Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
“In many spots the fibrous-tissue formation has proceeded to the point of
thick bands containing but few nucleated cells. Fig. 288_a_, which is a
photomicrograph of this portion of the section, shows these changes.
“In one of the foci of round-cell infiltration which have been surrounded
and invaded by bands of new fibrous tissue there are numerous giant cells
of the so-called ‘foreign-body’ type. This is shown in Fig. 288_b_.
[Illustration: FIG. 288_a_.—MICROPHOTOGRAPH SHOWING FIBROMATOSIS. × 40.]
[Illustration: FIG. 288_b_.—MICROPHOTOGRAPH SHOWING FIBROMATOSIS. × 40.]
“SUMMARY.—_Histological Diagnosis._—Diffuse fibromatories with fatty
infiltration and giant-cell formation in a vacuolated area produced by
paraffin injection.”
Once the hyperplasia is established the surgeon must simply wait until he
believes the activity of the abnormal growth has subsided and then remove
the superabundant tissue with the knife.
With another case, in which the patient was operated on by another
surgeon, the author was called upon to remove the growth. A part of the
coarse, yellowish pale and cartilagelike tissue was excised, sufficient
to restore the parts to a normal contour. After an uneventful recovery
the patient went away, greatly pleased, only to return in six months,
presenting a similar condition as before the extirpation.
A second operation was done, this time more extensively, the entire
yellowish connective tissue being removed by the aid of a long median
incision on the anterior aspect of the nose.
The wound healed readily and showed very little scar, and the patient was
discharged. One year after the last operation the nose was still normal
in appearance and the growth had not reappeared.
From this it is deemed absolutely necessary to remove practically all of
the newly formed tissue to warrant a nonrecurrence of the fibromatosis.
=21. A Yellow Appearance and Thickening of the Skin after Organization
of the Injected Mass Has Taken Place.=—This condition of the skin is
evidenced some time after the injected mass has become organized,
beginning about the sixth month after the time of injection. It has been
especially noticed with the hard paraffin fillings of the nose, but also
with other injections, even of the lowest melting points, about the
sternoclavicular regions of the neck.
The skin becomes at first streaked with a superficial and irregularly
defined patch of red, the forerunning indication of the size of the
ultimate pathological change. The red color subsides slowly, leaving the
area pale, which thereafter gradually thickens, taking on the appearance
of a light yellow stain in the skin.
Practically opposite to the condition in xanthalasma, where the yellow
area is slightly elevated and occurs in the loose tissue of the eyelids.
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