[Patient counseling in case of postoperative complication leading to emergency reintervention in plastic surgery. What is the current situation? How to improve? Retrospective study of counseling modalities and traceability in a series of 16 patients who needed emergency reintervention within a cohort of 402 patients]. / Information du patient dans le cadre d'une complication postopératoire nécessitant une reprise chirurgicale en urgence en chirurgie plastique. Quel est l'état des lieux? Comment améliorer notre pratique? Étude rétrospective des modalités et de la traçabilité de l'information sur une série de 16 patients réopérés en urgence issus d'une cohorte de 402 patients.

AIM: Preoperative counseling is structured and well defined. Nevertheless, in the event of a complication leading to a new emergency surgical procedure, counseling is not well defined. We conducted a retrospective study of information delivered in this situation at our institution. PATIENTS AND METHODS: We included all the patients who underwent emergency reintervention because of hematoma or operative site infection between November 2013 and October 2014. Sixteen patients were included over the 402 patients operated during this period. RESULTS: Information before initial surgery: all patients had at least two preoperative consultations, and all preoperative informed consents were obtained. Complications leading to reintervention were mentioned in the consultation record in 31% of cases, and in a letter to another practitioner in 19% of cases. SofCPRE information card was delivered in 63% of cases. Information before reintervention: reintervention indication was mentioned in the hospitalization report in 81% of cases, and in the operative report in 88% of cases. Blood count results were mentioned in 55% of cases when it had been done. Patients were orally informed of reintervention in 100% of cases, and this new information was mentioned in 50% of cases. A new informed consent was signed in 31% of cases and postoperative letter was written in 25% of cases. CONCLUSION: Information delivery traceability is mandatory. In case of complication leading to emergency reintervention, traceability should be done in the same way as prior to initial surgery.

[French lawsuits after breast implantation]. / Mises en cause sur prothèses mammaires, le point de vue du défendeur. Etude de sinistralité sur six ans (1999-2004).

Standpoint of surgeon about the french legislation on breast implant surgery in 2005. All possible proceedings in France are listed: Ordinal court (Deontology and professional risks), Civil court (Sharing of the costs and after-effects), Penal court (Personal punishement) and recently National Office on therapeutic hazards. Sinistrality observed in one insurance practice, in France, is described (1999-2004). Preparation of surgeon's defence is described, particulary for the expertal debate, indispensable preliminar before lawsuit in France.

[The therapeutic function of the aesthetic surgery]. / La fonction thérapeutique de la chirurgie esthétique.

By its definition and its etymology, aesthetic surgery is as much a surgery for the soul as for the body. Aesthetic surgery is a true "armed" therapy that essentially targets the psychology of the patient. This therapeutic "arsenal" preserves and/or restores the health of the patient according to its different aspects as defined by the World Health Organization. The plastic surgeon is always concerned about his patient as a whole, and as a human being, of whom he takes charge. Indeed there lies his specificity: He is as well a surgeon and a physician. We identify and analyze, in this chapter, the particular quality of patient-surgeon relationship on a surgical, psychological and juridical level. It is interesting to note that this collaboration results from a spontaneous convergence. The surgeon, the main interested figure, asserts himself mainly as a physician that is totally involved in a dialogue with his patient. He multiplies the interviews and he sharpens his clinical approach, and his own reactions, with regard to the demand for plastic surgery. The psychiatrist establishes the theoretical and practical aspects of the patient demand. The jurist, far from the barren dissertation of the law, reconsiders the environment of the demand and legitimates the generating wish: he insists on the necessary information but also on assuming responsibility. The therapeutic function of the plastic surgery appears essentially related to the success of a psychic repair solicited by the patient but that is scarcely specified by him as such, and of which he is, most probably, rarely fully aware. The process is to listen and to gather the information that guarantees mutual understanding. Plastic surgery is considered irreplaceable by many of our patients, and indisputable by us. It brings incomparable social and human fertility. It is, however, an ambitious and difficult project that is highly demanding. It is far from the impression of facility reflected by the media. Every actor of this scene, where the patient takes the center stage, must be aware of it.