Search

Copyright of EMC-Chirurgie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: As, quest for beauty has always been an aim. There is a need to define the “ideal” beautifull breast with objective caracteristics, usable in plastic, reconstructive and aesthetic surgery. After, we have defined the necessary parameters usable in breast surgery. We realized an anthropomorphic study including 70 volunteer women and one molded model. Multiple pictures have been taken for each volunteer, that were evaluated and noted by five plastic surgeon, five doctors from other speciality, five women, five men. A twenty notation was used for this study. The main values for the ten women that obtained best notation (>or=14/20) were used in order to defined the ideal measures for surgery. Breast arrow and breast arrow over the trunck height were the most significant factors. According statistical studies, this fraction is about 0,387 (P =0,000969). The nice breast has a round shape and look like juvenile breast. Bra size, cup size, base, segments II and III, fraction II/III are not significant in our series of (non operated) natural breast. The ideal breast is in harmony and proportional to the trunck height, with the main fraction of breast arrow on the trunck height about 0,387 in our serie. [Copyright &y& Elsevier]

Summary: Study purpose: The funnel chest or pectus excavatum (PE) is the most common congenital deformity. In women, it can be associated in some cases with breast asymmetry. It is the main cause of consultation in these patients. We report our management of this malformation by thoracic silicone prothesis modeled by computer-aided design. Materials and methods: Two correction procedures are proposed: One-stage procedure including thoracic silicone prothesis or breast implants only, or two-stage procedure by the combination of the two techniques in two steps. Results: Between 1998 and 2011, 31 patients had a PE, within 26 patients were treated for breast asymmetry associated with a PE. The average age was 23.1 years (15–39). The median follow-up was 65 months (24–86). Type I Chin was found in five cases (19%), type II in two cases (7.7%) and type III Chin was found in 19 cases (73%). Of these 26 patients, in both cases a breast augmentation with asymmetric volumes of implants (7.7%) has adequately corrected the problem. Thoracic endoprothesis was performed in 24 patients to treat the initial breast asymmetry. Twenty-one patients (87.5%) were satisfied with the final symmetry and have not required a breast augmentation. Three patients (12.5%) underwent a second surgical procedure to correct the initial breast asymmetry. Conclusions: Breasts asymmetries associated with PE can be adequately corrected using an isolated thoracic endoprothesis. Whether it remains a lack of results, perform an unilaterally or bilaterally breast augmentation in a second time is always possible. [Copyright &y& Elsevier]

Abstract: Breast augmentation offers a high rate of satisfaction but the local complications remain frequent. These are mainly capsular contracture, malpositions of implant, acute or infraclinical infections. The causes of these complications are multifactorials. The goal of this chapter is to determine the effect of the surgical technique on the result. We think that if no routine procedure can be proposed, a reflexion on the objectives of the breast augmentation and the adaptation of the surgical technique is necessary for each surgeon. We identify twelve aims and discuss them: rigorous preoperative planning, determination of the position of the implant, creation of an adapted implant pocket, as much atraumatic as possible dissection, no bacterial contamination, no foreign particles, respect of the implant, drainage or not, efficient suture, pain and discomfort control, need for contension and clear postoperative advices. These objectives being precised, we integrate them in a chronological surgical process under the form of questions. Each surgeon can then choose his answers by evaluating the arguments, which led to his choices. [Copyright &y& Elsevier]