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Biomedical subjects

M Lejour

Publications and source records attributed to M Lejour.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Vertical mammaplasty as secondary surgery after other techniques.

Vertical mammaplasty, a technique that avoids submammary scars, has proved to be a reliable method of breast reduction because it is adaptable to most cases and produces beautiful and durable results. What about secondary cases? In the last 14 cases referred for secondary mammaplasty, at 1-19 years after their initial surgery, patients' indications were poor shape (14), visible and improperly located scars (9), excess volume (8), asymmetry of the areolas (5) or the breasts (1), insufficient volume (2), and asymmetry with reconstructed breast (2). The original scars were inverted T (10), periareolar (2), oblique (1) or vertical (1). Their appearance was a concern for nine patients. All patients but one, who had long submammary scars surrounded by heavy stitch marks requiring correction, could benefit from a vertical mammaplasty. This avoided long months of scar redness and visibility along the submammary folds. Good symmetry and shape could be obtained in all cases by adjusting the markings to the needs. Liposuction was a great help to remove volume without endangering the blood supply of the areolas, possibly transforming reductions in simple mastopexies.

Adult↗
PubMedDate not supplied

[Microsurgery and free flaps as indications for the reconstruction of the mouth and pharynx region following tumor resection].

This article describes the microsurgical approach of the head and neck team of the Bordet Institute. During a period of 2 1/2 years 35 free flaps, 71 Pectoralis Major and 9 local flaps were performed for oropharyngeal reconstruction. Different types of free flaps were used and analyzed: 15 latissimus dorsi myocutaneous, 8 radial forearm, 1 gastric, 3 jejunum, 2 crista iliaca osteocutaneous, 1 scapular osteomyocutaneous, 3 scapular osteo-muscular of a new type (discovered in our department), 1 serratus anterior muscular and 1 flap composed of 3 others (a latissimus myocutaneous, a serratus anterior and a scapular osteo-muscular flap). 60% of the microvascular anastomoses were performed in a previously heavily irradiated area and none failed. The indications of some of these flaps are discussed and summarized.

Bone Transplantation↗
PubMedDate not supplied

[Experience with 38 deltopectoral flaps in reconstructive surgery of the head and neck (author's transl)].

The deltopectoral flap was described by Bakamjian in 1965 for pharyngo-oesophageal reconstruction. Since then, the indications of this excellent flap have been extended and the versatility of the flap has allowed extensive skin and mucous membrane resections in cancerology. The authors have used 38 deltopectoral flaps in 36 patients with difficult reconstructive problems. The results have been good in 31 cases. There were 7 failures.

Aged↗
PubMedDate not supplied

[Surgical treatment of some "historical" x-ray dermatites (author's transl)].

Six cases are presented: two degenerated and four necrotic X-ray dermatitis. Four patients had received X-ray therapy for benign lesions. All suffered long standing X-ray dermatitis lasting up to 60 years. The princip of treatment is a complete excision of the diseased skin and the covering of the defect with flaps. Such severe cases which need a complex treatment, must be handled with caution. X-ray therapy is a powerful but dangerous tool; its dangers are often known late; it should be reserved for severe conditions.

Adult↗
PubMedDate not supplied

[Analysis of 163 latissimus dorsi muscle flaps].

During the last 9 years, 163 latissimus dorsi flaps (LTD) were used in our department for different kinds of reconstructions. The indications for raising this flap were various. The pedicled flap (129 cases) provided an adequate solution for breast reconstruction (109 cases). As a free tissue transfer (34 cases) the LTD flap was mainly used for head and neck reconstruction (12 cases) after removal of infiltrating tumours. In the lower limb (12 cases) this myocutaneous flap remained an ultimate solution for coverage of open fractures, exposed osteosynthesis material and for treatment of chronic osteomyelitis. The authors further stress the constant anatomy and the ease of dissection. Removal of the muscle leaves minimal functional donor deficits. The high success rate of 95% as a pedicled flap and of 94% as a free flap highlight the reliability of the LTD flap and advocate its use for "all seasons".

Back↗
PubMedDate not supplied

[Recent advances in breast reconstruction].

In ten years, breast reconstruction has become a routine procedure. It is now well established that it does not influence breast cancer. Techniques have been refined, and even use the excess of skin and fat of the lower abdomen to reconstruct a breast without a prosthesis. The indications of reconstruction remain mainly psychological, and it is difficult to predict which patients will be candidates for a reconstructive procedure after their mastectomy. Immediate reconstruction is more often proposed since expansion prostheses are used. It should however be reserved to highly selected cases. An unusual type of reconstruction is now becoming more common, after conservative treatment of breast cancer. It is asked by patients who are disappointed by the aspect of their breast after partial mastectomy and irradiation. Reconstructive surgery is specially difficult in these cases, and may induce more complications than usual reconstruction. It is therefore important that surgeons keep such procedures for cases in which they have good chances to leave a breast with satisfactory volume, consistency and aspect.

Breast↗
PubMedDate not supplied

Breast reconstruction at the tumor center of the University of Brussels. A three year report.

In 80 cases, breast reconstruction was performed as a secondary procedure at least one year after mastectomy for cancer. The prerequisite was absence of local recurrence and distant metastasis, good general condition and careful information on the result to be expected. In the majority of the cases reconstruction was accomplished in two stages: volume replacement with a prosthetic implant was followed after 3 months, by nipple-areolar reconstruction-usually from the opposite side. Capsulotomy or replacement of the prosthesis in case of asymmetry could be performed at this time. If necessary, skin replacement was done as a first procedure by means of a thoraco-epigastric or a latissimus dorsi myocutaneous flap. Aesthetic results are improving with experience and the positive psychological response of the patients is an encouragement to proceed in helping also patients with a rather poor prognosis.

Adult↗
PubMedDate not supplied

Management of the remaining breast in breast reconstruction.

Prophylactic subcutaneous mastectomy is performed only in high risk patients. In other cases, the breast is adapted if needed by conventional techniques. These are slightly modified to obtain a less conical shape of the breast and preserve the whole surface of the areola. In the majority of the cases the nipple-areolar complex will be used at a second stage as donor site for the reconstructed breast.

Breast↗
PubMedDate not supplied

Reconstruction of the nipple-areolar complex after radical mastectomy.

Reconstruction of the nipple areolar complex should be done as a second stage procedure about three months after volume replacement. Symmetry in position, size, and color is of utmost importance for the overall aspect of a breast reconstruction. One piece full thickness grafts from the opposite areola and nipple give the best results. When the remaining areola is too small to provide a full thickness graft, shaving of its surface may be used but often leads to later depigmentation. In these cases inguinal or perineal full thickness skin grafts seem preferable. Projection of the nipple remains a difficult goal. Experience of the authors with 74 nipple areolar reconstructions is discussed.

Breast↗