[Objective evaluation of the results of interventions for breast hypertrophy]. / Evaluation objective des résultats des interventions pour hypertrophie mammaire.

It would appear to be impossible to compare completely different techniques of mammaplasty performed in very different clinical situations. However, we thought it would be useful to approach the result of mammaplasties from a more "orthopaedic" point of view. Such an approach distinguishes populations of patients with different results and in whom the postoperative assessment must take into account the result obtained, the residual scars and the final breast shape. A formula has been developed after multiple attempts: [formula: see text] This formula expresses positive factors: the quantity of glandular tissue removed (in grams), the final appearance of the scars, the appearance of the overall shape of the two reconstructed breasts and the reappearance of ptosis measured from the edges of the breast below the inframammary sulcus (in the erect position). In this way, it is possible to express these positive factors by the multiplying the scores attributed to each of the factors. For example, a resection of 150 g will be scored as 1.5 and a resection of 1,200 g will be scored as 12, i.e. the weight in grams is simply divided by 100 to give the score for weight. The scar will be scored according to an individual scale of 1 to 5. The shape will also be scored according to an individual scale of 1 to 5. The division factors include the length of the inframammary scar (segment 3); this inframammary vertical line will be included directly in the calculation. In contrast, the length of the horizontal inframammary scar will be divided by 10.(ABSTRACT TRUNCATED AT 250 WORDS)

[Selective galactophorectomy: technic and indications]. / La galactophorectomie sélective: technique et indications.

The authors describe the way of operating the selective galactophorectomy and discuss the indications. Each pathological nipple discharge may reveal a carcinoma. The clinical characteristics of the discharge, the results of the cytology, of the mammography and the galactography help to come to a diagnosis. This can only be confirmed after a thorough histological examination of the involved duct. Selective galactophorectomy is a simple operation that hardly leaves any scars. According to the authors, this method has a real advantage to find the diagnosis and to treat pathological nipple discharge.

[Myocutaneous flaps of the pectoralis major. Anatomy, technic and clinical applications]. / Le lambeau musculo-cutané du grand pectoral. Anatomie, technique et applications cliniques.

The authors emphasize the versatility of the pectoralis major myo-cutaneous flap in head and neck reconstruction. They describe the vascular anatomy of the flap after dissection and catheterization of the deep pectoral branch of the acromio-thoracic artery in twenty cadavers. They emphasize the consistency and the size of this artery and describe a rich and regular network of perforating myo-cutaneous arteries. These allow a high versatility in the size of the cutaneous area. The use of this flap to cover carcinologic or post-radiotherapic defect is indicated because it brings a richly vascularized muscular tissue. The arc rotation of the flap is very large and permits reconstructions in axillary, thoracic and facial area. A "S" superior incision save the possibility of using a homolateral delto-pectoralis cutaneous flap. The authors present five typical clinical applications of this flap.

[The thoracodorsal skin flap. Anatomy and clinical applications (author's transl)]. / Le lambeau thoraco-dorsal. Anatomie et applications cliniques.

The authors remind of the interest of the thoracodorsal flap among the free flaps and of the armpit as donor site. Two vast reliable and trustworthy skin flaps, with varying thickness, can fairly easily be taken at this level: - the first one, based on the cutaneous branch of the thoracodorsal artery, is a flat skin flap essentially cutaneous, specially convenient for the face because of its tissue colour, the thinness of the skin and its having no hair; - the second one, centered on the thoracodorsal muscle ending or artery of the latissimus dorsi muscle, allows to cut off a musculocutaneous flap that can take away, if necessary, the quasi-totality of the latissimus dorsi muscle. They describe the anatomical observations on twenty armpits dissected on cadavers and underline length, size and constancy of these vascular pedicles. They present three clinical applications which are representative of the most favorable indications of the thoracodorsal flap.