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Introduction
Skills and Expertise
Publications
Publications (205)
Dorsal seroma is a common complication of autologous latissimus dorsi flap (ALDF) in breast reconstruction, and has limited the use of this technique, despite its aesthetic success. It is important to find a right technique to limit the incidence of seroma formation after ALDF. The aim of this study was to evaluate the effectiveness and tolerance o...
Background:
Complications of reduction mammoplasty can lead to aesthetic sequelae, which are known to be difficult and delicate to treat, and only a few articles deal with this subject.
Purpose:
The objective of this article is to present and analyze our experience of lipomodeling for the secondary management of aesthetic sequelae occurring afte...
Résumé
À la suite de l’apparition récente de cas répétés de lymphomes anaplasiques à grandes cellules associés aux implants mammaires (LAGC-AIM), dont la manifestation principale est le sérome tardif péri-prothétique, la survenue d’une telle manifestation clinique est devenue une complication redoutée du chirurgien plasticien. Ce dernier étant souv...
Résumé
Le syndrome de Poland est une malformation congénitale caractérisée par l’absence du muscle grand pectoral, souvent associée à d’autres malformations comme une hypotrophie mammaire, une asymétrie thoracique, ou des anomalies du membre supérieur homolatéral. La déformation thoraco-mammaire du syndrome de Poland, à laquelle nous nous intéresso...
Résumé
Les malformations thoraco-mammaires apparaissent visibles généralement à l’adolescence, entraînant souvent une perturbation de la construction de l’individu et de son identité lors de cette étape cruciale. Un large panel de techniques chirurgicales est aujourd’hui disponible pour corriger ces différentes anomalies. Les transferts de tissus a...
Soft tissue sarcomas are rare malignant tumors with pejorative prognosis. They require a multidisciplinary approach in a specialized hospital belonging to the NetSarc network in France. In all cases treated with curative intent, the objective of excision surgery is to achieve wide, microscopically negative margins (R0 according to the UICC classifi...
Amongst various techniques of breast reconstruction, Autologous Latissimus Dorsi (ALD) flap without breast implant is the newest technique that took advantage of recent improvement during the last decade. Surgical procedure is well standardized, and allows to harvest various fat areas attached to the muscle, to obtain an autologous reconstruction....
Only a few surgical choices are available for cervical and thoracic spine coverage. The trapezius perforator flap is relatively unknown and only a few authors have published on this subject. In this article, we report on four clinical cases where a trapezius perforator flap was used either as a propeller flap, as a tunnelized island flap, or as a s...
La nostra esperienza degli innesti di tessuto adiposo in regione toracomammaria è iniziata nel 1998. In seguito a questa esperienza, gli autori ritengono che il lipomodellamento della mammella, o trasferimento adiposo alla mammella, rappresenta un importante progresso nella chirurgia plastica del seno. La tecnica è, attualmente, ben codificata e il...
Cervicofacial lifting is one of the most iconic procedure of plastic surgery and is about hundred years old. In the following chapters of this report, numerous technical points will be specify. A baseline reliable and reproducible technique, appealing to the largest possible audience is presented in order to begin this surgery in optimum conditions...
The understanding of the face anatomy is mandatory before to be able to appreciate the different surgical techniques of face lifting. Despite numerous controversies and anatomical variations, we can find in the literature several keystone works that allows us to understand that the soft tissues of the face are not only a superposition of layers but...
Objectives:
Over the past 30 years, surface imaging has made tremendous progress. Surgical management has also been subject of numerous technical and strategic developments. For a better understanding of the curative strategies of face aging, the authors have put into perspective the three-dimensional data acquired up to date.
Method:
A review o...
Introduction:
Immediate breast reconstruction (IBR) improves the quality of life of patients who undergo mastectomy. The latissimus dorsi flap (LDF) method provides particularly good aesthetic results, but its tolerance to subsequent radiotherapy remains unclear. We thus sought to assess tolerance and esthetic results and satisfaction, as reported...
Introduction:
The mucosal cylindroma or adenoid cystic carcinoma is the second sinonasal non-epithelial malignant tumor frequency argument. Due to the achievement of the nasal mucosa and a late diagnosis reconstructions are often complex. We report the case of a mucous cylindroma recurrence of nasal septum requiring a wide and deep excision of the...
Résumé
La drépanocytose est une anémie chronique rare en France, mais fréquente en Afrique, responsable d’une rigidification des globules rouges en faucilles qui s’agglomèrent et obstruent la microcirculation. Elle est ainsi une contre-indication habituelle à la microchirurgie. Ses principales manifestations cliniques sont les crises vaso-occlusive...
La déformation thoracomammaire du syndrome de Poland est une entité malformative difficile à traiter. De nombreuses interventions ont été proposées pour corriger cette situation difficile, cependant dans les formes sévères de déformations thoracomammaires de Poland, aucune technique ne donnait une correction pleinement satisfaisante avant l’arrivée...
La cirugía estética genital tiene como finalidad mejorar el aspecto estético y funcional de los órganos genitales externos. Ha experimentado un desarrollo importante desde la década de 1980. En las mujeres, la intervención más frecuente es la ninfoplastia de reducción, que consiste en disminuir el tamaño de los labios menores. La técnica de las «V...
Breast implant-associated anaplastic large cell lymphoma (ALCL) is an extremely rare disease. Is a new nosologic entity with a multifactorial origin and a wide occurrence delay after breast implantation. This article reports the case of a 60 years old patient with a progressive swelling of the right breast after aesthetic breast implants. Diagnosti...
Here, a protocol to quantify epithelial early common progenitor/stem cells grown as spheres in non-adherent culture conditions is described. This protocol is based on the combination of two functional tests: the sphere assay to maintain and enrich early progenitor/stem cells, and the epithelial colony-forming cells (E-CFC) assay to identify and qua...
Evolutions in pediatric cardiovascular surgery have allowed the treatment of a various range of cardiovascular malformations in infants. It is a difficult branch of surgery, with vital impact, which can also leave residual thoracic scars, possible sources for thoracomammary deformities in adults. Most thoracomammary deformities after thoracotomy ar...
Il rimodellamento della figura è una richiesta frequente da parte delle pazienti. Queste desiderano anche un miglioramento estetico della regione glutea. Dal punto di vista della paziente, la regione glutea riveste un’attrattiva sessuale importante e costituisce uno dei simboli della femminilità. Dal punto di vista del chirurgo, l’analisi semeiolog...
Introduction:
The clinical surveillance of a patient treated for breast cancer involves many specialists: a surgeon, an oncologist, a radiotherapist, a gynecologist, and a general practitioner. The patients diagnosed with breast cancer will require regular clinical examination in order to identify possible recurrences. In our team, fat grafting ha...
Introduction:
The fat transfer or the lipofilling is a technique that had a major impact on the breast surgery results. We have been using this technique since 1998 as an adjuvant in breast reconstruction. The transferred fat is partially resorbed in the first three months after fat grafting. Literature shows that fat resorption varies from 30 to...
Introduction:
Fat grafting for breast surgery, in reconstruction or aesthetics, gained a lot of popularity over the last years. As an addition to breast reconstruction with flaps or prosthesis, lipofilling improved the aesthetic result, increasing the patients' satisfaction rate. The demand for breast reconstruction using only fat grafting increas...
Objectives:
Rates of immediate breast reconstruction (IBR) after mastectomy are currently increasing, leading us to evaluate outcomes of breast reconstruction with latissimus dorsi without implant followed by adjuvant radiotherapy.
Materials and methods:
From January 1999 to August 2013, 31 breast reconstructions with latissimus dorsi have been...
La remodelación de la silueta es una petición frecuente de las pacientes. Éstas también desean una mejora estética de la región glútea. Desde el punto de vista de la paciente, la región glútea presenta un atractivo sexual importante y constituye uno de los símbolos de la feminidad. Desde el punto de vista del cirujano, es importante realizar un aná...
Breast lipomodeling, or breast fat grafting, is a major development in breast plastic surgery. This technique has a low complication rate, excellent results, and patient acceptance. Radiologic evaluation mostly shows a normal-appearing breast. During breast reconstruction, fat grafting is the ideal complement of the latissimus dorsi flap. Fat graft...
INTRODUCTION
Fat necrosis is a phenomenon that has been known for a long time in surgery. The fat necrosis is produced because of tissue ischemia and it is also known as cytosteatonecrosis. These lesions can appear with different manifestations: indurations or cysts. Fat necrosis develops in breast aesthetic surgery (breast reduction) or reconstruc...
The association of Becker's nevus with other cutaneous, musculoskeletal or maxillofacial anomalies is called Becker nevus syndrome. Ipsilateral breast hypoplasia is the main reason for female patients to seek medical advice. We present two clinical cases of Becker nevus syndrome with thoracic nevus and ipsilateral breast hypoplasia treated with lip...
Understanding the cell of origin of cancer is pivotal for a better prevention and more efficient cure of the disease. Some examples of cancers arising from the transformation of stem cells have been shown, but in most cases, the cell of origin remains unknown. In healthy tissue, the microenvironment (niche) governs the fate of stem cells by balanci...
Aim of the study
Fat transfer significantly improved results in breast reconstruction. Final breast symmetry is very important in breast reconstruction, but sometimes, the result is not perfect with usual techniques. The aim of this study is to evaluate the tolerance and efficacy of lipomodelling as a complementary technique for breast symmetrisati...
Breast conservative surgeries, associated with radiotherapy within the framework of conservatives treatments for breast malignant tumors, can occur deformation of the breast in 10 to 15% of cases. The deformity can be more or less important according to the size of the initial lesion and the glandular reshaping reconstruction. Our experience in onc...
Les tumorectomies du sein, associées à la radiothérapie adjuvante dans le cadre du traitement conservateur du sein pour les tumeurs malignes, peuvent entraîner des séquelles à type de déformation du sein modérée à sévère dans 10 à 15 % des cas. La déformation peut être plus ou moins importante en fonction de la taille de la lésion initiale, du volu...
Tuberous breast is a rare malformation that has major, negative physical and psychological impacts during puberty. A range of surgical techniques has been used to correct breast shape and volume in this context. Most techniques are based on a combination of skin plasty and mammary gland remodelling, in order to redistribute volumes. Prostheses and...
Poland's syndrome is a rare congenital malformation with thoracic and breast deformities very difficult to treat. Several techniques can be used involving, sometimes, implant insertion. Most of the classic techniques could not be used in this patient. Particularly, the transfer of the latissimus dorsi flap could not be performed because of the agen...
Les seins tubéreux représentent une malformation rare du sein. Le retentissement physique et psychologique est important pour la patiente lors de la puberté, pouvant entraîner une véritable gêne. De nombreuses techniques chirurgicales ont été proposées pour redonner une forme et un volume satisfaisants au sein. Elles combinent habituellement des pl...
INTRODUCTION, DEFECTS
Achilles tendon are common in patients after immobilization, therefore the reconstruction of a ruptured Achilles tendon with defects remains a surgical challenge. The ideal characteristics are a thin layer of skin, a strong tendon component, combined with a reliable blood supply and minimal morbidity at the donor site. We pres...
Background
Prescription of preoperatory imaging assessment prior to planned breast reconstruction surgery (reduction or augmentation mastoplasty, correction of congenital breast asymmetry) is poorly codified. The objective of this study was to analyze the attitudes of French radiologists and plastic surgeons with regard to prescription of preoperat...
Introduction, defects
Achilles tendon are common in patients after immobilization, therefore the reconstruction of a ruptured Achilles tendon with defects remains a surgical challenge. The ideal characteristics are a thin layer of skin, a strong tendon component, combined with a reliable blood supply and minimal morbidity at the donor site. We pres...
Introduction
Pyoderma gangrenosum (PG) is a rare disease whose precise etiology remains unknown. It causes rapidly developing skin necrosis and can occur after surgery, or after a nonspecific external stimulus. This condition is difficult to diagnose because it often mimics a fulminant infection.
Clinical case
We present a case of very significant...
Breast reconstruction or for breast deformities is a difficult challenge to get excellent results. Lipomodeling technique can improve thoracic malformations and breast deformities. Percutaneous fasciotomies can be an excellent tool for recipient site improvement. The aim of this study is to discuss interest of percutaneous needle fasciotomies with...
Background: The management of breast deformities can be very difficult in the presence of breast shape retraction. Percutaneous fasciotomies, which release fibrous strings, can be a very useful tool for shape improvement in the recipient site for a fat graft.
Objectives: The authors evaluate the efficacy of fasciotomies in association with fat graf...
Background: In women, pectus excavatum malformation can cause modified breast morphology, resulting in mammary asymmetry, which can be increased by placing mammary implants alone. Fat transfer can be an elegant solution to increase the volume and projection of the breast.
Objectives: The authors discuss their experience treating pectus excavatum wi...
Objectives
Thoracic wall reconstruction after oncologic resection remains a complex form of surgery that implies a multidisciplinary approach. The purpose of this study is to present our experience in full thickness thoracic wall reconstruction after tumor resection.
Methods
A retrospective study, including patients who were operated for full thick...
Introduction
The most common surgical techniques performed for gluteal augmentation employ gluteal implants. Gluteal augmentation is today a consultation request for many patients. The results can be interesting, but this surgical procedure can provide some complications. Fat grafting is reliable technique to remodel the buttocks. The aim of this s...
Introduction
Fat grafting is very interesting for breast reconstruction and for breast deformities. Fat grafting can improve results with a long-standing follow-up. Pre-expansion with BRAVA® can be a powerful tool for recipient site improvement. The aim of this study is to evaluate tolerance of BRAVA by the patient.
Material and methods
We do real...
Introduction: Tuberous breast is a rare malformation that has negative physical and psychological impacts during puberty. A range of surgical techniques has been used to correct breast shape and volume in this context, including a combination of skin plasty and mammary gland remodeling, as well as prostheses and locoregional flaps. The authors have...
Introduction:
The elbow defects can raise problem to plastic surgeon. Indeed, this region is characterized by thin and mobile tissues; its reconstruction must be long-lasting, resistant to movements, to shear forces and to external support. Perforator propeller flaps beings appear an interesting option in the reconstruction of elbow defects. In th...
Introduction
Pyoderma gangrenosum (PG) is a rare chronic inflammatory skin disease characterized by the recurring development of necrotizing and painful ulcers and therefore, often misinterpreted. This condition can simulate fulminant infection, particularly after surgery. The presentation is often impressive in extensive ulcerations and scarring a...
Breast cancer surgical treatment results in important damage to women. The damage is to both the body and the mind. Breast reconstruction belongs to the treatment of breast cancer. An increasing number of patients benefit from immediate or delayed reconstruction. Breast reconstruction is a difficult challenge which can help women in their own recon...
The correct management, with the classic techniques, of the thoracic deformity in Poland's syndrome is difficult, with often insatisfactory results. The current surgical treatment involves the use of prothetic material and/or different flaps with their own complications and scares. The experience of our team with fat grafting (we named lipomodeling...
Breast reconstructions are plastic surgeries that female patients, who have undergone mastectomies, are increasingly using. While the morphological results are appreciated by patients themselves as being more and more satisfactory, results in terms of sensitivity remain uncertain and depend on type of reconstruction used. The chest wall skin alread...
Introduction:
Cutaneous radionecrosis and osteoradionecrosis are severe complications of the radiotherapy which can arise after a variable free interval. The loss of substance is frequently associated with a peripheral radiodermatitis and stays an infectious front door exposing patients to a sepsis. The reference treatment remains surgical and con...
The mutilating surgery for breast cancer causes deep somatic and psychological sequelae. Breast reconstruction can mitigate these effects and permit the patient to help rebuild their lives. The purpose of this paper is to focus on breast reconstruction techniques and on factors involved in breast reconstruction. The methods of breast reconstruction...
Introduction
Breast reconstruction or for breast deformities is a difficult challenge to get excellent results. Lipomodeling technique can improve thoracic malformations and breast deformities. Percutaneous fasciotomies can be an excellent tool for recipient site improvement. The aim of this study is to discuss interest of percutaneous needle fasci...
Based on long-term experiences, the authors consider lipomodelling to be a major advance in plastic, reconstructive and aesthetic surgery of the breast. The technique is now well established and the complication rate is very low. The risk of focal fat necrosis is around 3%. Oncological follow-up (now 14 years for the first patients) shows no increa...
Breast reconstructions are plastic surgeries that female patients, who have undergone mastectomies, are increasingly using. While the morphological results are appreciated by patients themselves as being more and more satisfactory, results in terms of sensitivity remain uncertain and depend on type of reconstruction used. The chest wall skin alread...
Mammary gland development is an important phase of puberty, and it marks the passage into adulthood for women, so any trauma leading to mammary deformities has an important physical and psychological impact. Often, classic techniques are difficult to use in the treatment of traumatic breast lesions. In this article, the authors present an exception...
INTRODUCTION: The most common surgical techniques performed for gluteal augmentation employ gluteal implants. Gluteal augmentation is today a consultation request for many patients. The results can be interesting, but this surgical procedure can provide some complications. Fat grafting is reliable technique to remodel the buttocks. The aim of this...
The gluteal region is an important pressure zone in every day life. Defects associated with bone exposure in the sacral region are more frequent among pressure sores. The gold standard treatment consists in a musculocutaneous gluteal flap; it can have as side effects functional deficits for walking and an important scar. In order to diminish the do...
The correct management, with the classic techniques, of the thoracic deformity in Poland's syndrome is difficult, with often insatisfactory results. The current surgical treatment involves the use of prothetic material and/or different flaps with their own complications and scares. The experience of our team with fat grafting (we named lipomodeling...
The mutilating surgery for breast cancer causes deep somatic and psychological sequelae. Breast reconstruction can mitigate these effects and permit the patient to help rebuild their lives. The purpose of this paper is to focus on breast reconstruction techniques and on factors involved in breast reconstruction. The methods of breast reconstruction...
Introduction
The aim of this study is to assess our results of autologous breast reconstruction using a combined muscle sparing latissimus dorsi flap (MSLD) and fat tissue transfer.
Methods
A prospective study was performed on 20 patients over a period of 1 year. Three objective criteria were analyzed: morphometric, surgical procedure and postoper...
The aim of this study is to assess our results of autologous breast reconstruction using a combined muscle sparing latissimus dorsi flap (MSLD) and fat tissue transfer.
A prospective study was performed on 20 patients over a period of 1 year. Three objective criteria were analyzed: morphometric, surgical procedure and postoperative latissimus dorsi...
Women undergoing breast conservation therapy (BCT) for breast cancer are often left with contour defects and few acceptable reconstructive options. RESTORE-2 is the first prospective clinical trial using autologous adipose-derived regenerative cell (ADRC)-enriched fat grafting for reconstruction of such defects. This single-arm, prospective, multi-...
Here we describe a protocol established in our laboratory to quantify early common progenitors/stem cells grown as spheres in non-adherent culture conditions. This protocol is based on the combination of two functional tests: the mammosphere assay to maintain and enrich early mammary progenitors/stem cells, and the epithelial colony-forming cells (...
This case report is of a 47-year-old woman who suffered a ballistic chest trauma with severe left hemothorax and heart wound. She was treated in emergency for the collapse by heart surgery. Then the coverage for her soft thorax tissue loss was done by an ipsilateral musculocutaneous latissimus dorsi pedicled flap. The patient was subsequently addre...
A partire da un’esperienza di 950 interventi di innesto di tessuto adiposo nella regione toracomammaria realizzati dal primo autore di questo articolo, gli autori ritengono che il lipomodellamento della mammella, o trasferimento adiposo al seno, rappresenti un importante progresso nella chirurgia plastica del seno. La tecnica è, attualmente, ben co...
Lateral breast defect after partial mastectomy is a difficult challenge. Pedicled perforator flap is a new indication for breast surgery. Perforator flaps and fat tissue transplant are new concepts in this kind of reconstruction. Lateral intercostal artery perforator (LICAP) flap has been used for a lot of indications. It can be used for lateral br...
Keller et al. (1) highlighted the use of the CD10 and epithelial cell adhesion molecule (EpCAM) markers to discriminate basal from luminal breast epithelial subpopulations. Based on the same two markers, we have previously developed a simple, robust, and reliable flow cytometry sorting technique to separate luminal populations cleanly from the rest...
The major components of the mammary ductal tree are an inner layer of luminal cells, an outer layer of myoepithelial cells, and a basement membrane that separates the ducts from the underlying stroma. Cells in the outer layer express CD10, a zinc-dependent metalloprotease that regulates the growth of the ductal tree during mammary gland development...
Lateral breast defect after partial mastectomy is a difficult challenge. Pedicled perforator flap is a new indication for breast surgery. Perforator flaps and fat tissue transplant are new concepts in this kind of reconstruction. Lateral intercostal artery perforator (LICAP) flap has been used for a lot of indications. It can be used for lateral br...
Introduction
Breast rupture is an uncommon event that has become more frequent from the 1980s, with the generalisation of the seat belt, so that we can now speak of seat belt related injuries. The trauma is often forgotten and leaves a fibrous band in the breast as only mark. In this way, the breast can be deformed by the scar as much as the retrac...
Lipofilling is now performed to improve the breast contour, after both breast-conserving surgery and breast reconstruction. However, injection of fat into a previous tumor site may create a new environment for cancer and adjacent cells. There is also no international agreement regarding lipofilling after breast cancer treatment.
The authors include...
This case report is of a 47-year-old woman who suffered a ballistic chest trauma with severe left hemothorax and heart wound. She was treated in emergency for the collapse by heart surgery. Then the coverage for her soft thorax tissue loss was done by an ipsilateral musculocutaneous latissimus dorsi pedicled flap. The patient was subsequently addre...
Fat transfer to healthy breasts, that is, in women with no history of breast disease, particularly breast cancer, is becoming increasingly popular. The main issue remains whether the transfer of fat cells to the native breast hampers breast imaging. This pilot study aimed to assess the effectiveness of radiographic evaluation after breast lipomodel...
Breast rupture is an uncommon event that has become more frequent from the 1980s, with the generalisation of the seat belt, so that we can now speak of seat belt related injuries. The trauma is often forgotten and leaves a fibrous band in the breast as only mark. In this way, the breast can be deformed by the scar as much as the retraction is impor...
INTRODUCTION: Pyoderma gangrenosum (PG) is a rare chronic inflammatory skin disease characterized by the recurring development of necrotizing and painful ulcers and therefore, often misinterpreted. This condition can simulate fulminant infection, particularly after surgery. The presentation is often impressive in extensive ulcerations and scarring...
En la actualidad, la reconstrucción mamaria es una parte integral del tratamiento de las secuelas del cáncer de mama. El objetivo de la reconstrucción mamaria inmediata o diferida consiste en recuperar una simetría mamaria armoniosa y restaurar la piel si es necesario, así como la forma, la consistencia y el volumen parecidos a los de una mama norm...
La ricostruzione mammaria fa ora parte integrante del trattamento degli esiti del cancro al seno. L’obiettivo della ricostruzione mammaria immediata o differita è di ricreare una simmetria mammaria armoniosa, di restaurare la cute se necessario, la forma, il volume e la consistenza vicina a un seno normale. In più, è auspicabile disporre di una tec...
The efficacy of fat grafting has long been a controversial issue. Breast lipomodelling after extended latissimus dorsi flap reconstruction was first attempted at the Plastic and Reconstructive Surgery unit of Leon Berard Cancer Centre in 1999. We present the results of a retrospective report of the first 200 consecutive patients treated at our inst...
Grace to the creativity of surgeons and the introduction of new technologies, second half of the XXth century opened the era of innovations and decisive progress. At the same time, however, is born the feeling of distrust and claiming which has come with the graving and threatening juridiciarisation. The evolution of complex structures of our socie...
Flap surgery is the art of transposing an autonomous vascularised tissue, from a donor site to a distant recipient site. It was born 2000 years ago in India, evolving from random flaps to microsurgical flaps with a skeletonised vascular pedicle. This evolution was possible through the knowledge of cutaneous vascularisation and allows today the spre...
The radiation treatment of malignant facial tumors in children may induce major functional and cosmetic sequelae, mainly due to uneven growth of the bones and soft tissues, resulting in facial asymmetry and hemihypotrophy at adult age. Although fat transfer has proven effective for facial cosmetic treatment, few studies have demonstrated the benefi...
The major components of the mammary ductal tree are an inner layer of luminal cells, an outer layer of myoepithelial cells, and a basement membrane that separates the ducts from the underlying stroma. Cells in the outer layer express CD10, a zinc-dependent metalloprotease that regulates the growth of the ductal tree during mammary gland development...