[Areolar approach to augmentation mammaplasty]

Treatment of breast hypoplasya or hypomastia requires a breast augmentation surgery using implants. The request for surgery remains always a voluntary step of each patient. Beyond the aesthetic improvement that this intervention offers, the psychological repercussion is generally beneficial. However, these implants have side effects and insufficiencies compared to the natural breast. These facts must be perfectly explained to the women who want the breast implants. Let us quote in particular the risk of hematoma or periprosthetic hull which counts among the most serious complications of this type of intervention and which requires an immediate surgical recovery. The aerolar approach to augmentation mammaplasty by implants is an interesting technique in breast augmentation. We report the case of a 36 years old patient who present a breast hypomastia and who profited from this technique

Surgical treatment of gynecomastia

Gynecomastia is an hyperplasia of the male breast glandular tissue. It is the most common breast's problem in men that causes an important embarrassement and distress. Patients are asking for rapid results, surgical treatment is the best solution. Patients and methods: We have treated 16 patients in the departement of plastic and hand surgery at Avicenne hospital, aged between 16 to 70 years between 1995 and 2002. Surgical technique based on mastectomy through an inferior periareolar incision described by Dufourmentel and Webster, preceded by liposuction which facilitates the excision and ameliorate the aesthetic results. We did no notice any immediate or late post-operative complications for a period of 4 years, and all our patients were satisfied by the aesthetic results, and lead a normal social life. This treatment has a double effect: knowing the diagnostical aetiology and obtaining rapid aesthetic results, for our patients who previously were embarrassed by their pathology

Treatment of sacred scabs in cardiac patient

The sacral scab constitutesa very serious decubitus complication in the enduringly bedridden patients; It is much more serious when it occurs on a deleterious vascular land in which the cutaneous vascularisation is precarious and hostile to skinning. The musculo - cutaneous rotation flap of gluteus maximus muscle constitutes a very good flap in the treatment of the sacral scab constituted on these lands because of its vascular reliability, its well codified dissection and of the very good quality of cover that it procures. The musculo - cutaneous flap of big buttock brings by its good musculo-cutaneous vascularisation dependent on the two gluteal arteries of these patients, a filling and a cover of the scab consecrated of very good plastic quality. From October 95 to June 2002, we counted among the twenty cases of scabsmedicated sacral, 2 cases of sacral scabs occurring respectively in diabetic and arterial deleterious vascular land in 2 aged patients aged 65 and 67 years, valids and operated in cardiovascular surgery for coronary pathology. They underwent a quadriple and a triple coronary bypass, followed by a prolonged stay in resuscitation. These two patients benefited of a paring first of soft-tissue and the room of detachment and a resection of the bony prominence; The cover has been achieved by a musculo - cutaneous rotation flap of the superior half of the maximusgluteus muscle with preservation of its innervation. No complication is to deplore regarding the viability of the flap, neither recidivism of scab after 6 years of evolution. The two patients don't present any problem of marching or stability of their hip