By Nathalie Bricout MD (auth.)
Much development has been made lately and new ideas were built within the box of cosmetic surgery of the breast. Breast Surgery provides plastic surgeons with a accomplished precis of present perform and the ideas available.
Clearly written in language obtainable to either experts and non-specialists, Breast Surgery offers a spread and diversity of ideas with which first-class ends up in either plastic and reconstructive breast surgical procedure might be completed. Over six hundred drawings and images, either in black and white and in color, accompany the textual content, supplying the plastic doctor with clearly-illustrated instructions to follow.
Dr. Nathalie Bricout is a number one determine within the box of cosmetic surgery of the breast in France.
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As Vilain has pointed out, the outcome of a mammoplasty is judged from in front. Hence one should be wary of articles which shows a frontal view preoperatively and a three-quarter view for the result! Photography 37 a b c d e f Fig. 29 a-f. Background and frame. a, b a black or very dark background is not very flattering, unlike a medium background. c, e three-quarter views are difficult to standardise, but are useful in assessing curvature. d, f skewed lateral views showing the curve of the other breast allow better assessment of any asymmetry and are more objective than the two false proflles shown (d seems to show symmetric curvatures but the asymmetry suggested by the frontal view is confirmed in f) Breast reconstruction: a, C, e: mastectomy - immediate reconstruction by expansile prosthesis, fllms taken at end of expansion b, d, f: after change to a definitive inflatable implant, reduction plasty of opposite breast, reconstruction of areola by tattooing and graft from opposite nipple 38 The normal breast For proper analysis, the setting must respect certain conditions.
Postoperatively: - films taken before 6 months are oflittle value, except when taken before a second-stage procedure, as the shape and scars are not yet stabilised; - the postoperative ftlms are valuable: • after 6 months, where the essential shape is usually achieved, • subsequently, ftlms taken at 1 and 2 years, and later when possible. Conclusion It is relatively simple, and possible, for every surgeon to produce correct and objective photographs suitable for analysis and publication. It should no longer be acceptable to see: - poor frames, taken every which way, showing background features such as the corner of a toilet or a door, the shiny windows of an operating room, the anesthetic equipment, more or less well hidden by a drape creating folds and held across by the assistant, whose hands and even face are visible, - ftlms so dark as to be uninterpretable, - more serious, fums taken in conditions that verge on manifest intellectual dishonesty, because: • routinely under-exposed preoperatively, • and over-exposed postoperatively, which has the "advantage" of blurring the scars and, in facial surgery, of considerably improving the effects of a face-lift on the wrinkles, • taken in high-angle preoperatively, and low-angle postoperatively, which is much more flattering for the curve of a breast, especially in three-quarter view.
29) It is easy to respect anonymity in the surgery of the breast, since the face has no place in this type of photography. On the other hand, the view should not be too close-up, or it will give the eye a disagreeable impression of being situated too close to the subject. Such close-up views, which do not provide an overall view of the operated region, do not by themselves allow objective analysis of the result. These films, or the films of a detail, should only be shown if accompanied by an overall view.