Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
While the numerous white spots so caused are objectionable, they are
better borne by patients than the pigmented appearance. A thorough
needling of the spot in this way eventually brings about an improvement,
and if, for æsthetic reasons, the patient objects to the unsightliness of
the result thus obtained, the white area may be carefully tattooed with
an appropriate color to match the rest of the skin of the face or neck.
If the pigmented area is not too large, it can be excised with the knife
and the healthy skin be brought together with a fine silk suture, thus
leaving a thin linear scar which can be dealt with as the punctate scar
area, if desired; the electrolysis being a painful procedure at all
times, since sufficient milliampères must be used to cause scar-tissue
formation, which is between 20 to 30 milliampères in such cases.
=22. The Breaking Down of Tissue and Resultant Abscess Due to the
Pressure of the Injected Mass upon the Adjacent Tissue after the
Injection Has Become Organized.=—The above result is particularly
noticeable when the injections have been made into the cheek or the
breast. It is understood that the suppurative changes under consideration
herein are not attributable to imperfect sterilization of the injected
matter, although it is possible, and perhaps is the cause in fifty per
cent of the suppurative elimination of the infected mass from the cheek,
that a nucleus of infection is carried into the tissues and is held in
suspense for a time, because of its imbedment in a neutral media that
does not readily permit of bacteriological propagation, but eventually
this nucleus must come in contact with tissue which it can affect, and
only then may its infection be taken up.
The author believes that such secondary affections are accountable to
pressure effects upon the blood vessels or glandular structure, as in the
case of breast injections, the new connective tissue causing a lack of
nourishment in the part or gland, and a resultant breaking down of the
tissue, directly influenced in some instances by external violence.
Tuffier reports the elimination of paraffin injected into the breast
several weeks after the injection. If this elimination had been caused
by primary infection an acute reaction would have taken place at least
within forty-eight hours, ending in abscess shortly after.
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