[Side effects of cortisone in prostheses used for breast reconstruction].
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Biomedical subjects
Publications and source records attributed to M Lejour.
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No significant differences are found among the different groups. Some of the observed minor differences between the cleft and the control groups may be the result of sampling error. Our findings are not surprising because our cleft patients have no other congenital anomalies. Indeed aberrant dermatoglyphic patterns are found mainly in generalized dysmorphogenesis, such as in chromosomal syndromes, rather than in isolated congenital malformations, exception being made of course for congenital malformations of the hand itself.
An island skin flap sliding on its own subcutaneous tissue is described to replace large cheek wound defects after tumor resection in elderly patients. The simplicity of the method and the uniformly good results in 25 cases have led the author to prefer this flap to all other types of local flaps.
The candidate to cosmetic surgery is not, contrary to a too common idea, a frivolous creature trying to become more beautiful. He is generally a person with a physical disgrace that induces a frustrating sense of inferiority. The role of the surgeon is to help by removal of the disgrace. The operative indication is thus only psychologic and in some extreme cases, difficult to establish, because the surgeon is badly prepared to this role. A study was performed to understand better the motives and psychologic results of cosmetic operations. Sixty-eight candidates were chosen by the surgeon who considered their disgrace operable. All accepted a psychologic analysis. Following this they were divided into 3 groups: "adapted" (39), "worried" (21) and "perturbated" (8), according to the increasing importance of their emotional disturbances. None of these patients was really psychotic. In the great majority of cases (83%), the interviews with the psychologist disclosed parental difficulties during childhood, followed by a sensation of frustration and of insecurity. Of the 64 operated patients, 62 were reviewed by the psychologist. Fifty-four (87%) were satisfied with the result, among which 45 felt improvement in their psychologic state. Eight were disappointed. Among these, 7 had been classified as "worried" or "distressed". Only 2 patients had reasons to be dissappointed, the others focussed a depressive tendency on a minor and temporary unperfection. Cosmetic surgery thus produces the best psychologic results in "adapted" patients, but is also justified in "worried" or "distressed" patients as the majority will benefit from the operation. In these a careful psychologic contact with the surgeon is mandatory to diminish the postoperative emotional disturbances.
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