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Basocellular carcinomas are characterized by their non-deep spread neoplastic nature. Although treatment typically proceeds without complication, excision in critical facial regions can lead to aesthetically undesirable defects. Furthermore, elderly patients often express aesthetic concerns, particularly regarding the thinning of the upper lip over time. This article presents the case of a 75-year-old patient with a basocellular carcinoma located on the tip of the nose, amidst a history of multiple neoplastic conditions. To address the defect, an inferiorly-based philtral advancement flap was employed, accompanied by a lip lift procedure, resulting in favorable aesthetic and functional outcomes., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Background: Pseudoxanthoma elasticum (PXE) is a hereditary disorder of connective tissue characterized by progressive calcification and fragmentation of elastic fibers, which primarily affects the skin, retinal and arterial walls. Skin damage takes the form of yellow papules that can merge to create a cutaneous fold. This is accompanied by an excess of skin on the different sides of the neck and in the largest folds. These changes to the skin have a significant aesthetic, functional and psychological impact, especially among women., Patients and Methods: We evaluated the treatment options in all patients with PXE of our University-Hospital. This group contains people who have been hospitalized for the assessment of their disease and applicants for surgical correction. The goal of the surgery was not the total removal of the lesions but instead a decrease in their size and a tightening of the skin., Results: In total, 250 patients were seen between 2007 and 2022. Surgical treatment was advised for 29 women and 1 man. The main interventions were based on standard techniques such as cervico-facial facelifts, brachioplasties and cruroplasties. The results obtained during postoperative follow-up consultations were rated satisfactory to very good, both aesthetically and functionally. There were no postoperative complications recorded: neither bruising nor scarring issues. Patients with PXE heal as normal., Conclusion: Surgical treatment for excess skin observed during PXE is poorly described. Yet, these excesses can be removed when they become troublesome by making use of and adapting the traditional methods of plastic surgery for tightening of the skin., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

The acts of plastic surgery consist in providing care to patients and pursue a therapeutic purpose. They benefit from VAT exemption in accordance with European legislation. They appear in the Common Classification of Medical Acts as therapeutic acts, whether or not they are covered by health insurance. To assist the plastic surgeon during the consultation in his role as a medico-surgical expert, we propose a global assessment scale for physical disgraces. This scale specifies the importance of disharmony, its etiology, and considers the patient in his entirety, both biologically and psychosocially. All repercussions are analyzed: physiopathological impact, pain, functional impact on daily life activities, pleasure and sexual activities, psychological, social, and professional impact. Each item is independently rated. Depending on the overall score obtained, the therapeutic nature of the act can be confirmed. The proposed scale is a simple tool that easily and seriously supports the therapeutic nature of our acts. It ensures argued expertise, a reliable and indisputable synthesis. We are, above all, doctors, caregivers, contributing to health as defined by the WHO: "a state of complete physical, mental, and social well-being." We alone are able to judge the therapeutic nature of a service, in agreement with our patients., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Background: In this study we have based our research on botulinium toxin injection via targeted neuromuscular end plate zones, specifically in muscles with diffuse distribution of the latter. The muscular surface anatomical variety was also taken into consideration with thorough pre-injection examination of every subject., Method: With consideration of the facial muscles anatomical variation and neuromuscular bundle distribution, we have applied the method of retrograde botulinium toxin injection on a series of 10 patients on the right side of the face with the left side as a control side, it was injected in a regular perpendicular manner in order to conclude the efficacy of targeted motor end zone injection. Using an auto-injecting syringe, we have delivered 6 Allergan units per zone (frontalis, glabellar lines of corrugator supercilii and orbicularis oculi crow's feet)., Results: On control day 8 we have noticed a more prominent effect mainly on the level of the orbicularis oculi muscle and the corrugator supercilii muscle on 9 out of 10 patients. Nine patients out of 10 needed the delivery of an additional 6 Allergan units per zone on the control side's glabellar lines and crow's feet rhytids. Where 1 out of 10 patients needed the reinjection of the control side on the glabellar lines zone., Conclusion: The musculature of the face varies when it comes to neuromuscular plate distribution. Muscles with scattered distribution patterns show an optimal response to botulinum toxin injections when delivered in a retrograde manner. This has allowed us to achieve of optimal results while minimizing injection sites and hence pain, the use of lower dosage and hence treatment cost, as well as lowering the unwanted product dissemination to the neighboring mimic muscles., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Background: In recent years, the progress of anatomical knowledge and microsurgical techniques, in particular the development of perforator flaps, has risen the number of flaps available for lower leg reconstruction. The esthetic consequences of flap choice and harvest do have an impact on patients' quality of life. Nowadays, more researchers evaluate the esthetic changes following lower limb reconstruction., Objectives: This review aims to summarize the available evidence on the esthetic outcome of lower limb reconstruction., Data Sources: A systematic review was planned to identify the most relevant indexed articles on this subject. The search was performed on Pubmed database without date of publication limits., Study Eligibility Criteria: All papers about reporting information about the esthetic outcome of lower limb reconstruction were selected. Case reports and the articles not including specific information about complications, secondary procedures, and outcomes were excluded. The articles were categorized according to their topic and date of publication. The full texts of all the articles were obtained and read thoroughly. The references for each article were screened to identify articles that were eventually left outside our database search., Participants, and Interventions: One hundred and eight articles were retained for the definitive review. Eleven review articles were kept because they represented a good source of information. Thirty-three articles were added after reading the full texts. The articles appear highly heterogeneous and at, this stage, only a critical and qualitative analysis could be performed., Results: We found information about 7895 lower reconstructions, 1295 local flaps, 6546 free flaps., Limitations: The esthetic evaluation is intrinsic subjective. Many psychological and cultural factors influence both the patient and the surgeon. There is not a validated assessment tool for the esthetic outcome of lower leg reconstruction. Therefore, no quantitative analysis was performed., Conclusions: Some ancient techniques are today obsolete, like the rectus abdominis free muscle flaps and perhaps free forearm flap, others are always useful, like gracilis and latissimus dorsi free flap. ALT flap is the most versatile perforator flap today available, but the SCIP flap is gaining the favor of a growing number of surgeons. Local flaps will be always performed with success but their indications should not be pushed beyond the medium-size defects. The best cosmetic outcome for each patient cannot necessarily be obtained neither with the easiest techniques nor with the most technically demanding ones. It is necessary to develop validated tools to assess the cosmetic outcome of lower limb reconstruction., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Secondary genioplasty can be a real challenge for the practitioner. We will review the different types of genioplasty, the difficulties encountered and the possibilities of repair using concrete examples., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Complications of breast implants are rare in regard to the morphological and psychological benefits induced by this intervention. The main complications are; hematoma, infection, seroma with the absolute necessity to look for anaplastic large cell lymphoma associated with breast implants and capsular contracture. Apart from complications, the plastic surgeon may be faced with a bad result, from his surgery or after an intervention realised by a colleague. It is most often a malposition of the implant, primary or secondary ptosis of the breast. The rupture of the implant membrane is inevitable in the more or less long term and raises the problem of supervision and implants changes that will be expected in a very variable time. The author recalls the elements of diagnosis of complications or defects of aesthetic result and the conduct to take to avoid or treat them., (Copyright © 2019. Published by Elsevier Masson SAS.)

Introduction: The aim of this study is to analyze the patients' satisfaction after aesthetic abdominal etching or associated with an abdominoplasty., Material Et Methods: All records of patients who underwent abdominal etching between 2016 and 2017 were analyzed. Eligible patients were contacted, by telephone and submitted to a questionnaire of satisfaction. The patients were then divided into 3 groups according to the operative indication: aesthetic abdominal etching, abdominal etching for breast lipofilling and abdominal etching associated with an abdominoplasty., Results: Twenty-two out of 30 patients agreed to answer the questionnaire: 6 in the aesthetic abdominal etching group, 9 in the breast lipofilling group and 7 in the abdominoplasty group. For 41% of patients, the result was entirely in line with their expectations. It was fairly consistent in 50% of cases and non-compliant in 9% of cases. 50% of the patients were completely satisfied with the stability of the result over time and 45% were quite satisfied, an average satisfaction of 95%. Fourteen percent of patients rated their result as excellent, 41% as very good, 32% as good and 14% as average. No patient rated his result as mediocre. For 96% of patients, the choice of intervention was a good or very good decision and 77% would do it again without hesitation., Conclusion: Abdominal etching provides a high overall patients' satisfaction. It has a positive impact on the patient's life, with a low risk of complications., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Introduction: Botulinum toxin injections in aesthetic medicine are the most widely used products, ahead of hyaluronic acid, and aesthetic medicine is constantly increasing, including in the male population. The objective of this development was to show the specificities described in the literature concerning botulinum toxin injections in men., Material and Method: A systematic literature search was carried out using the Pubmed search engine. Data were then collected to determine the specificities of botulinum toxin injections in men according to the morphology of the male face and the wishes of these patients., Results: The studies conducted show that it is necessary to inject higher doses in men than in women to obtain a satisfactory result, due to a higher muscle mass. This adjustment gives the number of points to be performed per injection site, as well as the number of points to be performed, compared to the female population., Conclusion: Botulinum toxin injections for aesthetic purposes in men are different from those in women. Taking these particularities into account is essential to patient satisfaction., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Background: Surgical approaches in neck dissection: comparing functional, oncologic and aesthetic aspects of transverse cervicotomy to Paul André's approach., Methods: This single-center retrospective study compares a new transverse incision for cervicotomy to the classical approach described by Paul André in neck dissections. The evaluation criteria were: number of lymph nodes analyzed, operative time, complications, patient satisfaction and aesthetic aspects of the scar., Results: A total of 34 patients were included in this study, from September 2009 until January 2015. The number of lymph nodes analyzed is not affected by this new approach compared to the classical one (P=0.9). The scar has a significantly more discreet appearance in the transverse cervicotomy group (P=0.023) likewise; patient satisfaction is higher in this group (P=0.006)., Conclusions: Aesthetic and functional impairment can be reduced using this new transverse cervical approach hidden in the natural creases of the neck described by Langer., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Nasal lesions, which are often carcinomas, require a histological control of the excision sometimes forcing to postpone the reconstruction source of nasal mutilation disfiguring. Reconstructive procedures have made steady progress and the notion of reconstruction in three planes advocated by Tiersch has been improved in a major way by Millard, Burget and Menick, who added an essential aesthetic dimension. We present our experience in this field by selecting procedures that seem most appropriate and describing the key points of the operating process, which remain the guarantee of both therapeutic and aesthetic success., (Copyright © 2013. Published by Elsevier SAS.)

Lip reconstruction can be performed with numerous surgical techniques. The aim was here to present these usual techniques and to focus on the details that can be used to obtain the most favourable results. The goal of this surgery, that represents a compromise between function and aesthetic, has to be kept in mind to prevent mistakes that decrease the quality of the result., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

The purpose of this article is to address the techniques of reconstruction of the forehead and the temple trying to add an "aesthetic" dimension, as the fourth dimension introduced by Burget for the reconstructive surgery of the nose. Achieve "aesthetic" reconstruction is to have constant attention to details. This is how to choose the right indication depending on the age and the etiology of the defect. This is to place incisions to perfection. And it is to be humble and open oneself to criticism, always seeking to improve the quality of its results., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

In eyelid reconstruction, filling the defect is not sufficient. In young patients, the aim is to obtain a reconstructed eyelid, as normal as possible. In elderly patients, the large amount of available skin and the good quality of scars seem to be favorable. But weakening and stretching of the connective tissue and eyelid structures and deficient production of tears may compromise the functional result. In every case, restoring aspect and function are going together. The purpose of this chapter is to show how different techniques may be used in eyelid reconstruction with good cosmetic result. Different cases are carefully described and illustrated., (Copyright © 2013. Published by Elsevier SAS.)

There are many possibilities for nasal skin defect reconstruction. The purpose of this article is to highlight the important points to respect in order to achieve aesthetic results. The principles that must be observed in nasal reconstruction are recalled. The most interesting techniques are detailed and illustrated with clinical cases., (Copyright © 2013. Published by Elsevier SAS.)