Sequelae of firearms or gunshot
Gun accidents cause major sequelae especially at the face, hands, and breasts levels. Initially, it is appropriate in emergency to save the patient who often presents in the context of a gunshot complex visceral lesions (heart and lung);then, to rebuild the breast of the patient. For this reconstruction, each case is particular and the fine analysis of the residual tissues and segments of the breast makes it possible to precisely plan the treatment. It is often necessary to combine the techniques.The lipomodeling of the breast allowed us to obtain unexpected results in these complex cases. In this situation, among the most complex that is, the lipomodelling has again shown its major contribution. By applying the principle of “who can most, can least”, these cases have shown us that all the simpler indications could advantageously be treated by the lipomodelling technique.
Horse or animals’ bite
The breast is an organ protected by clothing, animal bites at this level are rare or even exceptional. However cases of dog or horse bites can exceptionally be encountered and lead to significant lesions, see a sub-total amputation of the breast. The initial lesions are treated in the context of the emergency by trimming, disinfection and suture, with the precautions and the infection follow-up as for the other animal bites. Then, at a distance from the trauma, the management of the sequelae can be performed by a experienced practitioner in breast repair surgery. We were confronted with an exceptional case of a young girl who suffered a subtotal amputation of the breast following a horse bite. This girl was bitten over the fence between her and the neighbours, the bite through the T-shirt resulting in the amputation of most of the breast. At a distance from the trauma, we followed contralateral breast growth by reconstructing the traumatized breast by 2 lipomodeling sessions with an excellent final result, without adding any prosthesis or additional scar, and restoring a supple and sensitive breast.
Breast fracture
Wearing a seatbelt can prevent many deaths and significant facial trauma. In case of a violent car accident, it can appear on the breast, in an exceptional way and often secondarily, a typical depression with aspect of “fracture of the breast”.An underlying fibrous band “cuts” the breast in two, giving as a result an unsightly appearance and a depression on the breast. The correction of this sequelae can be done by reduction mammoplasty when the patient has a large breast, and she wishes a mammary reduction, and realization of a posterior glandular flap coming to fill the subcutaneous depression. In other cases, the post-traumatic sequelae can be corrected by a lipomodelage of the breast, which reduces the underlying fibrosis and makes it possible to fill the subcutaneous depression; the lipomodelage of the breast allows these patients to find a satisfactory mammary shape.