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AESTHETIC PLASTIC
RECONSTRUCTIVE
SURGERY
SEBASTIEN GARSON M.D
COSMETIC OR PLASTIC
PREAMBULE
Cet abécédaire est destiné à vous éclairer sur la différence entre les actes pouvant bénéficier d’une prise en charge par la sécurité sociale et ceux qui sont hors nomenclature dit esthétiques. Pour de plus amples renseignement n’hésitez pas à cliquer sur les liens en savoir plus...
Tout acte chirurgical qu’il soit plastique ou esthétique doit avoir une consultation préopératoire.
Dans le cadre d’une chirurgie esthétique, il est cependant obligatoire de respecter le délais de 15 jours avant de réaliser l'intervention, c'est le délais de réflexion.
Pour les actes dont le dépassement d’honoraire est supérieur à 300€ pour les actes esthétique et 70€ pour les actes plastiques, un devis doit être donné avec une fiche de consentement éclairé. Ces derniers dûment remplis doivent être retournés au chirurgien pour confirmer l’intervention.
Après l’intervention, vous êtes revu régulièrement en consultation pour contrôler l’évolution de la cicatrisation.
Enfin, il faut toujours garder à l’esprit qu’une cicatrice évolue dans le temps. Elles sont toujours plus visibles vers 3 mois post-opératoires avant de débuter leurs blanchiments. Le processus normal de maturation s’achève vers un an post opératoire.
PLASTIC SURGERY
This is the set of acts enjoying supported by social security. The mutual patient takes all or part of the fee exceeded the surgeon and the anesthesiologist according to the contracted warranty.
For the acceptance of support, it is sometimes necessary to make a prior arrangement sheet (otoplasty, abdominoplasty, ... Lipodystrophy).
a.Abdominoplasty
Requires prior agreement. Are supported only the wombs that overlap the pubis. The number of pregnancy is not a factor supported.
It is a gesture that supports a pan-cutaneous abdominal adipose surplus is accompanied by lower abdominal apron. Frequently found a diastasis of the rectus abdomen. The gesture is a tummy tuck with transposition of the umbilicus, myoraphie of diastasis and liposuction on demand.
It is essential that the patient stop all tobacco consumption under penalty of delayed healing with a significant risk of skin necrosis lower median.
The well relieved by analgesics Class 1 post-operative pain is due to myoraphie.
A jacket restraint is implemented in postoperative day and night for a month and a half and then the day for one month.
The work stoppage is 1 month on average. The resumption of sexual activity can resume a week, 10 days after healing. Sweet sports (cycling, swimming) can be taken at 1 month and a half, the other about 2 and a half months. Read more ...
b.Arm lift
Requires prior agreement.
This move allows the removal of excess fat cutaneous the inside of the arm often present during significant weight loss.
The work stoppage is 3 weeks on average. Read more ...
c.Burns
All burns above a 2 deep in an area of 10% of the body surface to electrical or chemical burns require specialized care.
The objective is to obtain healing in 3 weeks to minimize the aesthetic and functional sequelae.
Healing may involve skin grafts or not associated with dermal substitutes.
Monitoring is always performed to guide the best scar integration.
d.Cellulite
This is an emergency requiring a major surgical excision followed at a distance by a skin graft coverage.
e.Scars
They can be post-traumatic, post-surgical, post burns.
They are hypertrophic or keloid.
The first treatment for scars is small medical before considering surgical recovery. Read more ...
f.Thigh lift
Requires prior agreement.
This move allows the removal of a cutaneous adipose surplus inner thighs is often present in a significant weight loss.
The work stoppage is 3 weeks on average. Read more ...
g.Pressuresore
Prevention is the best therapy. If proven ulcer treatment involves the dressing (hydrocolloid, VAC ...) after surgical excision. A refeeding sometimes feeding is necessary to improve healing.
The flaps cover (surgical treatment of ulcer) concerned a minority of patients (rather young and in good condition).
h.Gynecomastia
Surgery is considered only a hormonal balance and comprehensive breast screening. The entire glandular tissue is sent for histological examination.
Healing in 15d, three weeks. Wearing a compression bolero day and night for one month and one month of day.
i.Lipodystrophy
Requires prior agreement.
Two scenarios are supported. Lipodystrophy acquired as protease inhibitors and lipomatoses.
In the first case, a filling by adipocyte graft (Lipostructure ®) is made. Social foreclosure is on average a week.
In the second case, surgical resection can be achieved and in rare cases liposuction. Read more ...
j.Thoracic deformity
Requires prior agreement.
We distinguish the pectus excavatum, Poland syndrome and tuberous breasts.
It requires a combination of techniques, Lipostructure ®, mammaplasty, prosthesis.
The work stoppage is 1 month on average.
k.Mammoplasty
Support is obtained in a systematic way if the removal is more than 300g per breast. Breast hypertrophy is often accompanied by back pain and neck pain. Surgery is possible dice late adolescence if the functional and social genes are too large. Care must be taken to allow sufficient glandular tissue to calmly consider future pregnancies.
Typically, this action is performed after pregnancy breast changes once stabilized. A preoperative mammogram is systematic past 30 years.
The work stoppage is 1 month.
Restraint day and night by a sports bra is worn for a month. Read more ...
l.Otoplasty
It is necessary to wait a minimum of 7 to 8 years before considering this surgery. It must be driven by the child himself and not his mother. This surgery is done under local anesthesia. Wearing a sport headband is required day and night for three weeks and then only at night for a month. Scarring is acquired in 5 days. Stop sports is provided for a period of two months. Read more ...
m.Breast Reconstruction
It can be immediate or delayed, only the oncological status prevails for type of scenario to choose from. In the case of radiation, it is necessary to wait a year after the end of treatment to consider surgery. Reconstruction may use a prosthesis or flap. In over 80% of cases, it is necessary to perform a balancing act of 5 months after the first intervention that ended with the reconstruction of the nipple areola under local anesthesia.
Breast reconstruction does not prevent the oncology monitoring and does not cause mortality. Read more ...
n. Skin Tumor
Whether benign or malignant, it is often accompanied by a reconstruction based on the resection margins. According to the histological status, taking multi disciplinary charge may be made.
Additional treatments can be conducted. Read more ...
AESTHETIC SURGERY
Cosmetic surgery is the only financial burden of the patient and rule that the total expenditure.
The patient can not receive sick leave and must grant postoperative leave. Care and post-operative suites are provided in the estimate for the first 3 months.
a.Abdominoplasty
More advice of doctors refuse supported for abdominoplasty. Multiple pregnancies are not a sufficient criterion for reimbursement.
The patient remains hospitalized 2-3 nights.
The gesture is a tummy tuck with transposition of the umbilicus, myoraphie of diastasis and liposuction on demand.
It is essential that the patient stop all tobacco consumption under penalty of delayed healing with a significant risk of skin necrosis lower median.
The well relieved by analgesics Class 1 post-operative pain is due to myoraphie.
A jacket restraint is implemented in postoperative day and night for a month and a half and then the day for one month.
The work stoppage is 1 month on average. The resumption of sexual activity can resume a week, 10 days after healing. Sweet sports (cycling, swimming) can be taken at 1 month and a half, the other about 2 and a half months. Read more ...
b.Blepharoplasty
It restores the youth a look working on the upper and / or lower eyelids.
Ophthalmologic assessment in search of a dry syndrome is needed.
The upper eyelids are only done under local anesthesia.
The lower eyelids are generally performed under anesthesia potentiated.
This procedure is feasible as an outpatient.
Healing is fast and ablation occurs son J4. Read more ...
c.Facelift
It may be possible from 40, 45 years if clinically warranted. Midface treating area is accompanied by treatment of the lower eyelid. It is very often associated with treatment of cervical area to restore a smooth jaw line.
The lift can be accompanied by Lipostructure ® to restore the missing volumes.
It takes one or two night hospital stay.
The swelling and bruising will disappear in 15/21 days but the patient can resume a social life soon the end of the first week with a suitable makeup and a pair of sunglasses if they wish .
The main gene is cervical in the first 24 hours due to the re-tension neck.
The result is visible as soon the end of the second month.
It is best to stop smoking before the procedure.
Healing occurs in 7/10 days, resorbable son go alone.
Can be taken to provide an injection of botulinum toxin away to perfect the result and / or a skin peel if the skin has important characteristics of solar elastosis. Read more ...
d.Liposuction
This move aims to correct the shape and not to lose weight patients. These need to be in balance weight before considering liposuction.
Wearing a panty after surgery is highly recommended day and night for a month and a half and then the day for a month.
The bruises are sometimes impressive and postoperative edema. Both fade from the third week. It is normal for patients no longer temporarily return to their favorite pants.
The result can only be assessed from three months. Read more ...
e.Mastopexy
It is needed when there is significant ptosis without hypertrophy. The scar is that of a mammoplasty. A sports bra is necessary day and night for the first month.
In the absence of sufficient glandular tissue, it is necessary to add to it a breast implant.
Healing is achieved in 21 days in the absence of complications. Read more ...
f. Fillers
They are used to hide some wrinkles or furrows expression harm experienced by patients. It is best to choose a product that resorbable fillers certainly will subside (average 12 months) but has the undeniable advantage of not leaving a foreign body granuloma with inflammation or infection can still occur even remotely gesture. These products can expect a facelift for example, or in addition. Read more ...
g. Breast Implants
The implants can be used in saline pre-filled silicone gel or hydrogel. Their shapes are round or anatomical. The implant may be implemented by various means at first to be chosen in accordance with the patient.
The position of the latter is pre-or retro chest.
A breast contenseur is set up day and night for the first month.
The massage aids is critical to the quality of the result.
The implants are beings monitored regularly to make change if necessary. Read more ...
h.Rhinoplasty
This procedure is generally performed under general anesthesia. It can correct cartilage defects and / or bone of the nasal pyramid. It can be associated with septoplasty if necessary.
In case of para nasal osteotomy a peri orbital hematoma is often present and dissipates in 15 days.
A nasal splint is often set up for the first week. The nose still has significant edema mask the result to three postoperative months. The final result is obtained within one year. Read more ...
i. Botulinum Toxin
The use of botulinum toxin type A can correct wrinkles and expression lines. It does not freeze the expression of the person.
It should not be injected in a pregnant woman or affect myasthenia gravis.
Taking aspirin or NSAIDs the week before is prohibited.
Avoid making efforts 48 hours after injection.
Active mobilization of the treated area is carried out after the first day.
The result is set up after the first week and lasts about 4 months. We must inject within 3 months after treatment.
After the fourth or fifth session, the result becomes more stable over time for one to two years. Read more ...
Conclusion
Of course this list is indicative of and does not replace consultation with a professional who can best respond to your request.
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