Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
Comstock, with his experiences of injections of paraffins at high melting
points, found that the harder paraffins do not become encysted, but
become a part of the new tissue, which belief is corroborated by Downie,
who introduced paraffin into a carcinomatous breast. Upon subsequent
amputation and microscopic examination there was shown an intimate
connection between the ramified site of the injection and the surrounding
tissue. The same results have been noted by Jukuff.
Smith found that, in trying to remove an injected mass of paraffin
several months after introduction, the greater part of the mass had
become so thoroughly imbedded in the meshes of the newly formed
connective tissue that it was practically impossible to remove it without
including a considerable portion of the connective tissue as well.
Stein claims also that the paraffin is absorbed, little by little, as
it is replaced by the new connective tissue, no matter what the melting
point of the introduced paraffin might have been. The mass grows smaller
to a degree, according to the amount injected; finally, at the end of
a month or more, the entire mass is replaced by a tissue perceptibly
analogous to cartilage.
Freeman, like Eckstein, claims that encystment of the paraffin occurs
soon after the injection, much like that following a bullet or other
foreign body in the tissues, but, unlike the latter author, that a
limited amount of the connective tissue also penetrates the mass, which
is speedily converted into a solid cartilagelike body.
Wendel believes entirely in the encystment theory, while Hertel, in
specimens removed twelve to fifteen months after injection of paraffin
with a melting point of 100° F., found a wall of round cells under
various states of inflammation surrounding the masses with fibers of
connective tissue traversing the latter. In the various histological
findings he argues that the greater the tissue surface exposed to the
injected foreign body the greater the irritation, and the larger the
smooth paraffin mass the less the reaction; in other words, small masses
of the injected mass cause a higher rate of tissue formation, while the
larger masses have a tendency to encystment merely. He also believes that
the harder paraffins require a greater length of time to become absorbed,
and that during such time of resorption new connective-tissue growth is
established, continuing to the time of its complete disappearance.
Comstock, after thorough and extensive investigation with the injection
of paraffins of various melting points made at varying times after the
injection of such procedures, concludes definitely that, “In paraffin we
have a substance that will fill in spaces of lost tissue, and not remain
entirely a capsulated foreign body, but become a bridgework, and, in
fact, a part of the new tissue.”
Public-domain text, read in full here on John Shaqi.
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