Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
Freeman and the author add to this by advocating the use of a somewhat
blunt-pointed needle instead of the extremely sharply pointed knife-edged
needles usually furnished with syringes intended for this purpose.
=11. Primary Diffusion or Extension of Paraffin.=—The spreading of
paraffin into normal tissues about the site to be corrected by prothetic
injection is a fault due principally to a careless use of the syringe.
The employments of an improper syringe in which the amount to be injected
cannot be graduated or controlled will be considered later—the result
with such being hyperinjection. In this event, when the anterior line
of the nose is to be restored, the mass is liable to find its way into
the loose areolar tissue of the infra-orbital region; in correcting
a nasolabial furrow the mass is pushed upward or is forced into the
tissue of the cheek above it, aggravating the trouble; in obliterating a
frown it travels upward toward the margin of the scalp, giving a median
prominence to the forehead that is found to be very difficult to correct;
in injections about the mouth the mass moves down upon the chin or
accumulates at the angle of the jaw; in correcting the creases beneath
the chin it seeks the sides of the neck, even traveling to the superior
border of the clavicle at its sternal third. Many other forms of such
diffusions can be mentioned directly due to primary diffusion the result
of hyperinjection.
Enough has been said of the danger of hyperinjection, yet even with a
proper amount of the injected mass this distention may be observed. To
avoid this the operator, or his assistant, should compress the margins
of the site of the injection with his fingers firmly applied, as, for
instance, in the injection of the root of the nose pressure should be
made at both inner canthi and over the tissue just above the root of the
nose and beneath the finger tips.
Downie advocates the use of celloidin in the correction of a saddle nose
as follows: He paints a band of celloidin or collodion down each side of
the nose, limited by the line of junction with the cheeks, and another
band across the root of the nose. These painted on bands he allows to
dry and contract for fifteen minutes before undertaking the injection.
The contraction of these bands prevents to a certain extent the spreading
or extension of the liquid paraffin into the cellular tissue about the
eyes, yet experienced digital pressure is at all times to be preferred.
Public-domain text, read in full here on John Shaqi.
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