BREAST RECONSTRUCTION AFTER ONCOLOGIC TREATMENT
The unit at the American Hospital of Paris proposes all the techniques for breast reconstruction, regarding the quality of the skin and the extent of the defect.
If the remaining skin is large and soft enough, the combination of an implant and/or fat filling can be the easier alternative.
If the skin has no more elasticity and is too tight, the only way to rebuild a breast is with a flap. It can be a pediculated musculo-cutaneous flap (dorsalis flap) or just a cutaneous flap based on the same vessels if there remains an extra fold in the axillary region (TDAP). The scar will be in the lateral and dorsal region under the bra. Those flaps do sometimes require the insertion of a prothesis to have enough volume.
Reconstructions without foreign bodies require microsurgical techniques: the use of the skin and fat below the umbilicus combined with abdominoplasty and breast reconstruction. This is a very elegant technique but needs experienced hands. We can also use a skin paddle from the interior or posterior part of the thigh (TUG or PAP).
All these flaps can be combined with a free lymph node transplantation to replace the nodes in the axillary region and treat lymphedema.
Secondary corrections are performed to achieve symmetry of both breasts: reduction, mastoplasty of the other breast, fillings, and reconstruction of the areola.
The areola can be rebuilt through 3D tattooing or with skin from the upper lid (blepharoplasty) or with some skin from the contralateral areola in case of reduction and mastoplasty of the normal breast.
The performance of all these interventions: intensive care unit, microscope, laser, monitoring of flaps by tissue oximeters, state-of-the-art equipment for performing lipofilling, etc. This complete offer allows patients to undergo the reconstruction method best suited for their case.
SURGERY OF BREAST MALFORMATIONS
To treat breast malformations, the combination of breast mastopexy and breast reduction procedures will be performed. In order to increase breast volume, it is preferable to use fat obtained from liposuction of fatty areas.
BREAST REDUCTION AND MASTOPEXY
These interventions are carried out by attempting to reduce the scars as much as possible, which are, however, unavoidable. They can be combined with fillings or even mini implants to increase the projection of the breasts in case of gland loss, especially after pregnancy. Correction of hypertrophy, ptosis, 1, 2, or 3 scar method are treatments that can be associated with implant placement or fat injections. Each indication is made on a case-by-case basis.
CAPSULECTOMY AND PROTHESIS REMOVAL WITH FAT REPLACEMENT
Over time, some patients develop an intolerance to prostheses, resulting in hard shells. In some cases, they may even become immune to these prostheses, which is known as ASIA syndrome. Consequently, it becomes necessary to completely remove both the prostheses and the shells. Fortunately, we can restore the shape of the breasts using lipofilling.
LIPOSUCTION
In cases of localized fat overload, it is possible to make corrections thanks to liposuction. Modern liposuction uses specific equipment that increases precision and efficiency in order to improve the result. The American Hospital of Paris is equipped with the "gold standard" in the field, the MicroAire system, which provides mechanical assistance for aspiration and which offers a wide selection of cannulas, adapted to each area and each type of skin.
What technical improvements make it possible to practice micro lipofilling? Thinner fat injection cannulas.
The micro lipofilling cannulas are as fine as the fine needles conventionally used in aesthetic medicine. In addition, these cannulas have several advantages:
The blunt end allows non-traumatic introduction, reducing any risk of hematoma.
The cannulas are made of high quality, thin-walled stainless steel and have a surface smooth for an easy and non-traumatic introduction.
The base of the cannula has an ergonomic shape to facilitate handling during insertion.
The side hole at the end of the cannula ensures an injection product management.
In order to be able to inject fine particles of fat, the fat must first be removed in the form of fine particles. For this, very thin sampling cannulas have been developed by the laboratories, the diameter of the fat sampling cannula corresponding to the diameter of the reinjection cannula. This avoids traumatizing the fat.
MINI FACELIFT
The mini facelift is a surgery to reduce wrinkles on the face and neck. It can be done with minimal scars in the hairline in the temporal region. This surgery is less extensive compared to a full facelift. The duration of the effects is, of course, shorter, but the results are highly visible without altering one's facial expression. This surgery can also be combined with local fillers and Botox injections, resulting in a truly rejuvenated appearance. Eyelid correction can also be combined with the mini facelift.
However, a complete facelift is sometimes necessary when the skin on the lower part of the face is excessively relaxed. This surgery is more extensive, with scars located in the temporal area, around the ears, behind the ears, and in the neck.
BLEPHAROPLASTY
Blepharoplasty is the procedure that rejuvenates the eyelids. This intervention can concern the upper or lower eyelids or the 4 eyelids at the same time. Recent techniques combine the resection of excess skin with the treatment of volumes by ablation of fatty hernias and filling by injections of fat taken from the patient, which improve the result. If only the upper eyelids are done, local anesthesia is possible.
NOSE SURGERY
Noses may not match the type of the face, being too wide, too strong, too long, or distorted. Cartilage reconstructions via the internet can compensate for these defects. The important thing is to keep the personality of the face, and not that the nose is "operated".
FACIAL BALANCING AND LIPOSUCTION
The chin may be too fat, the ncsogenian folds too pronounced, some unsightly wrinkles: in this case a remodeling of the face by liposculpture with very fine cannulas and/or injection of fine fat into the wrinkles can be performed, allowing rejuvenation and better balance. These techniques can often be done under local anesthesia.