Publications (22)46.8 Total impact
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Article: Poland syndrome and breast tumor: a case report and review of the literature.
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ABSTRACT: Poland syndrome is a rare congenital malformation. Hypoplasia of the sternocostal portion of the pectoralis major muscle is the most significant feature and is most frequently associated with homolateral breast hypoplasia. In this article, the authors present a case of bilateral phyllodes tumors in a 28-year-old woman with Poland syndrome and discuss (1) the relationship between the condition and breast cancer, (2) the modes of surveillance in patients with Poland syndrome, and (3) its impact on breast reconstruction.Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery 01/2012; 32(1):77-83. -
Article: Reply: major pedicles of the sartorius muscle.
Plastic and reconstructive surgery 12/2011; 128(6):786e-8e. · 2.74 Impact Factor -
Article: On the classification of postoncologic midfacial defects.
Plastic and reconstructive surgery 08/2011; 128(2):588-9; author reply 589. · 2.74 Impact Factor -
Article: Influence of age and body mass index on the yield and proliferation capacity of adipose-derived stem cells.
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ABSTRACT: Adipose tissue is commonly used for volume restoration. It is also a source of adipose-derived stem cells (ASCs), easy to obtain in large quantities by liposuction or resection techniques. The aim of this study was to determine the influence of body mass index (BMI) and age on the number (yield) and proliferation capacity of ASCs. A prospective study was conducted in 42 women. They were divided into two groups: age ≤ 40 or >40 and BMI ≤ 25 or >25. Fat tissue was harvested via manual lipoaspiration always from the abdominal region. After centrifugation in the OR, the harvested fat (100 cc) was sent to the laboratory for isolation and cultivation of ASCs. The yield of viable ASCs was evaluated by the trypan blue exclusion test. Viable ASCs were cultured and their proliferation capacity was evaluated by the growth kinetics assay. Results were statistically analyzed. The average cell yield was 0.380 × 10(6)/ml. Cell yield and proliferation capacity did not show statistically significant correlation to the age and BMI of patients, with regression lines showing null correlation. There was no significant difference between the cell yield and proliferation capacity between the different groups. The results from this study suggest that there is no statistically significant correlation between ASC yield and proliferation capacity and age and BMI.Aesthetic Plastic Surgery 05/2011; 35(6):1097-105. · 1.41 Impact Factor -
Article: The endoscopic latissimus dorsi flap harvest: advantages and technical drawbacks.
Journal of Laparoendoscopic & Advanced Surgical Techniques 05/2011; 21(6):541-2. · 1.40 Impact Factor -
Article: Stem cells, mature adipocytes, and extracellular scaffold: what does each contribute to fat graft survival?
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ABSTRACT: Soft tissue engineering offers new perspectives for improving fat graft survival, for which the appropriate association of cells and scaffold seems essential. This study aimed to analyze the survival of free-cell grafts compared with adipose-derived stem cells (ASCs) seeded on collagen scaffolds. Adipose tissue from a single volunteer was used for the following preparations: purified adipose tissue, isolated mature adipocytes (free-cell graft), cultured ASCs without scaffold (free-cell graft), collagen scaffold only, cultured ASCs in collagen scaffold without and with bioactive factors, and freshly-isolated ASCs in collagen scaffold. These were grafted on 18 nude mice for 2 months, after which specimens were evaluated grossly and histologically using hematoxylin-phloxine-safran (HPS), Oil-Red-O, and antivimentin labeling. Specimens and animals were weighed before implantation and after explantation, and weight values were statistically analyzed. Free-cell grafts (mature adipocytes and free ASCs) showed complete resorption in 50 and 60% of the animals (remaining weight fraction was 22.5 and 5.3%, respectively). The survival of purified adipose tissue was 81.8% (statistically greater compared with free-cell grafts; p < 0.05). In the ASCs-scaffold association, the remaining weight fractions (87.3-70.4%) were statistically greater than in free-cell grafts (5.3-22.5%; p < 0.05), but the difference between ASC-scaffolds and fat grafts was not statistically significant. These results were confirmed by clinical and histologic observations. Three-dimensional collagen scaffolds seem to improve survival of ASCs compared with free-cell grafts (adipocytes and free ASCs).Aesthetic Plastic Surgery 05/2011; 35(6):1061-72. · 1.41 Impact Factor -
Article: Redefining the Vascular Anatomy and Clinical Applications of the Sartorius Muscle and Myocutaneous Flap
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ABSTRACT: Background: The sartorius muscle is a superficial thigh muscle with specific anatomical characteristics in terms of shape and vascular supply. Few studies have assessed the vascular supply of the muscle and overlying skin paddle and its potential in reconstructive surgery. The study used three-dimensional, four-dimensional imaging to analyze the segmental vascularity of the muscle, as well as the overlying skin paddle, to define arcs of rotation based on its major pedicles. Methods: Thirty sartorius muscles and the circumferential skin of the thigh were harvested from adult cadavers. Anatomic considerations, such as pedicle number, location, diameter, and length, were recorded. Three-dimensional and four-dimensional computed tomography angiography was used to measure the length of muscle perfused by a single pedicle defined as a major pedicle. Lastly, the area of cutaneous territory supplied by each major pedicle was calculated. Results: The sartorius muscle is supplied by six to eight vascular pedicles. Two clusters of major pedicles (diameter greater than 1.8 mm) were described (proximal and distal), which are located 18 to 25 cm and 35 to 44 cm from the anterior superior iliac spine, respectively. The proximal major pedicle perfuses almost 80 percent of the muscle, and the distal major pedicle perfuses almost 90 percent. The average area of skin perfused was 330 cm2. Conclusions: This study suggests greater anatomical assurance of the potential use of the sartorius muscle and its overlying skin as a local transposition and free flap. The vascular supply of the muscle and skin by two major pedicles allows two pivot points for muscular or musculocutaneous flaps. The various applications for reconstructive surgery based on these arcs of rotation are discussed.Plastic & Reconstructive Surgery 04/2011; 127(5):1946-1957. · 3.38 Impact Factor -
Article: Reply: distally based superficial sural artery flap excluding the sural nerve.
Plastic and reconstructive surgery 04/2011; 127(4):1750-1. · 2.74 Impact Factor -
Article: Redefining the vascular anatomy and clinical applications of the sartorius muscle and myocutaneous flap.
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ABSTRACT: The sartorius muscle is a superficial thigh muscle with specific anatomical characteristics in terms of shape and vascular supply. Few studies have assessed the vascular supply of the muscle and overlying skin paddle and its potential in reconstructive surgery. The study used three-dimensional, four-dimensional imaging to analyze the segmental vascularity of the muscle, as well as the overlying skin paddle, to define arcs of rotation based on its major pedicles. Thirty sartorius muscles and the circumferential skin of the thigh were harvested from adult cadavers. Anatomic considerations, such as pedicle number, location, diameter, and length, were recorded. Three-dimensional and four-dimensional computed tomography angiography was used to measure the length of muscle perfused by a single pedicle defined as a major pedicle. Lastly, the area of cutaneous territory supplied by each major pedicle was calculated. The sartorius muscle is supplied by six to eight vascular pedicles. Two clusters of major pedicles (diameter greater than 1.8 mm) were described (proximal and distal), which are located 18 to 25 cm and 35 to 44 cm from the anterior superior iliac spine, respectively. The proximal major pedicle perfuses almost 80 percent of the muscle, and the distal major pedicle perfuses almost 90 percent. The average area of skin perfused was 330 cm. This study suggests greater anatomical assurance of the potential use of the sartorius muscle and its overlying skin as a local transposition and free flap. The vascular supply of the muscle and skin by two major pedicles allows two pivot points for muscular or musculocutaneous flaps. The various applications for reconstructive surgery based on these arcs of rotation are discussed.Plastic and reconstructive surgery 01/2011; 127(5):1946-57. · 2.74 Impact Factor -
Article: The posterior thigh flap for ischial pressure sores.
Journal of Reconstructive Microsurgery 10/2010; 27(2):141-2. · 1.43 Impact Factor -
Article: Vascular supply of the distally based superficial sural artery flap: surgical safe zones based on component analysis using three-dimensional computed tomographic angiography.
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ABSTRACT: Distal lower limb reconstruction remains challenging for surgeons. Since its description, the distally based superficial sural artery flap (sural flap) has gained popularity for these indications. The authors' aim was to determine which components were necessary to maintain this flap's arterial supply. Anatomical components were studied on 24 fresh adult cadaver legs and included the following: skin, adipose tissue, lesser saphenous vein, deep fascia, and sural nerve. Thirty-two flaps were harvested and divided into the following combination groups: cutaneous-venoneuroadipofascial (n = 5), venoneuroadipofascial (n = 3), neurofascial (n = 4), cutaneous-adipovenous (n = 2), cutaneous-venoadipofascial (n = 9), venoadipofascial (n = 5), and purely fascial (n = 4). Leg length, location of the sural nerve crossing the deep fascia, and location of peroneal and posterior tibial artery perforators were recorded. Twenty-eight of the combination flaps were injected with barium sulfate. Three-dimensional computed tomographic angiography was used to analyze the vascular territory of each flap. The cutaneous-venoneuroadipofascial and cutaneous-venoadipofascial flaps were perfused 86.5 percent and 80.2 percent, respectively, followed by cutaneous-adipovenous (75.7 percent), venoneuroadipofascial (87.1 percent), and venoadipofascial (74.8 percent) flaps. In contrast, the neurofascial and purely fascial flaps were merely perfused 40.8 percent and 44.1 percent, respectively, using only a perineural vascular network, with minimal fascial contribution. The lesser saphenous vein and the deep adipose tissue are necessary for the arterial supply of the sural flap. The deep fascia serves only as mechanical support. The sural nerve contributes to the vascular network, but its inclusion does not increase the vascular territory. Noninclusion of the sural nerve defines a new pivot point that should be identified before the harvest of the sural flap.Plastic and reconstructive surgery 10/2010; 126(4):1240-52. · 2.74 Impact Factor -
Article: Madelung disease: on the morphologic criteria for diagnosis and treatment.
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ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.Annals of plastic surgery 06/2010; 64(6):807-8. · 1.29 Impact Factor -
Article: New abdominal flap design for breast reconstruction in association with the thoracoabdominal flap.
Plastic and reconstructive surgery 02/2010; 125(2):475-8. · 2.74 Impact Factor -
Article: Breast reduction in gigantomastia using the posterosuperior pedicle: an alternative technique, based on preservation of the anterior intercostal artery perforators.
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ABSTRACT: The purpose of this study was to describe and evaluate the outcomes of breast reduction in cases of gigantomastia using a posterosuperior pedicle. Four hundred thirty-one breast reductions were performed between 2004 and 2007. Fifty patients of 431 (11.6 percent) responded to the inclusion criteria (>1000 g of tissue removed per breast (100 breasts). The mean age was 33.2 years (range, 17 to 58 years). The average notch-to-nipple distance was 37.9 cm (range, 35 to 46 cm). The mean body mass index was 27 (range, 22 to 35 cm). The technique of the posterosuperior pedicle was used, in which the perforators from fourth anterior intercostal arteries are preserved (posterior pedicle). Results were evaluated by means of self-evaluation at 1 year postoperatively. The average weight resected was 1231 g (range, 1000 to 2500 g). The length of hospital stay was 2.3 days (range 2 to 4 days). Thirty seven patients evaluated their results as "very good" (74 percent), nine as "good" (18 percent), and four as "acceptable" (8 percent). There were no "poor" results. The chief complaint was insufficient breast reduction (four patients), despite the considerable improvement in their daily life (8 percent). Back pain totally resolved in 46 percent and partially (with significant improvement) in 54 percent of cases. One major and seven minor complications were recorded. The posterosuperior pedicle for breast reduction is a reproducible and versatile technique. The preservation of the anterior intercostal artery perforators enhances the reliability of the vascular supply to the superior pedicle.Plastic and reconstructive surgery 01/2010; 125(1):32-43. · 2.74 Impact Factor -
Article: Improvement of skin quality after fat grafting: clinical observation and an animal study.
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ABSTRACT: Restoration of volume and contour defects is a challenge in plastic surgery. Autologous fat tissue transfer is gaining increasing popularity in this field. The aim of this study was to investigate the histologic modifications of the skin after fat tissue grafting on an animal model. Thirty nude mice, divided into three groups, were used in the experiment. All 30 mice received human fat tissue on one side. On the opposite side, 10 mice received nothing (negative control group), 10 mice received cell proliferation medium, and the remaining 10 mice received only subcutaneous tunneling. Eight weeks later, biopsies of the skin and subcutaneous tissue were performed and specimens were analyzed by hematoxylin-phloxin-saffron staining. Dermis thickness was measured. To differentiate human from murine collagen fibers, human and murine collagen type I antibodies were used. The other types of collagen were investigated by immunohistochemistry (immunostaining) using collagen type III, V, and VI antibodies. Fat tissue was found in all animals. Macroscopically, fat tissue presented normal aspects, with abundant peripheral neovascularization. Histologic examination showed abundant extracellular matrix around the injected human fat tissue. This was attributable to increased type I collagen fibers of murine origin as a result of the murine fibroblast stimulation by the grafted human fat tissue. Dermal thickness after fat grafting was significantly greater. This was not attributable to inflammatory reactions, because no modification was detected in our control groups. This study shows that fat tissue grafting stimulates a neosynthesis of collagen fibers at the recipient site and makes the dermis thicker. However, the long-term effects remain undetermined and need further investigation.Plastic and reconstructive surgery 10/2009; 124(3):765-74. · 2.74 Impact Factor -
Article: A primary ovarian hydatid cyst.
Australian and New Zealand Journal of Obstetrics and Gynaecology 09/2009; 49(4):441-2. · 1.24 Impact Factor -
Article: Influence of the recipient site on the outcomes of fat grafting in facial reconstructive surgery.
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ABSTRACT: The purpose of this study was to analyze the role of fat grafting for restoration of facial contour deformities (volumes) in traumatic and malformation cases. Outcomes were evaluated for each facial aesthetic subunit to demonstrate the role of the recipient site. An algorithm for the treatment of facial malformations and traumatic sequelae by subunits, in relation to the results obtained in this study, is proposed. This retrospective study involved 100 patients treated by structural fat grafting of the facial region. Results were evaluated by a subjective self-evaluation survey (i.e., a questionnaire answered by patients) and an objective assessment by a five-member jury. Each subunit of the face was studied separately. Results were presented separately and compared. The average follow-up period was 23 months. The overall satisfaction rate of patients was 74 percent. The average score for subjective evaluation was 14.5 of 20. The objective score was 13.9 of 20. The results were significantly different depending on the aesthetic subunit of the face. The best results were achieved in the malar (89 percent good results) and lateral cheek areas (84 percent good results). The poorest results were registered for the lower and upper lip areas (34 percent and 31 percent good results, respectively). Minor complications were observed in 3 percent of the cases. Fat tissue grafting is a simple, efficient, and reproducible technique for restoration of facial volumes. In the absence of functional disorders, it is the authors' first choice in the decision-making process for the treatment of facial soft-tissue deficiencies.Plastic and reconstructive surgery 09/2009; 124(2):471-83. · 2.74 Impact Factor -
Article: Analysis of a series of autologous fat tissue transfer for lower limb atrophies.
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ABSTRACT: Localized and circumferential atrophies of the lower extremities have been difficult to treat with few simple autologous solutions available. The aim of this study was to analyze the efficacy of fat grafting in lower limb atrophies. There were 20 patients (17 females and 3 males) at an average age of 33 years. Twelve patients had localized and 8 patients circumferential atrophies of various etiologies: traumatic (60%), congenital (25%), and iatrogenic (15%). The average number of fat injections was 1.1 per patient (range 1-2) for localized atrophies and 2.2 per patient (range 1-3) for circumferential atrophies. The average follow-up period was 2 years. The average volume injected at each stage was 79 mL for localized atrophies and 137 mL for circumferential atrophies. In the cases of circumferential atrophies, an average augmentation of 1.9 cm (range 1-6 cm) of the limb perimeter per injection was achieved. The overall satisfaction of the patients was high. Autologous fat grafting is a reliable technique for lower limb atrophies.Annals of plastic surgery 12/2008; 61(5):537-43. · 1.29 Impact Factor -
Article: The keystone island and pedicle flap: a handy local flap for soft tissue reconstruction.
Annals of Surgical Oncology 09/2008; 15(12):3625. · 4.17 Impact Factor -
Article: Breast reconstruction in Poland anomaly with endoscopically-assisted latissimus dorsi muscle flap and autologous fat tissue transfer: a case report and review of the literature.
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ABSTRACT: The breast deformity in females with Poland anomaly (Poland syndrome) can be particularly embarrassing from esthetic and social point of view. Various methods of breast reconstruction were reported comprising breast implants, latissimus dorsi (LD) flap or the combination of these two. The aim of this study was to present a breast reconstruction in Poland anomaly with endoscopically-assisted LD muscle flap in association with autologous fat tissue transfer and to analyse the results in the light of the literature data. An 18-year-old woman presented with severe left breast hypoplasia (in the context of a Poland anomaly) with heavy social and psychological impact on both private and professional life. No thoracic deformity was clinically and radiologically detectable. The preoperative imaging studies of the breast (mammography and ultrasound) did not show any pathological findings. A three-stage autologous breast reconstruction was performed. An endoscopically assisted LD muscle flap was carried out during the first stage. This was followed by two stages of autologous fat tissue transfer and reduction mammaplasty of the opposite breast. No postoperative complications were observed. The postoperative pain was less intensive than in the classic open technique. The LD muscle harvesting was carried out through a smaller incision which left a smaller back scar. The final result was breast symmetry of excellent quality. The breast reconstruction in Poland anomaly can be performed with entirely autologous techniques. Endoscopic techniques in LD harvesting leave smaller scars and cause less postoperative pain. The autologous fat tissue transfer can be an useful adjunct to the classic flap techniques provided that safety requirements in technique and follow up are strictly observed.Folia medica 02/2008; 50(1):63-9.
Top co-authors
Top Journals
Institutions
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2008–2012
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CHU de Lyon - Groupement Hospitalier Edouard Herriot
Lyon, Rhone-Alpes, France
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2011
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St George Hospital
Sydney, New South Wales, Australia
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2010
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Université de Lyon
Lyon, Rhone-Alpes, France
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2008–2010
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St. George's University
- Department of Surgery
Grenada, MS, USA
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