Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
However, it is possible to have such redness develop weeks or months
after the injections are made. In such cases it is not due to the primary
pressure of the injection, but to that of the newly developed tissue
which has taken its place, but which is slightly overdeveloped for the
same unaccountable reason already referred to.
Almost every surgeon who has used this method of restoring the contour of
parts of the face has observed redness, more or less permanent, follow
the method used, but in most cases liquid paraffin of high melting points
had been forced into the tissues at great pressure.
In one case, that of a southern operator, the entire tip of the nose had
become injected by primary diffusion or direct filling.
It became inflamed immediately after, and some weeks later, when the
swelling had subsided, the lobule was found to be very hard, tense, and
extremely red. Two years after the author saw this case, and the tip
of the nose still appeared like a red cherry with numerous capillaries
showing over its area, while the rest of the nose, although much
broadened by secondary displacement of the paraffin, was natural in color.
This proves that as the pressure was relieved by absorption and
displacement, the tissue took on a normal appearance, whereas in the
lobule of the nose, where there was no relief from the pressure, nature
could do nothing to relieve the inevitable result.
In cases where the redness is suspected it may not be too late, a day or
two after the injection, to remold the mass into such form as to relieve
the acute tension.
If the redness develops early, cold applications of an antiseptic nature
or ice cloths can be used to advantage. Antiphlogistin or other similar
preparations applied externally give good results.
Later ichthyol, twenty-five-per-cent solution, may be applied; acetate
of alumen in saturated solution seems to do well. Some operators
apply hydrogen peroxid, but it gives only temporary benefit. When the
capillaries have become distended and the redness is practically chronic
the vessels should be destroyed with a fine electric needle, using about
20 milliampères—direct current.
Sometimes when the redness is acute and seems to persist depletion of
the part does some good. This is done by nicking the skin here and there
with a fine bistoury and allowing the part to bleed freely. Care should
be taken not to puncture the skin too deeply, so as not to allow the
injected mass to escape.
In some cases it is allowable to open the filled cavity early and remove
enough of the filling to overcome the difficulty, injecting later, after
the filling has become organized, to make up the deficiency.
When the redness is secondary—that is, when it develops after the
connective tissue has replaced the paraffin—it is best to open up the
part and excise enough of the tissue to overcome the pressure.
Public-domain text, read in full here on John Shaqi.
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