Doctor
David MALADRY
PLASTIC, RECONSTRUCTIVE & AESTHETIC SURGERY
Medical office: plastic & aesthetic surgery
0142881868
36 avenue Théophile Gautier 75016 PARIS

Français English

Advice and recommendations concerning plastic,
reconstructive and aesthetic surgery.

Plastic, Reconstructive and Aesthetic Surgery

To clarify certain terms, we point out that Plastic Surgery is a surgery of shapes, contours and morphology. Reconstructive Surgery aims to repair, replace, or improve some damage effects that could be of a traumatic, a surgical, a post secondary origin or that could be due to acquired medical anomalies or to the congenital ones. Cosmetic Surgery is intended to allow a better look. This surgery helps many patients who, in their hearts, are embarrassed by what they see as a disgrace. These three parts of the surgery that I do are obviously inseparable. It would be inconceivable to reconstruct a breast after a cancer without making the result pretty and pleasant, or even perform a secondary rhinoplasty after injury without making a better appearance. When I pose breast implants for cosmetic reasons, or when I do a liposuction, shape and contours change. It is therefore a plastic surgery. The psychological benefits of reconstruction are not only functional, but also provide some well-being to patients. This well-being is also obtained as a result of a facial cosmetic surgery (facelift, rhinoplasty...). So it is an extremely demanding vast discipline, as far as technical skills and the human sense of the practitioner whom you trust are concerned.

It is legitimate that you ask yourself whether the person that you have chosen for this type of surgery has all the necessary skills and qualifications. Since 1990, in France, there is specialized training in itself, the Diploma of Special Study in Plastic, Reconstructive and Aesthetic Surgery. I had the honor to be one of the first two holders of this Diploma in Paris, with my Diploma of Specialized Studies in Plastic, Reconstructive and Aesthetic Surgery. This diploma was awarded after a competitive selection process, and after a lot of training involving, on the one hand, the more traditional surgery, but on the other hand, the training in the best services for this specialty in Paris. After this training acquired during the Internat des Hôpitaux de Paris, in surgery, I was a Head of Clinic at the Faculty, Hospital Assistant where I could, first, practice numerous interventions in reconstructive surgery (burns surgery, microsurgery, hand surgery), but also a lot of plastic and cosmetic surgery. Then, I was responsible for the unit of Cosmetic Surgery, at the Boucicaut Hospital in the service of Plastic surgery and SOS Hands of Doctor Vilzin and Doctor Mitz. Finally, I am also a graduate of cosmetology and skin biology, which made me understand the best possibilities of healing and non-surgical means possibly act on aesthetics.

My current surgical activity includes an activity in the public hospital where I am a Hospital Surgeon. At the Hôpital Européen Georges Pompidou, I am responsible for the reconstruction of complex injuries of the face, limbs and hands. I am also responsible for silhouette surgery after a weight loss and for some reconstructive interventions (skin tumors, burns…). The aesthetic surgery is performed in private centers selected due to the safety of their technical platform.

I am also a member of the College of Plastic, Reconstructive and Aesthetic Surgery, Member of the French Society of Plastic, Reconstructive and Aesthetic Surgery, Member of the French Society for Surgery of the Hand and the International Group for Advancement of Microsurgery. I am also a professor in several university programs in order to teach our young colleagues, who will be operating you later, our discipline (scalp surgery program, hand surgery program, plastic surgery program...). I give you these details because it seems to me they can be useful for you both to let you make your choice in full knowledge of the facts, and especially to reassure you if it is necessary. Indeed, like any act of surgery where many questions may arise, it is necessary to talk about before.

General information before the surgery

Informations générales avant une chirurgie

If you want to benefit from a plastic, reconstructive and aesthetic surgery, you should note that even for an aesthetic surgery a protocol and certain precautions must be strictly followed.
To ensure the best safety and asepsis, all actions are performed in the operating room without any delegation.

You will need a preoperative anesthesia consultation and a check suitable to your condition and operational project. After surgery, various phenomena may occur. This is what is called the postoperative suites. They vary widely, primarily depending on the capabilities of healing and specific to each individual edematous reaction. So some people will be very presentable few days after eyelid surgery or a facelift, others will take several weeks to recover. These edemas, the bruising, these tautness to the skin, redness and scars, are common phenomena. I remain of course at your disposal in the postoperative suites to detect any abnormal changes and at least reassure you on changes that might worry.

Complications of traditional surgery or cosmetic surgery are the same: a superinfection, hematomas and lymph effusions, wound healing disorders with necrosis or disunity, allergy to threads ... In reality, even if you are subject to such problems, in general the end result will not be affected. It should be noted that the scar evolution is very long and the scar is much thinner when it occurs on a very thin skin (for example, eyelids) and it will often be large and thick in the areas where the skin is thick (for example, back). There is a normal physiological phase that everyone expresses more or less pronounced, which is called hypertrophic scar period, which occurs after a few months and may last 6 to 9 months. The scar will eventually refine, bleach, and become acceptable, sometimes after more than a year and a half. During the postoperative consultations, we can show you the methods that can help the rapid favorable scar evolution. Apart from the scar, the results, especially on the shape (plastic surgery) are rarely obtained immediately. In fact, even if we do not mention a significant hematoma, postoperative edema may increase the volume and not let envisage the final result before 3-4 months. Anyway, if an abnormal healing persists or if the result is judged inadequate or imperfect, it often happens that a significant improvement occurs over time and leads to the result. Conversely, other abnormalities may be the cause of a surgical remodeling (less than 1% of cases).

Some tips before the surgery

Conseils avant la chirurgie

Obviously you have to specify to the anesthetist and your surgeon, all the medical conditions, diseases and medical history, drug allergies, you may submit. This is your health. To avoid hematomas, do not take drugs that alter the flow of blood, especially the anti-inflammatory or anti-coagulant drugs.
However, it is often possible to have a surgery, even an aesthetic one, for patients carrying a relatively serious disease or for those under anticoagulant treatment, subject to certain precautions and preliminary recommendations.
On smoking and obesity: These two states not only increase the risk of poor wound healing (necrosis, wound dehiscence...), but also increase the risk of secondary infection and phlebitis with its corollary, pulmonary embolism, which can be very serious. However, there is no need to deny the surgery in case of excessive smoking: by informing me, you allow me to act with the techniques most suitable for your condition. Regarding obesity, the preoperative reduction, if possible, is recommended for a good postoperative course.

Some tips after the surgery

Conseil après la chirurgie

Most interventions performed in plastic, reconstructive and aesthetic surgery, are not very painful, and you receive a prescription for postoperative analgesics. In most interventions, usual hygiene is recommended and can be applied directly on the scars, even if they are still quite "young". In fact, the cleansing achieved by the use of the shower and soap, usually provides an excellent anti-infectious prevention and leads to a successful healing in excellent conditions. It is usual to see some serosa, sometimes slightly tinged with blood, the first day after surgery, at the surgical site. These serosa are witnessing a normal healing, but their accumulation at the wound, is responsible for microbial growth which can obviously affect healing. For this, the mechanical debridement performed during hygiene care, eliminating accumulations of blood residues, scabs, fibrinous masses, is especially favourable. Regarding the postoperative monitoring of temperature, the further may be possibly increased by a few tenths of a degree corresponding to the absorption of subcutaneous hematomas. However, in case of any thrill over 38, 38.5 °, excessive fatigues, change in the appearance of the wound, pain and especially if it is pulsatile (punctuated by heart rate) you should consult your doctor as soon as possible.

Three questions are usually also present postoperatively:

But eventually, after a year - a year and a half of development, these are often the scars that were normally exposed to the sun that are the finest, most flexible and most beautiful. You should be aware of the possibility of filing a pigmented degradation bruising (hemosiderin) also activated by the sun on brown skin. This deposit is visible by transparency, when dermis is thin, for over six moths. This transient phenomenon often occurs after rhinoplasty, particularly at the thin skin of the eyelids. This impression of a too strong bruise will gradually disappear. Finally, there is probably another reason to avoid sun exposure in general. This is the acceleration of skin aging, not only with the appearance of brown spots and small wrinkles consecutive to fractures of collagen and elastic fibers in the dermis but also the increased risk of skin tumors, some of which can be very serious ...
Anyway, after surgery we are at your disposal to answer all your concerns and requests. Do not hesitate to contact us.