[The effect of body mass index on outcome of body contouring surgeries]. / Influence de l'indice de masse corporelle sur les complications des chirurgies de séquelles d'amaigrissement.

BACKGROUND: The generalization of bariatric surgery interventions has led in recent years to an explosion in demand for body contouring surgeries. These operations can be followed by postoperative complications; and residual obesity, defined by a BMI≥30, is traditionally considered as a relative contraindication. The objective is to study the influence of a BMI≥30 on the risk of postoperative complications. METHODS: A retrospective study was conducted on all patients who underwent body contouring surgery between 2014 and 2020 at the Arras Hospital Center. Major complication rates were compared in obese and non-obese patients. RESULTS: Two hundred twenty-three patients were included, representing a total of 247 surgeries: 124 in the BMI<30 group and 123 in the BMI≥30 group. Sixteen surgeries were followed by at least one major complication, 6 in group I versus 10 in group II (RR=1.7 (0.6-4.5), NS, P=0.29). Therefore there were not significantly more major complications in obese patients. CONCLUSION: The incidence of major complications following body contouring surgeries is not modified by the presence of a BMI greater than 30, subject to a precautionary procedure adapted to each patient. BMI is therefore not a sufficient criterion to contraindicate this type of surgery.

[Stabilization and reanimation of the lower lip in facial palsy. Retrospective study about 66 patients and literature review. Proposition of a decision algorithm]. / Stabilisation et réanimation de la lèvre inférieure paralysée. Étude rétrospective de 66 cas et revue de la littérature. Proposition d'un algorithme décisionnel.

Several techniques for the stabilization and the reanimation of the paralyzed lower lip have been proposed, sometimes combined but the authors are rather vague. Thanks to our cases and a literature review, we suggest an algorithm. Sixty-six patients haven been reviewed. The static and dynamic clinical evaluation have been done thanks to the study of the medical files, photographs and videos samples. The different techniques we have used were: (a) botulinum toxin in the contralateral depressor labii inferioris (DLI) (n=66), contralateral DLI myectomy (n=1); (b) a strip of fascia lata (n=16) either combined with a lengthening temporalis myoplasty (MAT) (n=10) or only realizing a passive suspension thanks to one vector (n=4), or a passive suspension with two strips (n=2); (c) digastric muscle transfer (n=4). When the elevator muscles are sounds, botulin toxin (± myectomy) is proposed if the lower lip is not inverted. Otherwise, a suspension thanks to a digastric muscle transfer or a passive suspension with a horizontal and a vertical strips are recommended. If the elevator muscles are no more operational, a MAT with a passive suspension with one vector is considerated and if the lower lip is inverted, a digastric muscle transfer with a fascia lata strip or a MAT with two strips is proposed. This algorithm submission allows to refine the treatment of the stabilization and the reanimation of the lower lip.