The review of 42 cases of upper blepharoplasties operated since 2020 has confirmed the validity of our technique of significant resection of skin in the upper eyelid, leaving 10 to 12mm of skin above the eyelashes, and remaining approximately 8 to 10mm above the eyebrow line; we named the design of this surgery under the name of an Italian elegant sports car, because of the particular curves of this car in the rear part, which rises a little upwards, like the external segments of the skin resection that we recommend in the practice of an upper blepharoplasty; a hindsight of almost 35 years showed that this procedure had great value due to the durability of the result; nevertheless it is appropriate to discuss this surgical orientation in a context where Asian surgeons rather recommend short scars and a much lower situation than that which we practice in our European patients.

The teenager is more and more in search of cosmetic surgery. The current societal mode favors this evolution. There are, however, a variety of demands, from disabling major disgrace, through the desire for aesthetic consumption, to unjustified demand in the patient with dysmorphophobia. Information and consent of the patient and parents are mandatory. Cosmetic surgery is legally possible in minors but while it is possible for other therapeutic decisions, there is no anticipated medical majority for cosmetic surgery. Parental consent remains mandatory. The surgeon must also agree to perform this act, but he must take into account the maturity of the minor patient before giving his consent to the requested surgical act.

Esthetic and functional surgeries in the periocular region fall into the domain of oculoplastic, or plastic and reconstructive surgery and otorhinolaryngology. Oculoplasty is the largest surgical spectrum in ophthalmology including eyelids, orbits and the lacrimal system. Our purpose was to study the frequency of eyelid, lacrimal and orbital (oculoplastic) surgery at the CHU IOTA.
METHODS: Retrospective medical chart review of all the patients who underwent oculoplastic surgery was conducted from October 2015 to September 2016.
RESULTS: A total of 233 patients were included with 52% female and 48% male. Patients were 37 years old on average. In total, the surgery was performed on the eyelids in83 cases (35.6%), the orbits in 113 cases (48.5%) and the lachrymal system in 37 cases (15.9%).Eyelid surgery commonly resulted from eye trauma (43,3%), followed by malpositions (30,2%). Mutilating surgery accounted for 92% of the orbital surgery. External dacryocystorhinostomy was the main lacrimal surgery (42%) followed by canalicular lacerations 25%.
CONCLUSIONS: Oculoplasticsurgeryoccupies an important place in the surgical activities of the ophthalmologic University hospital despite a larger volume for cataractsurgery. Our studydoesn\'t highlight the outcome of the surgery itself but the epidemiology to help decision makers in their eye health policy including the reduction of mutilating surgery and oculoplastic training.
La chirurgie esthétique et fonctionnelle de la région périoculaire est du domaine de l\'oculoplastie, ainsi que de la chirurgie plastique et reconstructive et de l\'otorhinolaryngologie. L\'oculoplastie constitue le plus large éventail chirurgical en ophtalmologie regroupant la paupière, l\'orbite et le système lacrymal.
OBJECTIVE: Etudier la fréquence des procédures chirurgicales orbito-palpébrales et lacrymales (oculoplasties) dans un centre de troisième référence.
UNASSIGNED: Il s\'agissait d\'une étude rétrospective des dossiers de patients opérés pour pathologies oculoplastiques d\'octobre 2015 à septembre 2016.
UNASSIGNED: Au total 233 patients ont été inclus dont 52% de sexe féminin et 48% de sexe masculin avec un âge moyen de 37 ans ; parmi lesquels 83 cas (35,6%) de chirurgie palpébrale, 113 cas (48,5%) de chirurgie orbitaire et 37 cas (15,9%) chirurgie lacrymale.La chirurgie palpébrale était dominée parréparationdesplaies traumatiques (43,3%), suivi des malpositions (30,2%). La chirurgie mutilante constituait 92% de la chirurgie orbitaire. La dacryocystorhinostomie par voie externe était la principale chirurgie lacrymale soit 42%, suivie des lacérations canaliculaires 25%.
CONCLUSIONS: Notre étude ne met pas en exergue le résultat de la chirurgie elle-même, mais l\'épidémiologie du traitement chirurgical afin d\'aider les décideurs dans leur politique de santé oculaire notamment sur la réduction de la chirurgie mutilante et la formation oculoplastique.

OBJECTIVE: Fournir aux chirurgiens et autres fournisseurs de soins canadiens qui réalisent des interventions chirurgicales ou thérapeutiques esthétiques génitales féminines, et tout praticien demandeur, des directives fondées sur des données probantes en réponse à l\'augmentation des demandes et de la disponibilité des interventions chirurgicales et thérapeutiques vaginales et vulvaires sortant du cadre traditionnel de la reconstruction avec indication médicale.
UNASSIGNED: Les femmes de tous âges qui consultent pour subir une intervention chirurgicale ou thérapeutique esthétique génitale. BéNéFICES, RISQUES ET COûTS: Les professionnels de la santé qui prodiguent des soins aux femmes jouent un rôle important en renseignant les femmes sur leur anatomie et en les aidant à prendre conscience des variations individuelles. La plupart des femmes qui demandent une intervention chirurgicale ou thérapeutique esthétique génitale féminine ont des organes génitaux normaux, et jusqu\'à 87 % d\'entre elles sont rassurées par des conseils. À l\'heure actuelle, étant donné le manque de données probantes cliniques et scientifiques rigoureuses sur l\'efficacité et l\'innocuité à court et à long terme, il n\'y a aucune base pour se prononcer en faveur des interventions chirurgicales ou thérapeutiques esthétiques génitales féminines sans indication médicale. Les interventions chirurgicales ou thérapeutiques esthétiques génitales féminines sont généralement réalisées dans le secteur privé, où les coûts sont assumés par la patiente. DONNéES PROBANTES: La littérature publiée a été rassemblée par des recherches dans les bases de données Medline, Scopus et Cochrane Library au moyen de termes et mots clés pertinents et validés. Les termes de recherche sélectionnés se composaient de mots clés sur les interventions chirurgicales ou thérapeutiques esthétiques génitales féminines (labiaplasty, surgery, vaginal laser therapy, laser vaginal tightening, vaginal laser, vaginal rejuvenation, vaginal relaxation syndrome, hymenoplasty, vaginal cosmetic procedures) combinés à female genital counselling, consent, satisfaction, follow-up, adolescent et body dysmorphic or body dysmorphia. La recherche a été limitée aux articles publiés après 2012 afin de mettre à jour la documentation depuis la dernière directive à ce sujet. Les résultats ont été restreints aux revues systématiques, aux essais cliniques randomisés et aux études observationnelles. Les études ont été limitées à celles menées chez l\'humain seulement, et aucune restriction linguistique n\'a été appliquée. La recherche a été effectuée le 20 mai 2020 et mise à jour le 10 novembre 2020. MéTHODES DE VALIDATION: Les auteures ont évalué la qualité des données probantes et la force des recommandations en utilisant le cadre méthodologique d\'évaluation, de développement et d\'évaluation (GRADE). Voir l\'annexe A en ligne (tableau A1 pour les définitions et tableau A2 pour l\'interprétation des recommandations fortes et faibles). PROFESSIONNELS CONCERNéS: Gynécologues, fournisseurs de soins primaires, chirurgiens réalisant des interventions chirurgicales et/ou thérapeutiques esthétiques génitales féminines. RECOMMANDATIONS.

BACKGROUND: Requests for cosmetic eyelid surgery are frequent. The surgeon must carry out a complete clinical examination in order to rule out any orbital pathologies responsible for eyelid pockets.
METHODS: Study of ten patients who have consulted in the oculopalpebral surgery department of La Fondation Ophtalmologique de Rothschild for cosmetic surgery of the eyelid pockets and in whom an underlying pathology was diagnosed.
RESULTS: The clinical examination allows to look for signs of alarms, such as medical history, unilateral involvement, pain and the presence of exophthalmos. These should lead to perform orbital imaging and surgical biopsy if an orbital mass has been identified for histological analysis which will make the diagnosis. We identified four cases of orbital lymphoma, one foreign body granuloma, chronic bilateral dacryoadenitis, sarcoidosis involvement, AAPOX syndrom, cavernous hemangioma, and simple fatty hernia.
CONCLUSIONS: These cases shows the importance of not ignoring an underlying orbital pathology before proposing cosmetic surgery for eyelid pockets.

Dealing with Acute Complications of Aesthetic Surgery Procedures Performed Abroad: Cost Analysis for the Swiss Health System Abstract. Aesthetic surgery tourism is a growing phenomenon, with a steady increase of people travelling abroad for surgical procedures. In our hospital, a relevant number of patients consulted the emergency department for complications after cosmetic surgery performed in foreign countries. This progressively increasing trend leads to multiple outpatient clinic consultations and surgical re-operations. We investigated this phenomenon at Lausanne University Hospital from May 2015 to December 2018, with the aim to give a review of the surgical and hospital care costs, finally affecting the Swiss insurance system.
Résumé. Le tourisme médical pour la chirurgie esthétique est un phénomène en pleine croissance. Dans notre unité, nous avons remarqué une augmentation constante du nombre de patients consultant pour des complications dans les suites de procédures esthétiques faites à l’étranger. Cela mène à de nombreuses consultations ambulatoires, éventuellement à des réopérations ainsi qu’à des hospitalisations. Le but de cette étude est d’étudier les complications et leurs coûts pour les patients ayant consulté de mai 2015 à décembre 2018 dans notre hôpital.

In the course of treatment of cleft lip and palates, the quality of primary cheilo-rhinoplasty is essential to limit aesthetic and functional complications. This is why these primary reconstructions come under the domain of specialised centres with multidisciplinary teams. Unfortunately, residual imperfections often remain, especially in bilateral clefts, and secondary cheiloplasties represent for us a complex challenge. They aim at functional and aesthetic correction, and the choice of time is very random and depends largely on the psychological repercussions of the deformation in the child. It often occurs at the age of school entry and is combined with alveoloplasty. We then speak of alveolar transplantation with vestibulo and labio-plastie, the GPVP. Then we propose to combine all the resources of cosmetic surgery to improve the aesthetic and functional result of these children.

Born at the late 19th century, Suzanne Noël achieved, despite prejudices, to become at the same time the first female cosmetic surgeon and an influential feminist activist. Trained as a dermatologist by Professor Brocq, she first became fascinated by rejuvenation surgery during her studies by meeting Sarah Bernardh, who had undergone a facelift in the United States. As a surgeon, she mainly performed procedures under local anaesthesia in her salon, where she maintains worldly relations with her women clients. As an activist, she founded feminist clubs all over the world since 1923, under the aegis of a still flourishing organization: \"Soroptimist International\", which provided assistance in the field to women in need. She successively lost her first husband, then her single daughter and her second husband to be 46 years old, widowed, indebted and without any medical license. Their personal difficulties are not foreign to what she advocates: the women\'s emancipation by achieving economic independence. Suzanne Noel\'s journey is a singular paradox on the relationship between the earliest days of cosmetic surgery and feminist ideology. She structured the controversy within the various thinking movements at that time: does embellishing a woman serve her cause? Provocative but necessary question for thinking the surgical act. Suzanne Noël, as a liberal feminist, however, supported the idea that cosmetic surgery could be a transitional solution to integrate a working environment in which there was significant discrimination in women\'s employment.

Legends and myths regarding eternal youth exist since Antiquity. Prior to the 19th century those wishing to rejuvenate used baths or blood injections, searching to the Fountain of Youth or calling for an alchemist claiming to have found the Elixir of Youth. In the 19th century, Charles Edouard Brown Séquard (1819-1894), after the discovery of the function of the endocrinal glands and testicular secretions, inject himself with an extract from guinea pigs and dogs. He found himself rejuvenated! In the beginning of the 20th century, several surgeons transplanted human testicles coming from death row prisoners inmates or voluntary donors. The transplantation of monkey testicles by Serge Voronoff (1866-1951) had a important aftermath and more than 300 similar interventions took place. The simple ligation of the vas deferens (vasectomy) was recommended by Eugen Steinach (1866-1944). Sigmund Freud was one of the \"beneficiaries\". Steinach also advised the irradiation of the ovaries for female rejuvenation. In 1935, Alexis Carrel (1873-1944) and Charles Lindbergh (1902-1974) built a pump to feed and regenerate targeted organs. The discovery of pluripotent stem cells and senolytic molecules are building up new hopes on the matter.

There has been a growing number of patients asking for a lighter face lift than the classical biplane procedure with wide undermining; This explains the popularity of medical threads lifts. A surgical approach is nevertheless possible by performing a new technique, derived from minilfts, but with a dissection elevating skin and SMAS layers together, preserving as much retaining ligaments as possible, and allowing a predesigned skin excision. Thirty-two patients have been operated this way since 2014; 3 asked and sustained for a redo because of skin relapse at one year postoperatively. Few complications have occurred, mostly limited hematomas, or skin problems because of suture threads rejection. The best indications seemed to be young patients presenting a jowl ptosis or cervical skin laxity, and patients who require a secondary facelift as a lighter procedure.