our study is to evaluate the security et efficiency of this method.</div></div><div><h3>Material and methods</h3><div>A monocentric, and retrospective study was conducted, encompassing patients who began this protocol between July 2019 and December 2023. Complications and their management were documented at each stage.</div></div><div><h3>Results</h3><div>A total of eighty-two procedures were initiated. In the first stage, sixteen patients (19.5%) experienced complications resembling prosthesis rejection, s","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 5","pages":"Pages 377-383"},"PeriodicalIF":0.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762433","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 : 2025-07-25DOI: 10.1016/j.anplas.2025.04.004
A Auque, A Wessels, F Bodin
Introduction: Microsurgical breast reconstruction using a deep inferior epigastric perforator flap (DIEP) is currently considered the gold standard in autologous reconstruction. In some case, partial sectioning of the rectus abdominis muscle is necessary to include several perforators and make the flap more reliable. This technical note presents an optimized approach to transverse suturing of the rectus abdominis muscle after partial transection.
Technical note: A double transverse braided suture is made around the muscle band to be cut then the muscle strip is sectioned transversely. After weaning the flap, the two resulting strips of rectus muscle are joined by separate transmuscular stitches.
Conclusion: Transverse suturing of the rectus abdominis muscle after partial transection is a method that allows several perforators to be included in DIEP harvest, while limiting parietal complications.
{"title":"Transversal suture of the rectus abdominis muscle in DIEP harvesting to include more than one perforator: Technical note.","authors":"A Auque, A Wessels, F Bodin","doi":"10.1016/j.anplas.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.04.004","url":null,"abstract":"<p><strong>Introduction: </strong>Microsurgical breast reconstruction using a deep inferior epigastric perforator flap (DIEP) is currently considered the gold standard in autologous reconstruction. In some case, partial sectioning of the rectus abdominis muscle is necessary to include several perforators and make the flap more reliable. This technical note presents an optimized approach to transverse suturing of the rectus abdominis muscle after partial transection.</p><p><strong>Technical note: </strong>A double transverse braided suture is made around the muscle band to be cut then the muscle strip is sectioned transversely. After weaning the flap, the two resulting strips of rectus muscle are joined by separate transmuscular stitches.</p><p><strong>Conclusion: </strong>Transverse suturing of the rectus abdominis muscle after partial transection is a method that allows several perforators to be included in DIEP harvest, while limiting parietal complications.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719155","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 : 2025-07-25DOI: 10.1016/j.anplas.2025.04.006
B. Brunetti , M. Morelli Coppola , C.P. Mureddu , V. Petrucci , S. Tenna , M. Barone , P. Persichetti
<div><h3>Introduction</h3><div>Pedicled perforator flaps can be used not only in reconstructive scenarios but also for aesthetic purposes, thereby enhancing both the aesthetics and functionality of the treated area. The authors present two representative cases demonstrating an innovative indication for correcting contour deformities using de-epithelialized perforator flaps recycled from abdominoplasty excision patterns.</div></div><div><h3>Case reports</h3><div>Two patients presented with abdominal skin redundancy and contour deformities due to previous surgeries. The first patient, with a history of bladder exstrophy, underwent a fleur-de-lys abdominoplasty, with the soft tissue deficiency in the pubic region corrected using two DIEP flaps. The second patient, with a history of multiple surgeries for bilateral congenital hip dislocation, presented with retracted scars at the groins, which were corrected with bilateral SCIP flaps, harvested during a conventional abdominoplasty. The post-operative course was uneventful, and both patients reported a significant improvement in their perception of the operated regions according to the BODY-Q administered before and one year after surgery.</div></div><div><h3>Conclusion</h3><div>Perforator flaps recycled from abdominoplasty excision patterns may represent a reliable tool for correcting contour deformities during abdominoplasty procedures. This initial experience should be considered before sacrificing tissues that could potentially be better employed otherwise in order to optimize the morpho-functional outcomes in abdominal contour surgery.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div><div><h3>Introduction</h3><div>Les lambeaux perforants pédiculés peuvent être utilisés non seulement pour des actes de reconstruction, mais aussi à des fins esthétiques, améliorant ainsi l’esthétique et la fonctionnalité de la zone traitée. Les auteurs présentent deux cas représentatifs illustrant une indication innovante pour corriger les déformations de contour à l’aide de lambeaux perforants désépithélialisés, recyclés à partir de modèles d’excision d’abdominoplastie.</div></div><div><h3>Rapports de cas</h3><div>Deux patientes présentaient un excès de peau abdominale et des déformations de contour dues à des chirurgies antérieures. La première patiente, ayant des antécédents d’extrophie vésicale, a subi une abdominoplastie en fleur de lys, tandis que l’insuffisance des tissus mous dans la région pubienne a été corrigée par deux lambeaux DIEP. La deuxième patiente, ayant bénéficiée de multiples interventions chirurgicales pour une luxation congénitale bilatérale de la hanche, présentait des cicatrices rétractiles au niveau des régions inguinales, qui ont été comblées par des lambeaux SCIP bilatéraux, prélevés lors d’une abdominoplastie conventionnelle. Les suites opératoires se sont déroulées sans incident, et les deux patients ont rapporté une amélioration significative des régions opérées, selon le q
{"title":"Aesthetic use of recycled perforator flaps to correct contour deformities during abdominoplasty procedures","authors":"B. Brunetti , M. Morelli Coppola , C.P. Mureddu , V. Petrucci , S. Tenna , M. Barone , P. Persichetti","doi":"10.1016/j.anplas.2025.04.006","DOIUrl":"10.1016/j.anplas.2025.04.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Pedicled perforator flaps can be used not only in reconstructive scenarios but also for aesthetic purposes, thereby enhancing both the aesthetics and functionality of the treated area. The authors present two representative cases demonstrating an innovative indication for correcting contour deformities using de-epithelialized perforator flaps recycled from abdominoplasty excision patterns.</div></div><div><h3>Case reports</h3><div>Two patients presented with abdominal skin redundancy and contour deformities due to previous surgeries. The first patient, with a history of bladder exstrophy, underwent a fleur-de-lys abdominoplasty, with the soft tissue deficiency in the pubic region corrected using two DIEP flaps. The second patient, with a history of multiple surgeries for bilateral congenital hip dislocation, presented with retracted scars at the groins, which were corrected with bilateral SCIP flaps, harvested during a conventional abdominoplasty. The post-operative course was uneventful, and both patients reported a significant improvement in their perception of the operated regions according to the BODY-Q administered before and one year after surgery.</div></div><div><h3>Conclusion</h3><div>Perforator flaps recycled from abdominoplasty excision patterns may represent a reliable tool for correcting contour deformities during abdominoplasty procedures. This initial experience should be considered before sacrificing tissues that could potentially be better employed otherwise in order to optimize the morpho-functional outcomes in abdominal contour surgery.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div><div><h3>Introduction</h3><div>Les lambeaux perforants pédiculés peuvent être utilisés non seulement pour des actes de reconstruction, mais aussi à des fins esthétiques, améliorant ainsi l’esthétique et la fonctionnalité de la zone traitée. Les auteurs présentent deux cas représentatifs illustrant une indication innovante pour corriger les déformations de contour à l’aide de lambeaux perforants désépithélialisés, recyclés à partir de modèles d’excision d’abdominoplastie.</div></div><div><h3>Rapports de cas</h3><div>Deux patientes présentaient un excès de peau abdominale et des déformations de contour dues à des chirurgies antérieures. La première patiente, ayant des antécédents d’extrophie vésicale, a subi une abdominoplastie en fleur de lys, tandis que l’insuffisance des tissus mous dans la région pubienne a été corrigée par deux lambeaux DIEP. La deuxième patiente, ayant bénéficiée de multiples interventions chirurgicales pour une luxation congénitale bilatérale de la hanche, présentait des cicatrices rétractiles au niveau des régions inguinales, qui ont été comblées par des lambeaux SCIP bilatéraux, prélevés lors d’une abdominoplastie conventionnelle. Les suites opératoires se sont déroulées sans incident, et les deux patients ont rapporté une amélioration significative des régions opérées, selon le q","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 5","pages":"Pages 366-370"},"PeriodicalIF":0.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719215","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 : 2025-07-24DOI: 10.1016/j.anplas.2025.04.007
Ö Parıldar, R Anlatıcı, I Z Cengiz, H Karaduman
Introduction: Gynecomastia, the benign enlargement of male breast tissue, impacts physical and psychological health. Grade III gynecomastia often requires surgery. The postero-inferior pedicle technique offers an alternative to free nipple grafts, preserving neurovascular integrity and aesthetics.
Materials and methods: This retrospective study included 12 patients treated with the postero-inferior pedicle technique. Data included demographics, surgical details, and outcomes. Preoperative and postoperative assessments utilized the SF-36v2 quality-of-life survey and a 7-item satisfaction questionnaire.
Results: Patients had a mean age of 25.5years and BMI of 29.56kg/m2. Average operative time was 112.17mins, with 618.33g of tissue resected. Complications were minimal, with one hematoma. All patients rated chest aesthetics as "good" or "very good." SF-36v2 showed significant improvement in physical function (P<0.05) and pain reduction (P<0.05).
Discussion: The postero-inferior pedicle technique is a safe, effective method for Grade III gynecomastia, offering minimal scarring, preserved neurovascular function, and high satisfaction.
{"title":"New horizons in gynecomastia: Evaluation of the postero-inferior pedicle technique.","authors":"Ö Parıldar, R Anlatıcı, I Z Cengiz, H Karaduman","doi":"10.1016/j.anplas.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.04.007","url":null,"abstract":"<p><strong>Introduction: </strong>Gynecomastia, the benign enlargement of male breast tissue, impacts physical and psychological health. Grade III gynecomastia often requires surgery. The postero-inferior pedicle technique offers an alternative to free nipple grafts, preserving neurovascular integrity and aesthetics.</p><p><strong>Materials and methods: </strong>This retrospective study included 12 patients treated with the postero-inferior pedicle technique. Data included demographics, surgical details, and outcomes. Preoperative and postoperative assessments utilized the SF-36v2 quality-of-life survey and a 7-item satisfaction questionnaire.</p><p><strong>Results: </strong>Patients had a mean age of 25.5years and BMI of 29.56kg/m<sup>2</sup>. Average operative time was 112.17mins, with 618.33g of tissue resected. Complications were minimal, with one hematoma. All patients rated chest aesthetics as \"good\" or \"very good.\" SF-36v2 showed significant improvement in physical function (P<0.05) and pain reduction (P<0.05).</p><p><strong>Discussion: </strong>The postero-inferior pedicle technique is a safe, effective method for Grade III gynecomastia, offering minimal scarring, preserved neurovascular function, and high satisfaction.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719216","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 : 2025-07-23DOI: 10.1016/j.anplas.2025.05.017
G. Van Straaten, S. Tomczak, C. Philandrianos, B. Bertrand, M. Abellan-Lopez, D. Casanova
Introduction
Le tourisme chirurgical est en forte expansion depuis deux décennies, notamment en chirurgie esthétique. Facilitée par des agences spécialisées, cette pratique engendre des risques médicaux, la propagation de bactéries multirésistantes et un surcoût pour le système de santé des pays d’origine des patients.
Matériel et méthodes
Nous avons réalisé une étude rétrospective dans notre CHU, analysant les patients ayant présenté des complications après une chirurgie esthétique à l’étranger entre janvier 2018 et juin 2024. Le type de chirurgie initiale, de complications et le coût total engendré pour leur prise en charge ont été analysé.
Résultats
Trente-trois patientes ont été prises en charge pour des complications après une chirurgie esthétique à l’étranger, majoritairement en Tunisie. Les interventions les plus fréquentes étaient les augmentations mammaires (n = 15) et les dermolipectomies abdominales (n = 14). Les complications étaient des infections dans la moitié des cas (51 %). Le coût total de la prise en charge s’est élevé à 283 781,85 €, avec un coût moyen de 8599,45 € par patiente.
Conclusion
Notre étude souligne l’impact médical et économique du tourisme chirurgical, notamment la fréquence des infections et le coût de leur prise en charge. Des mesures de prévention et de régulation sont nécessaires pour limiter ses effets sur le système de santé.
Introduction
Surgical tourism has been rapidly expanding over the past two decades, particularly in aesthetic surgery. Facilitated by specialized agencies, this practice leads to medical risks, the spread of multidrug-resistant bacteria, and additional costs for the healthcare system of the patients’ home countries.
Materials and methods
We conducted a retrospective study in our University Hospital, analyzing patients who developed complications following aesthetic surgery abroad between January 2018 and June 2024. The type of initial surgery, complications, and the total cost of their management were analyzed.
Results
Thirty-three patients were treated for complications after undergoing aesthetic surgery abroad, mostly in Tunisia. The most frequent procedures were breast augmentations (n = 15) and abdominoplasty (n = 14). Complications were primarily infections, occurring in 51% of cases. The total cost of care amounted to €283,781.85, with an average cost of €8599.45 per patient.
Conclusion
Our study highlights the medical and economic impact of surgical tourism, particularly the frequency of infections and the cost of their management. Preventive measures and regulation are necessary to mitigate its effects on the healthcare system.
{"title":"Le coût des complications du tourisme chirurgical : notre expérience, étude rétrospective sur 6 ans","authors":"G. Van Straaten, S. Tomczak, C. Philandrianos, B. Bertrand, M. Abellan-Lopez, D. Casanova","doi":"10.1016/j.anplas.2025.05.017","DOIUrl":"10.1016/j.anplas.2025.05.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Le tourisme chirurgical est en forte expansion depuis deux décennies, notamment en chirurgie esthétique. Facilitée par des agences spécialisées, cette pratique engendre des risques médicaux, la propagation de bactéries multirésistantes et un surcoût pour le système de santé des pays d’origine des patients.</div></div><div><h3>Matériel et méthodes</h3><div>Nous avons réalisé une étude rétrospective dans notre CHU, analysant les patients ayant présenté des complications après une chirurgie esthétique à l’étranger entre janvier 2018 et juin 2024. Le type de chirurgie initiale, de complications et le coût total engendré pour leur prise en charge ont été analysé.</div></div><div><h3>Résultats</h3><div>Trente-trois patientes ont été prises en charge pour des complications après une chirurgie esthétique à l’étranger, majoritairement en Tunisie. Les interventions les plus fréquentes étaient les augmentations mammaires (<em>n</em> <!-->=<!--> <!-->15) et les dermolipectomies abdominales (<em>n</em> <!-->=<!--> <!-->14). Les complications étaient des infections dans la moitié des cas (51 %). Le coût total de la prise en charge s’est élevé à 283 781,85 €, avec un coût moyen de 8599,45 € par patiente.</div></div><div><h3>Conclusion</h3><div>Notre étude souligne l’impact médical et économique du tourisme chirurgical, notamment la fréquence des infections et le coût de leur prise en charge. Des mesures de prévention et de régulation sont nécessaires pour limiter ses effets sur le système de santé.</div></div><div><h3>Introduction</h3><div>Surgical tourism has been rapidly expanding over the past two decades, particularly in aesthetic surgery. Facilitated by specialized agencies, this practice leads to medical risks, the spread of multidrug-resistant bacteria, and additional costs for the healthcare system of the patients’ home countries.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective study in our University Hospital, analyzing patients who developed complications following aesthetic surgery abroad between January 2018 and June 2024. The type of initial surgery, complications, and the total cost of their management were analyzed.</div></div><div><h3>Results</h3><div>Thirty-three patients were treated for complications after undergoing aesthetic surgery abroad, mostly in Tunisia. The most frequent procedures were breast augmentations (<em>n</em> <!-->=<!--> <!-->15) and abdominoplasty (<em>n</em> <!-->=<!--> <!-->14). Complications were primarily infections, occurring in 51% of cases. The total cost of care amounted to €283,781.85, with an average cost of €8599.45 per patient.</div></div><div><h3>Conclusion</h3><div>Our study highlights the medical and economic impact of surgical tourism, particularly the frequency of infections and the cost of their management. Preventive measures and regulation are necessary to mitigate its effects on the healthcare system.</div></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 5","pages":"Pages 371-376"},"PeriodicalIF":0.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709997","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 : 2025-07-10DOI: 10.1016/j.anplas.2025.03.010
K Al Tabaa, R Louvel, F M Leclere, F Chatelet
Cutaneous nasal defects, often resulting from surgical excisions for cancerous, traumatic, or congenital lesions, represent a major challenge in reconstructive surgery. The aim of this single-center retrospective study was to evaluate surgical practices and factors influencing the choice between two reconstruction techniques : the nasolabial flap (NLF) and the folded paramedian forehead flap (PFF) according to Menick's technique. Between January 2017 and March 2024, 23 patients with full-thickness alar defects, with or without extension to the nasal tip, were included. Patients were divided into two groups : 13 underwent PFF and 10 underwent NLF. Demographic data, comorbidities, histological type (primarily basal cell carcinomas), and aesthetic and functional outcomes were analyzed. PFF was associated with a significantly higher number of aesthetic subunits reconstructed (2.6±0.8 vs. 1.3±0.4, P<0.001) and a greater number of surgical stages (3.6±1.1 vs. 1.4±0.7, P<0.001). Patients in the PFF group were primarily motivated by aesthetic considerations (66 %), while those in the NLF group prioritized the speed of the procedure (50%). An anonymous questionnaire was distributed to 63 head and neck surgeons to explore their preferences and reasons for their choices. The NLF was preferred by 84% of surgeons, mainly due to its simplicity and speed, while 49% opted for the PFF, despite its complexity and the social inconvenience caused by the pedicle before division. The main drawbacks of the PFF were the number of surgical stages (49%), social inconvenience (35%), and donor site scarring (29%). However, the aesthetic outcomes of the PFF were considered superior, particularly for defects involving more than one aesthetic subunit. The use of pre- and postoperative photographs to guide patients was more common among experienced surgeons (57%). In conclusion, although the NLF is more widely used due to its practicality, the PFF remains the technique of choice for complex defects, offering optimal aesthetic results despite its complexity. Clear information and the use of visual aids are essential to assist patients in their decision-making process.
皮肤鼻缺损通常是由于癌性、外伤性或先天性病变的手术切除引起的，是鼻部重建手术的主要挑战。这项单中心回顾性研究的目的是评估两种重建技术：鼻唇瓣（NLF）和折叠旁位前额瓣（PFF）之间的选择的手术实践和影响因素。2017年1月至2024年3月，纳入了23例鼻翼全层缺损患者，有或没有延伸到鼻尖。患者分为两组：13例行PFF， 10例行NLF。分析了人口统计学数据、合并症、组织学类型（主要是基底细胞癌）以及美学和功能结果。PFF与重建的美学亚单位数量显著增加相关(2.6±0.8 vs. 1.3±0.4，P
{"title":"[Total nostril wing reconstruction: Attitudes evaluation of reconstructive facial surgeons].","authors":"K Al Tabaa, R Louvel, F M Leclere, F Chatelet","doi":"10.1016/j.anplas.2025.03.010","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.03.010","url":null,"abstract":"<p><p>Cutaneous nasal defects, often resulting from surgical excisions for cancerous, traumatic, or congenital lesions, represent a major challenge in reconstructive surgery. The aim of this single-center retrospective study was to evaluate surgical practices and factors influencing the choice between two reconstruction techniques : the nasolabial flap (NLF) and the folded paramedian forehead flap (PFF) according to Menick's technique. Between January 2017 and March 2024, 23 patients with full-thickness alar defects, with or without extension to the nasal tip, were included. Patients were divided into two groups : 13 underwent PFF and 10 underwent NLF. Demographic data, comorbidities, histological type (primarily basal cell carcinomas), and aesthetic and functional outcomes were analyzed. PFF was associated with a significantly higher number of aesthetic subunits reconstructed (2.6±0.8 vs. 1.3±0.4, P<0.001) and a greater number of surgical stages (3.6±1.1 vs. 1.4±0.7, P<0.001). Patients in the PFF group were primarily motivated by aesthetic considerations (66 %), while those in the NLF group prioritized the speed of the procedure (50%). An anonymous questionnaire was distributed to 63 head and neck surgeons to explore their preferences and reasons for their choices. The NLF was preferred by 84% of surgeons, mainly due to its simplicity and speed, while 49% opted for the PFF, despite its complexity and the social inconvenience caused by the pedicle before division. The main drawbacks of the PFF were the number of surgical stages (49%), social inconvenience (35%), and donor site scarring (29%). However, the aesthetic outcomes of the PFF were considered superior, particularly for defects involving more than one aesthetic subunit. The use of pre- and postoperative photographs to guide patients was more common among experienced surgeons (57%). In conclusion, although the NLF is more widely used due to its practicality, the PFF remains the technique of choice for complex defects, offering optimal aesthetic results despite its complexity. Clear information and the use of visual aids are essential to assist patients in their decision-making process.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621255","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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