Annales De Chirurgie Plastique Esthetique最新文献

{"title":"[Reconstruction of breast burn sequelae in young girls through tissue expansion starting in the prepubertal phase].","authors":"A Al Bahrani, M Lherm, F Boucher, A-A Mojallal, H Person","doi":"10.1016/j.anplas.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.02.003","url":null,"abstract":"<p><strong>Introduction: </strong>Burns on the thorax are common in children. When these burns are deep and extensive in girls, they pose a risk of aesthetic and functional sequelae due to impaired breast growth. The management of these sequelae can be initiated as early as the prepubertal phase, with an initial stage involving the replacement of the scarred skin with healthy skin by using tissue expansion.</p><p><strong>Methods: </strong>We present our protocol for skin resurfacing of the breast areas through tissue expansion initiated in the prepubertal stage. We describe the indications (related to the patient, related to their burn, and other associated burns). We detail the preoperative planning and the operative technique, including the placement of expanders and the type of flap used. We illustrate this with clinical cases.</p><p><strong>Results: </strong>Between January 2018 and December 2023, six patients were followed in a multidisciplinary consultation for thoracic burn sequelae. Their initial burn occurred at an average age of 4.6 years, with the affected body surface ranging from 15 to 31%. All underwent early skin grafting. The sequelae affected at least two quadrants, involving both breasts in all cases. Treatment with tissue expansion began at an average age of 8.6 years, with one to three protocols per patient. A total of 24 expansion implants were placed, sometimes combined with other reconstructive surgeries. These were primarily placed in the supramammary region to position scars in the inframammary folds, and advancement flaps were used whenever possible to reduce scarred skin surface. Complications included prostheses protrusion without exposition, skin necrosis, and limited surgical revisions. All patients were able to complete their treatment without major therapeutic failure.</p><p><strong>Conclusion: </strong>Skin resurfacing of burned breast areas through tissue expansion before breast development offers many advantages. It allows either the natural growth of an undamaged gland or the gradual reconstruction of breast volume during puberty. This therapeutic strategy, when used under appropriate indications, helps to reduce the early aesthetic and psychological impact of breast burn sequelae in young girls.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671898","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}

{"title":"Dermatofibrosarcoma of the breast: A case report.","authors":"Z Taouji, D Adam","doi":"10.1016/j.anplas.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.02.004","url":null,"abstract":"<p><strong>Introduction: </strong>Dermatofibrosarcoma protuberans (DFSP) is a rare, low-grade fibroblastic mesenchymal tumor that develops in the dermal and hypodermal layers of the skin. DFSP arises typically on trunk and proximal limbs followed by the extremities. Intra-breast DFSP is even more uncommon, with only a handful of cases described in the literature.</p><p><strong>Presentation of case: </strong>We report the case of a 40-year-old woman who underwent her first breast screening. It revealed a 18mm mass in the lower outer quadrant of the right breast categorized as Breast-Imaging-Reporting and Data System (BIRAD) IV. A core-needle biopsy was performed and revealed a DFSP. We performed a monobloc cutaneous-glandular excision in the form of a T-shaped oncoplasty with a superior pedicle. Clear margins were obtained.</p><p><strong>Discussion: </strong>Intra-breast localizations are rare. Only a handful of cases have been reported in the literature, and only a few of these are truly intramammary, where the tumor arises in the subcutaneous tissue, complicating the clinical differential diagnosis with other benign breast tumors. Imaging may suggest a benign breast tumor, MRI may be helpful in the diagnosis. The overall recurrence rate is 7.3% and is directly related to the surgical margins achieved. Given the dermal origin of this tumor and its \"tentacular\" invasion, resection of the skin seems to be indicated and should be taken into account in the surgical procedure.</p><p><strong>Conclusion: </strong>This case illustrates that dermatofibrosarcoma is not always an obvious diagnosis, particularly in its intramammary forms. A wide skin resection must be performed to obtain clear margins.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671900","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}

{"title":"Assessing the ability of ChatGPT to generate French patient-facing information to improve patient understanding in hand surgery.","authors":"C Brenac, D Kawamoto-Duran, A Fazilat, J Tarter, M Witters, C Rahbi, C Macni, J B de Villeneuve Bargemon, C Jaloux, D C Wan","doi":"10.1016/j.anplas.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.02.005","url":null,"abstract":"<p><strong>Introduction: </strong>The advent of artificial intelligence technologies, such as ChatGPT and Gemini, presents new opportunities to enhance physician-patient communication through tailored patient-facing medical information (PFI). Effective postoperative care is critical to successful patient outcomes in hand surgery, making it essential to deliver information in a clear, comprehensible, and accurate manner. This study aims to evaluate the ability of ChatGPT to generate accessible PFI to enhance patient understanding in hand surgery.</p><p><strong>Methods: </strong>A cross-sectional study was conducted involving five French hand surgeons and 28 non-medical individuals. Participants blindly evaluated PFI containing text and images generated by ChatGPT and Gemini compared to those provided by established organizations (EOs). The evaluations focused on three common hand surgeries: carpal tunnel syndrome, Dupuytren's disease, and synovial cyst. Hand surgeons evaluated PFI based on accuracy, clarity, comprehensiveness, and overall preference. Non-medical participants evaluated PFI based on clarity and overall preference. Surveys were used to capture these evaluations, allowing for a systematic and effective comparison between both sources. Readability was analyzed using six readability formulas, and Likert scale responses were statistically analyzed using paired t-tests.</p><p><strong>Results: </strong>No significant difference was found in terms of accuracy between ChatGPT-generated text responses and EO-provided text responses. However, text responses provided by EOs were rated significantly higher in terms of comprehensiveness and clarity by hand surgeons. Interestingly, non-medical participants rated the clarity and overall preference of ChatGPT-generated text responses higher than those from EOs. EO-provided images were also significantly favored in terms of comprehensiveness and clarity by hand surgeons. Notably, 65% of non-medical participants preferred EO-provided images over AI-generated ones. Both sources, however, produced information that exceeded the recommended readability levels for patient comprehension.</p><p><strong>Conclusion: </strong>This study underscores the potential of AI-generated medical information to enhance patient understanding, particularly through the comprehensive nature of materials created by tools like ChatGPT. The divergence in preferences between hand surgeons and patients highlights the need to refine the accuracy, clarity, and relevance of AI-generated content to align with the standards upheld by healthcare professionals. Continued exploration in this area is crucial for optimizing patient education and communication, particularly in the context of postoperative care.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671899","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}

{"title":"Diffuse tenosynovial giant cell tumors of the hand and wrist, a case series and literature review.","authors":"Y Yahiaoui, C Lazerges, B Coulet, M Chammas, O Bozon","doi":"10.1016/j.anplas.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.02.002","url":null,"abstract":"<p><p>This study aimed to evaluate the management and outcomes of diffuse tenosynovial giant cell tumors (DTGCT) in the hand and wrist. We retrospectively reviewed five cases treated surgically between 2016 and 2020, with a minimum follow-up of two years. Preoperative MRI was used to assess tumor diffusion and involvement of adjacent structures, while diagnosis was confirmed through histological analysis of biopsy samples. Surgical treatment involved en bloc resection of the primary lesions. The study found a 37.5% recurrence rate, with recurrences occurring on average 6.7 months after initial surgery. Bone resection was needed in 60% of cases, either initially or due to recurrences. Active surveillance or repeat surgery managed recurrences. The findings highlight the importance of comprehensive preoperative imaging and aggressive surgical resection to minimize recurrence risk.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671901","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}

{"title":"Silicone particles in breast implant capsules: A retrospective single-center study evaluating silicone bleeding.","authors":"C Al Sammour, M Dziubek, M A Danino, S Ortiz","doi":"10.1016/j.anplas.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.02.006","url":null,"abstract":"<p><strong>Introduction: </strong>Breast implants consist of a silicone elastomer shell filled with either silicone gel or saline solution. As per the Food and Drug Administration (FDA), breast implants offer safety and efficacy but pose short and long-term risks, including capsular contractures, silicone leakage, and discoveries of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) and Breast Implant Illness (BII).</p><p><strong>Objective: </strong>This study aims to estimate the amount of silicone particles that leak from breast implants and deposit in the peri-prosthetic capsules of implants used in Belgium and investigate the various factors that may affect the magnitude of silicone leakage.</p><p><strong>Materials and methods: </strong>From a monocentric registry from the plastic and reconstructive surgery department of University Hospital Brugmann, thirty-nine capsules' slides were analyzed retrospectively using NDPView2 software. Silicone particles were counted and measured based on their largest diameter. The capsule surface area and its thickness were measured to calculate particle's density and total number of particles in each capsule.</p><p><strong>Results: </strong>Silicone particles were detected in 32 (82%) out of 39 capsules, with significant higher densities observed in silicone implants compared to saline implants (P=0.027). Overall average density was 66 particle/mm³. The density of silicone particles increased significantly with prolonged implantation duration (P<0.001). Particle's density tended to differ between different implants' textures and brands.</p><p><strong>Conclusion: </strong>Silicone particles were found in capsules of both saline and silicone implants. Silicone generates primarily from the silicone gel. Implants texture, brand, and duration of implantation are factors that influence silicone bleeding. Addressing silicone leakage is crucial for enhancing implant safety and patient well-being.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627066","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}

{"title":"Parcours universitaire en chirurgie plastique : challenges et opportunités","authors":"E. Lupon","doi":"10.1016/j.anplas.2025.02.001","DOIUrl":"10.1016/j.anplas.2025.02.001","url":null,"abstract":"","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"70 2","pages":"Pages 69-70"},"PeriodicalIF":0.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463493","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}

{"title":"[The submalar hiatus].","authors":"V Mitz","doi":"10.1016/j.anplas.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.12.004","url":null,"abstract":"<p><p>The submalar hiatus is a furrow located below the lower orbital arch; it is oblique downwards and outwards; it divides the cheek in two in some patients; it has been well individualized by artists since Antiquity, notably sculptors; some anatomists have called it the midjugal groove; its anatomical structure is very precise, however its origin is debated; some authors attribute to it the melting of the fat located between the external malar fat compartment and the fatty rim parallel to the nasolabial fold; other authors including myself rather invoke localized fat loss associated with a rotation of the nasolabial fat pad downwards and inwards. In fact, there is a center of rotation at the level of each nostril which has a fixed vascular hilum at depth. The submalar hiatus does not in itself constitute a marked ugliness but it can become a concern for certain patients, both women and men. The surgical correction of the submalar hiatus involves the repositioning of the fatty rim by a facelift, the technique of which can vary between a biplane skin+Smas facelift, with re-tensioning of the Smas upwards and outwards; another solution is the medio-facial lifting described by Le Louarn; finally, there is a non-operative solution thanks to aesthetic medicine using a specific injection technique that we describe.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470045","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}

{"title":"Abdominal wall complications: An unknown aspect of morbidity in phalloplasty. A comprehensive analysis and clinical implications.","authors":"K Allepot, N Morel-Journel, F Boucher","doi":"10.1016/j.anplas.2025.01.007","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.01.007","url":null,"abstract":"<p><strong>Background: </strong>Phalloplasty is a complex reconstructive procedure with complications broadly categorized as urinary, vascular, or donor-site related. This study investigates abdominal wall complications, such as bulging and lateral hernias, associated with the use of the inferior epigastric artery as the recipient vessel in microsurgical phalloplasty-a rare and underreported complication.</p><p><strong>Methods: </strong>A retrospective review was conducted on 37 patients who underwent microsurgical phalloplasty at a university hospital from January 2016 to February 2020. The most commonly employed technique was forearm flap phalloplasty, followed by the MSLD flap technique. The inferior epigastric artery was accessed via a 7cm oblique incision. Data collected included demographic details, BMI, smoking status, surgical technique, recipient vessel used, and postoperative complications. Follow-up evaluations were performed at 15 days, 3 months, 6 months, and 1 year postoperatively.</p><p><strong>Results: </strong>Of the 37 patients, the mean age was 33 years, with 84% undergoing phalloplasty for gender affirmation. Abdominal wall complications occurred in 11% of patients (n=4). Three patients developed parietal complications (hernia or bulging), all requiring surgical revision. All three were smokers, one had a BMI>28, and none had prior abdominal surgeries. Contributing factors included musculoaponeurotic disruption, relative denervation from vessel exposure, and smoking-related wound healing impairment.</p><p><strong>Conclusions: </strong>The use of the inferior epigastric artery in microsurgical phalloplasty may increase the risk of abdominal wall complications, particularly in smokers and patients with elevated BMI. Optimizing preoperative risk factors, including smoking cessation and careful vessel selection, is essential for reducing these complications. To reduce the occurrence of these complications, the choice of the recipient vessel should be considered alongside the surgical technique during operative planning. Further studies should explore technical refinements to minimize abdominal wall morbidity.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470046","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}

{"title":"Granulomatous mastitis a little known pathology in plastic surgery: Case report and literature review.","authors":"R Menéndez, L Sánchez, J López, C Morales, M Cálix","doi":"10.1016/j.anplas.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.01.002","url":null,"abstract":"<p><p>Granulomatous mastitis is an unknown disease for the plastic surgeon, it is frequent, benign and can be confused with an infectious process and its importance lies in the fact that it can occur after surgery. Its diagnosis is clinical, presenting an indurated region in the breast, which can progress to abscesses or crypts, as well as radiological and histological. We present the case of a 57-year-old patient who presented with a lesion 1 month after a reduction mammoplasty. Conservative treatment was carried out with the possibility of fat necrosis and due to persistence, granulomatous mastitis was confirmed by biopsy after 6 months of evolution. This article establishes a diagnostic and treatment protocol based on the latest recommendations in the literature, oriented towards plastic surgery, starting with oral steroids in long courses, and immunomodulators may be used for resistant cases, including excisional surgical management. In the case of abscesses or crypts, treatment of the concomitant infection should be given.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470047","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}

{"title":"[Combined folded paramedian forehead flap in extensive nasal tissue losses: A technical note].","authors":"K Al Tabaa, F M Leclere, C Halimi","doi":"10.1016/j.anplas.2025.01.005","DOIUrl":"https://doi.org/10.1016/j.anplas.2025.01.005","url":null,"abstract":"<p><strong>Introduction: </strong>Tissue defects (TD) at the nasal tip, dorsum, and alar regions can result from surgical excisions of cancerous skin lesions, congenital malformations, immunological diseases, trauma, or vascular anomalies. The ideal reconstruction should aim to restore the aesthetic subunits of the nose while minimizing donor site morbidity. Among the available techniques, the plicated paramedian frontal flaps (PPFF), combined with internal mucosal flaps, have proven particularly effective for extensive nasal pyramid tissue defects. This article presents our experience with a three-stage reconstruction technique using the PPFF combined with a mucosal flap for major tissue losses affecting the nasal tip and alar regions.</p><p><strong>Materials and methods: </strong>This monocentric retrospective study reviewed 52 cases of nasal reconstructions performed between January 2019 and January 2024, of which 37 were treated with PPFF alone and 6 with combined mucosal flaps. All patients provided informed consent, and the study was approved by the ethics committee. The parameters analyzed included the types of tissue defects, the type of reconstruction, and aesthetic outcomes. A satisfaction survey was conducted six months postoperatively.</p><p><strong>Results: </strong>Among the six cases of reconstruction using the combined PPFF and mucosal flap, no cases of necrosis were observed. The average size of the tissue defects was 4cm, with a functional satisfaction rate of 92% and an aesthetic satisfaction rate of 96%. Partial necrosis of the skin graft was noted in 16.5% of cases, but it did not affect the overall result. Donor site scars were well accepted by patients.</p><p><strong>Conclusion: </strong>The three-stage PPFF reconstruction technique is recommended for complex nasal tissue defects, offering excellent aesthetic and functional outcomes with low donor site morbidity. It simplifies the process by reducing the need for additional mucosal flaps, thus limiting complications and associated complexities.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470044","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}