Annales De Chirurgie Plastique Esthetique最新文献

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.

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.

Introduction: Oncological plastic surgery plays a central role in the management of cancers requiring complex reconstruction. Recent years have seen significant advances in oncology, both therapeutic and technological. The aim of this article is to provide an overview of major recent developments in oncological plastic surgery, through a selection of impactful recent studies chosen by national experts in three of the main fields of this specialty.

Methods: Between October and November 2024, national experts and/or representatives of French scientific societies were invited to participate in this analysis. The covered domains included senology, soft tissue sarcoma surgery, and oncological dermatologic surgery. Each expert selected two recent articles (≤5years) deemed relevant within their field of expertise. Selected studies had to have a direct impact on clinical practice in oncological plastic surgery. Each article was validated, analyzed, and synthesized with a focus on its practical implications for reconstructive plastic surgery.

Results: Recent developments in oncological plastic surgery show profound changes in treatment strategies, largely influenced by the emergence of neoadjuvant immunotherapy and an increasingly personalized approach to reconstruction. In senology, there is a reduction in surgical indications, particularly with the decreasing use of sentinel lymph node biopsy in early breast cancer and reconsideration of axillary dissection in the presence of positive sentinel nodes (but normal axillary ultrasound). In soft tissue sarcomas, the role of the plastic surgeon is reinforced to ensure clear resection margins, and a risk-based reconstruction algorithm now guides the use of flaps in high-risk patients. In oncological dermatology, neoadjuvant immunotherapy is gaining a growing role in the treatment of advanced stages of melanoma and squamous cell carcinoma, reshaping the timing and indications for surgical intervention.

Conclusion: Oncological plastic surgery is moving towards more targeted, less invasive approaches, integrated within multidisciplinary therapeutic strategies. In this context, understanding recent oncological advances - particularly in immunotherapy, neoadjuvant protocols, and patient selection criteria - is essential for plastic surgeons to ensure optimal and up-to-date patient care.

Introduction: Rhinoplasty is a commonly performed surgical procedure for both aesthetic and functional purposes. In recent years, advancements in surgical techniques, the widespread adoption of minimally invasive methods, and an increasing emphasis on patient satisfaction have significantly contributed to the rapid growth of scientific productivity in this field. This study aims to evaluate scientific productivity in the field of rhinoplasty and identify global trends through a bibliometric analysis.

Materials and methods: This study is based on bibliometric analyses conducted using the Web of Science (WoS) Core Collection database with the keyword "rhinoplasty." The number of publications by country, citation distribution, and annual trends were evaluated. The position of a specific country in the global literature was examined and compared with leading nations. The most cited studies were analyzed to identify prominent research topics in the literature. Furthermore, VOSviewer software was used to visualize author collaborations, citation relationships, and keyword trends.

Discussion: Between 1975 and 2024, a total of 2735 articles on rhinoplasty have been published, accumulating 91,714 citations. The United States ranks as the leading country in terms of the number of publications, while Turkey follows with 822 publications, representing 10.4% of the global literature. This country has received 8063 citations in total, with an average of 9.81 citations per publication. Global trends indicate a significant academic increase in rhinoplasty research since the 2000s. The rise in publication numbers has gained notable momentum, particularly after 2010. However, to sustain scientific impact, enhancing international collaborations and increasing publications in high-impact journals is essential. Additionally, the analysis revealed a statistically significant correlation between JIF (5years) and the number of citations (r=0.251, P=0.018). This finding suggests that articles published in high-impact journals receive more citations.

Conclusion: Bibliometric analyses demonstrate that scientific productivity in rhinoplasty has increased on a global scale, with certain countries making notable contributions to the field. However, to ensure sustained scientific impact, greater emphasis should be placed on fostering international collaborations, encouraging multidisciplinary research, and prioritizing publications in high-impact journals.

Level of evidence: Level V.

Objective: The primary objective of this study is to assess the inter-observer agreement in the analysis of digital flap photos using the Pixacare application. The secondary objective is to evaluate the implementation of outpatient telemonitoring for these flaps via the Pixacare application.

Methodology: This is a prospective monocentric study conducted at SOS Main Lesquin from January 1st to July 1st, 2023. Patients who underwent a digital flap procedure were included in the study. Home care nurses were asked to send a weekly photo of the flap via the Pixacare application. The collected photo sequences were then analyzed by three observers and classified into two categories (normal healing/complication). Patient satisfaction with the follow-up was rated on a scale of 5.

Results: A total of 27 patients were included, with 76 photographic sequences collected via the application. Fleiss' Kappa coefficient, evaluating inter-observer agreement, was calculated at K=0.64, 95% CI [0.51; 0.77], with P<0.001, indicating strong agreement. The average patient satisfaction score was 4.63/5.

Conclusion: The follow-up of digital flaps using the Pixacare application appears promising in reducing the frequency of consultations, given the strong inter-observer agreement. While patient satisfaction is very high, the implementation of this telemonitoring system will require some adjustments to ensure strong adherence from paramedical staff to photographic follow-up.