Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
A short stout needle should be employed, the puncture being preferably
made under ethyl-chlorid anesthesia, as the pressure necessary to raise
the tissue causes considerable pain.
To further facilitate the injection the operator should raise the skin
with the needle introduced subcutaneously.
Only one injection of small amount (10 to 15 drops) should be done at
a sitting. The injected mass, unless too easily introduced, and thus
forming a tumefaction, need not be molded out, since the pressure of
the skin overlying it will accomplish it more satisfactorily, while the
pressure required in molding tends only to press out more or less of the
mass, thus lessening the benefit of the operation.
A second sitting must be undertaken in not less than one week, or even
later, if a subcutaneous dissection has been done.
The secondary treatment should be followed as heretofore described.
The reaction, for even a small injection in these cases, is usually
considerable.
INTERCILIARY FURROW
This deformity is usually spoken of as a frown. It may be said to be
congenital, when it appears in early life, but is commonly acquired
through the habit of frowning.
The furrow may be a simple linear one or made up of a number of furrows.
The author has been called upon to correct one made up of six distinct
furrows.
The furrows or creases radiate upward and outward, conelike from a point
beginning at the root of the nose.
In the correction of this common deformity the operator is tempted to
overdo the fault by hyperinjection. A single furrow is readily corrected
by a few drops of the injection, which should be neatly smoothed out.
A little of the mass at this part of the face seems to accomplish
considerable; in fact, the part seems overcorrected for some time after
a judicious and carefully done operation, which is undoubtedly due to
the active reaction that follows such cosmetic procedure, owing to the
close proximity of the frontal veins and those of the venous arch at the
root of the nose, which undergo more or less phlebitis of a mild type,
the resultant edema depending upon the pressure caused by the mass on
these vessels. The intimate relation and anastomoses of the latter is
clearly shown in the carefully prepared dissection represented in the
frontispiece.
In injecting, the needle should be introduced at a point directly at the
root of the furrow or furrows—that is, at the junction of the forehead
with the nose.
A needle one inch long should be used, taking care not to puncture any
of the veins which are found to be very differently placed in various
patients. If blood flows from the needle puncture, no injection should
be made at that point, but another be chosen which does not give such
result, preferably at a later sitting.
The needle should be introduced well upward under the skin so that its
point corresponds to the point of greatest depression.
Public-domain text, read in full here on John Shaqi.
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