Visit Doctor Sylvain David is specialized in plastic surgery as well as microsurgery, and his expertise has enabled him to perform the first successful double arm reimplantation. This operation was carried out while he was head of the plastic surgery department at Nice University Hospital. Since then, Dr. David has moved to the Clinique St George center, where he practises plastic and hand surgery.
A hyper-specialty: hand surgery
Hand surgery is required in circumstances as diverse as fractures, sprains, burns, cuts, infections and degenerative conditions. It differs from general orthopaedic surgery in that it concerns a complex and precious organ that is at risk from any daily activity. It involves bones, muscles, ligaments, tendons, nerves, veins and skin. It calls on knowledge of orthopedics, traumatology, microsurgery and plastic and reconstructive surgery, as well as increasingly precise and complex techniques.
Hand surgery is most often emergency surgery. The majority of these are everyday accidents, less than half of which occur at work, and 20 % in road accidents. Of these, 1/3 are serious to very serious. Domestic or para-domestic accidents are the most common. These include burns from heat sources or chemicals; cuts from scissors, knives, broken glass or DIY tools; hands caught in doors or food processors; bites; and falls. In the workplace, despite judicious safety instructions, cuts, crushes and ring finger injuries still occur... To deal with these traumas, there are some thirty specialized centers in France, open 7 days a week, 24 hours a day.
Carpal tunnel syndrome surgery
Carpal tunnel syndrome is the most common work-related musculoskeletal disorder. It is caused by excessive strain on the finger flexor nerves, or by repeated microtrauma to the wrist bones. The carpal tunnel is where these nerves pass through the carpal bones that form the joint between the hand and wrist. Once the diagnosis has been made, it is essential for the patient to eliminate the cause of the trauma and take anti-inflammatory treatment. In most cases, however, surgical nerve release is indispensable.
Dupuytren's disease is revealed by the presence of nodules in the palm of the hand, gradually giving way to flanges that pull on the ring and little fingers, gradually preventing their extension. The causes of Dupuytren's disease are as yet unknown, although a link with alcohol and tobacco consumption is suspected. Some cases, however, follow surgery. There is no preventive treatment, and the cure involves surgery. The aim is to sever or even remove the bridles.
The treatment of skin tumors is at the heart of plastic surgery, and Dr. David is a specialist in the treatment of nevus moles, basal cell carcinoma and squamous cell carcinoma.
Hand rejuvenation is booming. Techniques such as hyaluronic acid injections and lipofilling are increasingly in use. Ageing of the hands is characterized by thinning of the skin, melting of subcutaneous fat and muscular amyotrophy. The injection technique is very simple and provides immediate hand rejuvenation without any functional discomfort.
Intrinsic: Cellular decay, alteration of the extracellular framework, hormonal "menopause".
Extrinsic: Sun UV, Tobacco, Pollution
Carruthers scale:
0: No subcutaneous fat melting
1: Slight fat loss, early visibility of veins and tendons
2: Moderate fat melting, moderate visibility of veins and tendons
3: Severe fat melting, visibility of veins and tendons
4: Severe fat melting, high visibility of veins and tendons
Hand rejuvenation techniques:
Dr. David uses a hyaluronic acid specially designed for hand injections. Hayluronic acid is injected in the doctor's office during a consultation, under rigorous aseptic conditions. Results are immediate, and last 1 year on average. This rejuvenation technique is useful in stages 1 and 2, but cannot be used in stages 3 and 4. In advanced stages, only fat transfer or lipofilling can treat aging hands.
The injection of autologous fat (the patient's own fat) corresponds to the procedure known as "lipostructure" or "lipofilling".
Filling is definitive, but must be performed under general anesthesia in the operating room.
The only technique that can be used in the advanced stages of hand aging
The advantage of this technique is that you can use your own fat, but it has the disadvantage of having to be performed in the operating room.
Superficial: To treat skin lesions (lentigos, hyperkeratoses...).
Medium: trichloroacetic acid: For fine lines and superficial scars
Deep: Phenol: For deep wrinkles.