[Improving the esthetic results and patient satisfaction in orthognatic surgery]. / Améliorer le résultat esthétique et la satisfaction du patient en chirurgie orthognatique.

The objectives of dental and maxillary defect management have changed over the last decade. Occlusal improvement is required, but it is expected to come with a good esthetic result for patients, especially for adults, and mentioned or not preoperatively. Thus, the maxillofacial surgeon must include complementary data in his therapeutic scheme, beyond the one provided by the cephalometric analysis. This chapter was drafted in pluridisciplinary mode to this end. A psychological approach and post-operative satisfaction are crucial factors that were studied prospectively (MD Battini and Courtois) and are a part of this chapter. Esthetic labial standard are also described, based on the results of a retrospective study (MD Hardy, Laure and Goga). Doctor Belhaouari presents solutions to embellish lips with filling products, initially or later. Finally, the complementary surgical techniques that can be used during orthognatic surgery are listed: lipofilling, rhinoplasty, surgery of mandibular angles, apposition of piriform aperture.

[Complications of laser facial resurfacing]. / Complications des abrasions du visage par laser.

Laser resurfacing is a burn of the superficial skin layers: it's a controlled burn in its depth, that can destroy epidermis and the dermis superficial part, but not deeper for avoiding healing complications. All complications and the normal postoperative follow-up can be explained by the fact that laser resurfacing is a burn of the dermis and epidermis, with the destruction, partial or total, of their components. It's essential to understand the normal postoperative process and complications to avoid them and to treat them in the beginning. Infection, persistent erythema, pigmentation troubles like hyperpigmentation or depigmentation and demarcation surrounding the resurfacing area, healing troubles like hypertrophic scarring, keloids, excess of skin retraction are the main complications. Careful preoperative explanation of laser-resurfacing follow-up will help the patient adjust more easily to postoperative care.

Shave excision and phenol peeling of generalized verrucous epidermal nevus.

BACKGROUND: Generalized verrucous epidermal nevus is a disorder characterized by papulokeratotic and verrucous plaques involving a large area of the skin. This disease has been associated with a number of malformations including osseous, neurological, and ophthalmologic anomalies. OBJECTIVE: To report clinical and histologic features of verrucous epidermal nevus that developed in association with osseous anomalies, and the surgical technique employed. METHODS: Treatment consisted of razor blade shaving using a dermatome, followed by phenol peeling on the pigmented areas of the face. RESULTS: The described procedure resulted in a cure of the verrucous epidermal nevus with good cosmetic outcome. CONCLUSION: Generalized verrucous epidermal nevus can be successfully managed by surgical excision using a razor blade mounted on a dermatome.

[Failure and problems: apropos of a cranioplasty]. / Echec et problèmes: à propos d'une crânioplastie.

The authors report a case of post-traumatic cranioplasty associated with various complications. They stress the difficulties in managing this type of reconstruction when a vast cerebral defect is associated with ventriculo-peritoneal by-pass.