[Patient-reported outcome of their breast reconstruction after mastectomy]. / Évaluation de la satisfaction des patientes de leur reconstruction mammaire après mammectomie.

BACKGROUND: The overall care of patients with breast cancer is a major public health issue. Breast reconstruction is a part of it, and could be modulated by factors related to their personal life or surgical management. The aim of our study was to investigate a statistical link between these factors of variability, and overall satisfaction after breast reconstruction. PATIENTS AND METHODS: We evaluated in a retrospective study patients' satisfaction in Plastic, Reconstructive and Aesthetic Surgery Department of the University Hospital, Poitiers, after breast reconstruction using different sources of variability: elements of life at the moment of reconstruction decision, reconstruction management and the feeling of involvement in decisions related to reconstruction. Satisfaction was quantified by modified BREAST-Q pre- and postoperative questionnaires ("reconstruction" module) complemented by an open question to address patients experience. RESULTS: From January 2005 to May 2011, 148 patients underwent surgery, 60.1% accepted to complete the survey (89 patients). Postoperative overall satisfaction was 89.1 out of 100. Satisfaction gradually decreased (P=0.022), postoperative overall satisfaction was non-significantly higher with autologous reconstruction, regardless of the variability factor studied. Secondary reconstruction with autologous reconstruction enhanced physical well-being (P<0.001). Patients expressed a high request for information about the different kinds of reconstruction, postoperative, as well as support groups. CONCLUSION: This study shows that patients are generally very satisfied, but do not explain the causes of dissatisfaction. It paves the way for development of satisfaction with breast reconstruction databases.

[Post-traumatic reconstruction of the lower lip after total or subtotal amputation using the Webster's modification of the Bernard cheiloplasty -- advantages, disadvantages and limitations: three cases]. / Reconstruction post-traumatique de la lèvre inférieure après amputation totale ou subtotale selon la technique de Camille-Bernard modifiée Webster - avantages, inconvénients, limites : à propos de trois cas.

Webster's modification of the Bernard cheiloplasty is a well-known technique, usually applied to the reconstruction of total or subtotal amputations of the lower lip following oncological resection. We present three cases of post-traumatic reconstructions with interesting results.

[Eyelid, medial canthus and medial orbital wall reconstruction using a combination of Hübner and conchal grafts with two illustrative cases]. / Reconstruction par greffons de Hübner et conque après exérèse étendue palpébro-cantho-orbitaire médiale - Présentation de deux cas.

Post-ablative medial canthus and medial orbital wall reconstruction may involve various materials. Few articles present such reconstructions using cartilage homografts, and very few opt for conchal cartilage. In some cases of medial orbital wall excision, at least half of the eyelid must also be removed. We present two cases where we decided to use conchal cartilage to reconstruct the medial orbital wall and tarsomarginal Hübner grafts to reconstruct the eyelid. This combination offers several advantages: a very limited resorption, only one operative field and a reduced infection risk.