Philippe Levan - Academia.edu (original) (raw)
Papers by Philippe Levan
Plastic and Reconstructive Surgery, May 1, 2018
Plastic and reconstructive surgery. Global open, Sep 1, 2017
Plastic and Reconstructive Surgery Global Open, 2017
videos was 13.1 (SE = .18) out of a possible 26. The videos found under the search “nose reshapin... more videos was 13.1 (SE = .18) out of a possible 26. The videos found under the search “nose reshaping” had the lowest mean score (10.24 SE = .74) while “eyelid surgery” and “buttock lift” had the highest (14.36 SE = .83, 14.36 SE = .70). Videos with physician authorship, (59% of included videos), were found to have a higher mean EQIP score and video views than those posted by patients.. Whether the search term used was the appropriate medical terminology for the procedure or a non-expert description, such as “otoplasty” versus “ear surgery,” influenced how many of the top 50 videos were relevant to plastic surgery and the average EQIP score for that search.
Le lambeau de cuir chevelu decrit par Leon Dufourmentel a ete pratiquement abandonne a cause de l... more Le lambeau de cuir chevelu decrit par Leon Dufourmentel a ete pratiquement abandonne a cause de la rancon cicatricielle. Une expansion prealable permet de reduire celle-ci, en rendant possible une suture directe apres la levee du lambeau. 15 patients ont ete operes a l'hopital Rothschild de 1984 a 1998. La technique est precisee avec son temps operatoire d'expansion et son temps de mise en place du lambeau. Les complications et les resultats sont etudies et deux exemples sont presentes. Les avantages et les inconvenients sont discutes.
Plastic and Reconstructive Surgery Global Open, 2017
videos was 13.1 (SE = .18) out of a possible 26. The videos found under the search “nose reshapin... more videos was 13.1 (SE = .18) out of a possible 26. The videos found under the search “nose reshaping” had the lowest mean score (10.24 SE = .74) while “eyelid surgery” and “buttock lift” had the highest (14.36 SE = .83, 14.36 SE = .70). Videos with physician authorship, (59% of included videos), were found to have a higher mean EQIP score and video views than those posted by patients.. Whether the search term used was the appropriate medical terminology for the procedure or a non-expert description, such as “otoplasty” versus “ear surgery,” influenced how many of the top 50 videos were relevant to plastic surgery and the average EQIP score for that search.
Plastic and reconstructive surgery, Aug 23, 2018
1. Schmitt T, Jabbour S, Makhoul R, Noel W, Reguesse AS, Levan P. Lower body lift in the massive ... more 1. Schmitt T, Jabbour S, Makhoul R, Noel W, Reguesse AS, Levan P. Lower body lift in the massive weight loss patient: A new classification and algorithm for gluteal augmentation. Plast Reconstr Surg. 2018;141:625–636. 2. Levan P, Bassilios Habre S. Gluteal implants versus autologous flaps in patients with postbariatric surgery weight loss: A prospective comparative study of 3-dimensional gluteal projection after lower body lift. Aesthet Surg J. 2017;37:1012–1021. 3. Sinno S, Chang JB, Brownstone ND, Saadeh PB, Wall S Jr. Determining the safety and efficacy of gluteal augmentation: A systematic review of outcomes and complications. Plast Reconstr Surg. 2016;137:1151–1156. 4. Vergara R, Amezcua H. Intramuscular gluteal implants: 15 years’ experience. Aesthet Surg J. 2003;23:86–91. 5. Kitzinger HB, Cakl T, Wenger R, Hacker S, Aszmann OC, Karle B. Prospective study on complications following a lower body lift after massive weight loss. J Plast Reconstr Aesthet Surg. 2013;66:231–238.
Annales de Chirurgie Plastique Esthétique, 2017
Aesthetic Surgery Journal, 2017
The American Journal of Cosmetic Surgery, 2017
We report the case of a patient who developed keloid scarring associated with Mammostat-induced s... more We report the case of a patient who developed keloid scarring associated with Mammostat-induced skin trauma during reduction mammoplasty. A 32-year-old patient consulted for breast hypertrophy and developed from the fourth postoperative month significant keloid scars on skin shears caused by dermal stretching techniques used during de-epithelialization. The Mammostat-related scars were keloid, while those found on old skin incisions were only enlarged and slightly hypertrophic. We followed up this patient for 7 years. During this time, she received the following local treatments: scar kneading, silicone dressings, intralesional injections of corticosteroids, and potent dermocorticosteroids. After balancing the benefit/risk ratio of a possible revision surgery for resection and plasty of her keloid scars, we opted for therapeutic abstention. In patients at high risk of keloids, we recommend a soft de-epithelialization causing no skin shear, performed by manual tensioning of the dermis.
Aesthetic surgery journal, Jan 26, 2017
Currently, there is no standardized approach for labia majora augmentation and controversies stil... more Currently, there is no standardized approach for labia majora augmentation and controversies still exist regarding this subject. This systematic review aimed to assess the evidence in the literature regarding labia majora augmentation. On November 20, 2016, we conducted an online search of published articles in the Medline, Embase, and Cochrane databases. All articles describing labia majora augmentation were included in this review. Nine studies were selected for inclusion in the systematic review. Only 2 studies were prospective trials. The most commonly used technique was fat grafting with a total of 4 articles and 183 patients. The mean total injected fat volume ranged from 18 mL to 120 mL per session. Two articles described hyaluronic acid injection techniques. The total injected volume of hyaluronic acid ranged from 2 to 6 mL per session. Three articles used surgical techniques for labia majora augmentation. All included articles did not report any major or life-threatening co...
Soins. Pédiatrie, puériculture, 2007
Plastic and Reconstructive Surgery, 2000
1 Les traitements antiretroviraux ont d'importants effets secondaires, dont les lipodystrophi... more 1 Les traitements antiretroviraux ont d'importants effets secondaires, dont les lipodystrophies ■ Ces troubles de la repartition des graisses se classent en deux categories: les lipoatrophies (pertes de tissu adipeux) et l'accumulation de volumes graisseux ■ Plusieurs techniques chirurgicales ont fait leurs preuves dans le traitement de ces lipodystrophies, dont la decision therapeutique resulte d'une collaboration etroite entre pediatres, chirurgiens, pedopsychiatres et psychologues, en lien etroit avec l'enfant et sa famille.
International journal of dermatology, 2018
The most widely recognized eyebrow model was described by Westmore in 1974. With the rapidly chan... more The most widely recognized eyebrow model was described by Westmore in 1974. With the rapidly changing concept of beauty, an accurate up-to-date model is needed. The Westmore model was tested on fashion models that were randomly selected from the covers of the 1965-1975 (group 1) and 2006-2016 (group 2) Vogue magazine. The eyebrows of fashion models, which represent the beauty ideals of these decades, were objectively measured and compared. We proposed a modified eyebrow model more adapted to the modern standards of beauty, applied it to group 2, and objectively compared it to the Westmore model. This new model was validated on a group of randomly selected Caucasian women. Thirty women were included in each group. The medial edge of the eyebrow was better defined by the Westmore model in group 1 compared to group 2. The lateral edge of the eyebrow was better defined by the Westmore model in group 2. The peak of the eyebrow was not well defined by the Westmore model in both groups. Th...
Plastic and Reconstructive Surgery
Plastic and reconstructive surgery, Mar 8, 2017
An often neglected part of the lower body lift procedure is the gluteal region. The objective of ... more An often neglected part of the lower body lift procedure is the gluteal region. The objective of this study is to classify the massive weight loss (MWL) patients undergoing a body lift procedure and provide a safe, standardized approach for gluteal augmentation. A retrospective review of all body lift procedures performed between January 2012 and January 2017 was conducted. Patients undergoing a lower body lift with or without gluteal augmentation were included for analysis. Patients were classified as follow: type I, minimal lower and upper back fat and deflated buttock; type II, substantial lower back fat, minimal upper back fat and deflated buttock; type III, substantial lower and upper back fat and deflated buttock; type IV, good buttock projection. Type I patients had gluteal implants, type II patients had autologous flap augmentation, type III patients had gluteal lipofilling and type IV patients did not have any gluteal augmentation. 280 patients were included for analysis. 2...
Aesthetic Surgery Journal
Deformities and excess skin resulting from massive weight loss are corrected with circumferential... more Deformities and excess skin resulting from massive weight loss are corrected with circumferential lower body lift (LBL). The gluteal area is frequently flattened due to aggressive skin excision during LBL. Gluteal implants can circumvent this problem. We aimed to objectively evaluate the outcomes of gluteal augmentation with implants versus flap surgery performed simultaneously with LBL. Between January 2014 and June 2015, twenty-seven patients underwent LBL with gluteal implants (10 patients), flaps (14 patients), or no gluteal augmentation (3 patients) in our hospital. Three-dimensional analysis was used to assess gluteal projection preoperatively and at 6 months. Gain in projection, pain scores, complications, and patient and surgeon satisfaction were compared. The mean follow-up duration was 18 months. The mean gain in projection at 6 months was 4.9 mm in the implant group, -0.5 mm in the flap group (P = 0.1), and -9.6 mm in the control group. The mean implant volume was 294.5 mL. Operation time was shorter in the flap group (192 min) than in the implant group (218 min, P = 0.001). Surgeon satisfaction was higher in the implant group (P = 0.007). Implants were more painful than flaps at 4 days and 2 weeks (P = 0.004 for both). There were 6 minor complications (60%) in the implant group versus 7 (50%) in the flap group (P = 0.94). In selected patients, LBL with gluteal implants is safe and slightly increases gluteal projection. 2.
Aesthetic surgery journal, 2017
Deformities and excess skin resulting from massive weight loss are corrected with circumferential... more Deformities and excess skin resulting from massive weight loss are corrected with circumferential lower body lift (LBL). The gluteal area is frequently flattened due to aggressive skin excision during LBL. Gluteal implants can circumvent this problem. We aimed to objectively evaluate the outcomes of gluteal augmentation with implants versus flap surgery performed simultaneously with LBL. Between January 2014 and June 2015, twenty-seven patients underwent LBL with gluteal implants (10 patients), flaps (14 patients), or no gluteal augmentation (3 patients) in our hospital. Three-dimensional analysis was used to assess gluteal projection preoperatively and at 6 months. Gain in projection, pain scores, complications, and patient and surgeon satisfaction were compared. The mean follow-up duration was 18 months. The mean gain in projection at 6 months was 4.9 mm in the implant group, -0.5 mm in the flap group (P = 0.1), and -9.6 mm in the control group. The mean implant volume was 294.5 m...
A retrospective study was done on a population of 258 women who had undergone surgery for abdomin... more A retrospective study was done on a population of 258
women who had undergone surgery for abdominal dermolipectomy between January of 1991 and May of 1996. The postoperative complications and flaws seen at longterm follow-up are discussed. The surgical techniques used, with or without lipoaspiration, were the infraumbilical plasty and full plasties with horizontal or inverted T scars. Six types of postoperative complications were noted: hemorrhage in 1.2 percent, lymphorrhea in 10.9 percent, infection in 7 percent, skin necrosis in 6.6 percent, secondary dehiscence of the scar in 2.3 percent, and thromboembolic accidents in 1.2 percent. No significantdifference was found in the rate of necrosis development between patients who did and did not undergo lipoaspiration. However, a statistically significant difference was seen in the rate of skin necrosis between the T-type plasty (35.5 percent) and the other two procedures (1.43 percent for infraumbilical plasties and 4.60 percent for full plasties with horizontal scar). With regard to the flaws found at long-term follow-up, the rate of above-scar fat folds and/or dog-ears was 27.9 percent, and the rate of defective scars was 26 percent. No significant difference
was found with regard to the rate of flaws. The rate of all
secondary surgical procedures was 29.1 percent, but performance of secondary procedures depended on the willingnessof the patient and on the surgeon’s judgment.
Abdominoplasty procedures involve a high risk of early
complications. The rate of skin necrosis is clearly augmented in cases of T-type plasty. The need for secondary surgical correction is frequent, and the patient should be reminded of this possibility during preoperative consultation. (Plast. Reconstr. Surg. 106: 1614, 2000.)
Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi, 2002
Large scalp defects that include periosteum set surgeons problems in closing the defect and in re... more Large scalp defects that include periosteum set surgeons problems in closing the defect and in reconstruction of the hair-bearing area. The external tissue extension (ETE) technique together with a skin expansion device allowed us to reduce a 12 x 7.5 cm scalp defect and to construct a self-closing flap.
Plastic and Reconstructive Surgery, May 1, 2018
Plastic and reconstructive surgery. Global open, Sep 1, 2017
Plastic and Reconstructive Surgery Global Open, 2017
videos was 13.1 (SE = .18) out of a possible 26. The videos found under the search “nose reshapin... more videos was 13.1 (SE = .18) out of a possible 26. The videos found under the search “nose reshaping” had the lowest mean score (10.24 SE = .74) while “eyelid surgery” and “buttock lift” had the highest (14.36 SE = .83, 14.36 SE = .70). Videos with physician authorship, (59% of included videos), were found to have a higher mean EQIP score and video views than those posted by patients.. Whether the search term used was the appropriate medical terminology for the procedure or a non-expert description, such as “otoplasty” versus “ear surgery,” influenced how many of the top 50 videos were relevant to plastic surgery and the average EQIP score for that search.
Le lambeau de cuir chevelu decrit par Leon Dufourmentel a ete pratiquement abandonne a cause de l... more Le lambeau de cuir chevelu decrit par Leon Dufourmentel a ete pratiquement abandonne a cause de la rancon cicatricielle. Une expansion prealable permet de reduire celle-ci, en rendant possible une suture directe apres la levee du lambeau. 15 patients ont ete operes a l'hopital Rothschild de 1984 a 1998. La technique est precisee avec son temps operatoire d'expansion et son temps de mise en place du lambeau. Les complications et les resultats sont etudies et deux exemples sont presentes. Les avantages et les inconvenients sont discutes.
Plastic and Reconstructive Surgery Global Open, 2017
videos was 13.1 (SE = .18) out of a possible 26. The videos found under the search “nose reshapin... more videos was 13.1 (SE = .18) out of a possible 26. The videos found under the search “nose reshaping” had the lowest mean score (10.24 SE = .74) while “eyelid surgery” and “buttock lift” had the highest (14.36 SE = .83, 14.36 SE = .70). Videos with physician authorship, (59% of included videos), were found to have a higher mean EQIP score and video views than those posted by patients.. Whether the search term used was the appropriate medical terminology for the procedure or a non-expert description, such as “otoplasty” versus “ear surgery,” influenced how many of the top 50 videos were relevant to plastic surgery and the average EQIP score for that search.
Plastic and reconstructive surgery, Aug 23, 2018
1. Schmitt T, Jabbour S, Makhoul R, Noel W, Reguesse AS, Levan P. Lower body lift in the massive ... more 1. Schmitt T, Jabbour S, Makhoul R, Noel W, Reguesse AS, Levan P. Lower body lift in the massive weight loss patient: A new classification and algorithm for gluteal augmentation. Plast Reconstr Surg. 2018;141:625–636. 2. Levan P, Bassilios Habre S. Gluteal implants versus autologous flaps in patients with postbariatric surgery weight loss: A prospective comparative study of 3-dimensional gluteal projection after lower body lift. Aesthet Surg J. 2017;37:1012–1021. 3. Sinno S, Chang JB, Brownstone ND, Saadeh PB, Wall S Jr. Determining the safety and efficacy of gluteal augmentation: A systematic review of outcomes and complications. Plast Reconstr Surg. 2016;137:1151–1156. 4. Vergara R, Amezcua H. Intramuscular gluteal implants: 15 years’ experience. Aesthet Surg J. 2003;23:86–91. 5. Kitzinger HB, Cakl T, Wenger R, Hacker S, Aszmann OC, Karle B. Prospective study on complications following a lower body lift after massive weight loss. J Plast Reconstr Aesthet Surg. 2013;66:231–238.
Annales de Chirurgie Plastique Esthétique, 2017
Aesthetic Surgery Journal, 2017
The American Journal of Cosmetic Surgery, 2017
We report the case of a patient who developed keloid scarring associated with Mammostat-induced s... more We report the case of a patient who developed keloid scarring associated with Mammostat-induced skin trauma during reduction mammoplasty. A 32-year-old patient consulted for breast hypertrophy and developed from the fourth postoperative month significant keloid scars on skin shears caused by dermal stretching techniques used during de-epithelialization. The Mammostat-related scars were keloid, while those found on old skin incisions were only enlarged and slightly hypertrophic. We followed up this patient for 7 years. During this time, she received the following local treatments: scar kneading, silicone dressings, intralesional injections of corticosteroids, and potent dermocorticosteroids. After balancing the benefit/risk ratio of a possible revision surgery for resection and plasty of her keloid scars, we opted for therapeutic abstention. In patients at high risk of keloids, we recommend a soft de-epithelialization causing no skin shear, performed by manual tensioning of the dermis.
Aesthetic surgery journal, Jan 26, 2017
Currently, there is no standardized approach for labia majora augmentation and controversies stil... more Currently, there is no standardized approach for labia majora augmentation and controversies still exist regarding this subject. This systematic review aimed to assess the evidence in the literature regarding labia majora augmentation. On November 20, 2016, we conducted an online search of published articles in the Medline, Embase, and Cochrane databases. All articles describing labia majora augmentation were included in this review. Nine studies were selected for inclusion in the systematic review. Only 2 studies were prospective trials. The most commonly used technique was fat grafting with a total of 4 articles and 183 patients. The mean total injected fat volume ranged from 18 mL to 120 mL per session. Two articles described hyaluronic acid injection techniques. The total injected volume of hyaluronic acid ranged from 2 to 6 mL per session. Three articles used surgical techniques for labia majora augmentation. All included articles did not report any major or life-threatening co...
Soins. Pédiatrie, puériculture, 2007
Plastic and Reconstructive Surgery, 2000
1 Les traitements antiretroviraux ont d'importants effets secondaires, dont les lipodystrophi... more 1 Les traitements antiretroviraux ont d'importants effets secondaires, dont les lipodystrophies ■ Ces troubles de la repartition des graisses se classent en deux categories: les lipoatrophies (pertes de tissu adipeux) et l'accumulation de volumes graisseux ■ Plusieurs techniques chirurgicales ont fait leurs preuves dans le traitement de ces lipodystrophies, dont la decision therapeutique resulte d'une collaboration etroite entre pediatres, chirurgiens, pedopsychiatres et psychologues, en lien etroit avec l'enfant et sa famille.
International journal of dermatology, 2018
The most widely recognized eyebrow model was described by Westmore in 1974. With the rapidly chan... more The most widely recognized eyebrow model was described by Westmore in 1974. With the rapidly changing concept of beauty, an accurate up-to-date model is needed. The Westmore model was tested on fashion models that were randomly selected from the covers of the 1965-1975 (group 1) and 2006-2016 (group 2) Vogue magazine. The eyebrows of fashion models, which represent the beauty ideals of these decades, were objectively measured and compared. We proposed a modified eyebrow model more adapted to the modern standards of beauty, applied it to group 2, and objectively compared it to the Westmore model. This new model was validated on a group of randomly selected Caucasian women. Thirty women were included in each group. The medial edge of the eyebrow was better defined by the Westmore model in group 1 compared to group 2. The lateral edge of the eyebrow was better defined by the Westmore model in group 2. The peak of the eyebrow was not well defined by the Westmore model in both groups. Th...
Plastic and Reconstructive Surgery
Plastic and reconstructive surgery, Mar 8, 2017
An often neglected part of the lower body lift procedure is the gluteal region. The objective of ... more An often neglected part of the lower body lift procedure is the gluteal region. The objective of this study is to classify the massive weight loss (MWL) patients undergoing a body lift procedure and provide a safe, standardized approach for gluteal augmentation. A retrospective review of all body lift procedures performed between January 2012 and January 2017 was conducted. Patients undergoing a lower body lift with or without gluteal augmentation were included for analysis. Patients were classified as follow: type I, minimal lower and upper back fat and deflated buttock; type II, substantial lower back fat, minimal upper back fat and deflated buttock; type III, substantial lower and upper back fat and deflated buttock; type IV, good buttock projection. Type I patients had gluteal implants, type II patients had autologous flap augmentation, type III patients had gluteal lipofilling and type IV patients did not have any gluteal augmentation. 280 patients were included for analysis. 2...
Aesthetic Surgery Journal
Deformities and excess skin resulting from massive weight loss are corrected with circumferential... more Deformities and excess skin resulting from massive weight loss are corrected with circumferential lower body lift (LBL). The gluteal area is frequently flattened due to aggressive skin excision during LBL. Gluteal implants can circumvent this problem. We aimed to objectively evaluate the outcomes of gluteal augmentation with implants versus flap surgery performed simultaneously with LBL. Between January 2014 and June 2015, twenty-seven patients underwent LBL with gluteal implants (10 patients), flaps (14 patients), or no gluteal augmentation (3 patients) in our hospital. Three-dimensional analysis was used to assess gluteal projection preoperatively and at 6 months. Gain in projection, pain scores, complications, and patient and surgeon satisfaction were compared. The mean follow-up duration was 18 months. The mean gain in projection at 6 months was 4.9 mm in the implant group, -0.5 mm in the flap group (P = 0.1), and -9.6 mm in the control group. The mean implant volume was 294.5 mL. Operation time was shorter in the flap group (192 min) than in the implant group (218 min, P = 0.001). Surgeon satisfaction was higher in the implant group (P = 0.007). Implants were more painful than flaps at 4 days and 2 weeks (P = 0.004 for both). There were 6 minor complications (60%) in the implant group versus 7 (50%) in the flap group (P = 0.94). In selected patients, LBL with gluteal implants is safe and slightly increases gluteal projection. 2.
Aesthetic surgery journal, 2017
Deformities and excess skin resulting from massive weight loss are corrected with circumferential... more Deformities and excess skin resulting from massive weight loss are corrected with circumferential lower body lift (LBL). The gluteal area is frequently flattened due to aggressive skin excision during LBL. Gluteal implants can circumvent this problem. We aimed to objectively evaluate the outcomes of gluteal augmentation with implants versus flap surgery performed simultaneously with LBL. Between January 2014 and June 2015, twenty-seven patients underwent LBL with gluteal implants (10 patients), flaps (14 patients), or no gluteal augmentation (3 patients) in our hospital. Three-dimensional analysis was used to assess gluteal projection preoperatively and at 6 months. Gain in projection, pain scores, complications, and patient and surgeon satisfaction were compared. The mean follow-up duration was 18 months. The mean gain in projection at 6 months was 4.9 mm in the implant group, -0.5 mm in the flap group (P = 0.1), and -9.6 mm in the control group. The mean implant volume was 294.5 m...
A retrospective study was done on a population of 258 women who had undergone surgery for abdomin... more A retrospective study was done on a population of 258
women who had undergone surgery for abdominal dermolipectomy between January of 1991 and May of 1996. The postoperative complications and flaws seen at longterm follow-up are discussed. The surgical techniques used, with or without lipoaspiration, were the infraumbilical plasty and full plasties with horizontal or inverted T scars. Six types of postoperative complications were noted: hemorrhage in 1.2 percent, lymphorrhea in 10.9 percent, infection in 7 percent, skin necrosis in 6.6 percent, secondary dehiscence of the scar in 2.3 percent, and thromboembolic accidents in 1.2 percent. No significantdifference was found in the rate of necrosis development between patients who did and did not undergo lipoaspiration. However, a statistically significant difference was seen in the rate of skin necrosis between the T-type plasty (35.5 percent) and the other two procedures (1.43 percent for infraumbilical plasties and 4.60 percent for full plasties with horizontal scar). With regard to the flaws found at long-term follow-up, the rate of above-scar fat folds and/or dog-ears was 27.9 percent, and the rate of defective scars was 26 percent. No significant difference
was found with regard to the rate of flaws. The rate of all
secondary surgical procedures was 29.1 percent, but performance of secondary procedures depended on the willingnessof the patient and on the surgeon’s judgment.
Abdominoplasty procedures involve a high risk of early
complications. The rate of skin necrosis is clearly augmented in cases of T-type plasty. The need for secondary surgical correction is frequent, and the patient should be reminded of this possibility during preoperative consultation. (Plast. Reconstr. Surg. 106: 1614, 2000.)
Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi, 2002
Large scalp defects that include periosteum set surgeons problems in closing the defect and in re... more Large scalp defects that include periosteum set surgeons problems in closing the defect and in reconstruction of the hair-bearing area. The external tissue extension (ETE) technique together with a skin expansion device allowed us to reduce a 12 x 7.5 cm scalp defect and to construct a self-closing flap.