Autologous fat transfer: an aesthetic and functional refinement for parotidectomy.

Parotidectomy is a surgical procedure associated to functional (Frey's syndrome) as well as aesthetic (facial asymmetry) complications that can be very disturbing for the patient. Several procedures have been described to primarily avoid or secondarily reconstruct the facial defect and treat the neurological iatrogenic syndrome. Autologous fat transfer was primarily used in 10 cases to avoid such complications. It is an easy technique widely used in cosmetic and reconstructive surgery. This technique gives very satisfying long-term results on the cosmetic as well as on the physiological point of view.

Circumferential body contouring in bariatric and non-bariatric patient.

BACKGROUND: Obesity is a serious global health-care concern, with rates in Europe and North America estimated at about 20-30% of the adult population. Bariatric surgery forms the basis of modified surgical approaches to body-contouring procedures, especially those involving circumferential abdominoplasty. This procedure produces tremendous aesthetic results with very high patient satisfaction. We applied this technique, as an alternative to classic abdominoplasty, on moderately to severely obese patients and on patients with no excess-weight problem but some degree of skin laxity and with no history of bariatric surgery. METHODS: The first author performed 80 consecutive circumferential abdominoplasties during a 4-year period. The patients consisted of two groups: post-bariatric patients (n=23) and those with no history of bariatric surgery (n=57). Factors such as age, gender, duration of the procedure and hospitalisation, among other relevant ones, are studied and the data are compared between the two groups, with a third group of patients who underwent, during the same period, a classical abdominoplasty (n=38), and with data from the literature. RESULTS: Circumferential abdominoplasty produces excellent aesthetical results with a high degree of satisfaction for patients with no bariatric history. The patients in this group are younger, their preoperative weight loss is lower, operative time shorter and per-operative blood loss lower. There is no statistical difference between the groups in terms either of the body mass index (BMI) at the time of circumferential abdominoplasty or of the resected tissue weight. Morbidity and rate of complications between these groups are not significant statistically, as with the case of data available in the literature. Compared with patients undergoing a classical abdominoplasty, we observe more complications related to delay in wound healing, less haematoma and less combined procedures in cases of circumferential abdominoplasty. CONCLUSIONS: Circumferential abdominoplasty is a body-contouring procedure initially developed for post-bariatric patients. This procedure can be ethically proposed to patients with body-contour deformities in a non-bariatric context (and even to non-obese patients with a skin laxity problem), giving excellent results with minor morbidity.