Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
Such wounds, when neatly sutured with No. 1 twisted silk, leave
surprisingly little scars; in fact, the cicatrices are rarely ever
detected a few days after healing has been established.
The treatment post-injectio for all furrow protheses should be as already
laid down.
Apart from general surgical cleanliness and an antiseptic powder, the
blepharoplastic operation mentioned required no special attention. The
sutures may be removed in forty-eight hours.
TEMPORAL MUSCULAR DEFICIENCY
_Unilateral and Bilateral_
This facial defect while possibly unilateral, as in hemiatrophy, is
generally met with in the bilateral form due to either hereditary causes
or a lack of nourishment of the parts, the latter usually involving the
greater part of the face. Chronic diseases and the cachexia dependent
upon disease may be the origin, in which the deformity is rarely ever
overcome entirely by internal treatment and massage of the parts; if
anything, massage tends to elongate the skin about the temples, causing
a worse disfigurement in the form of numerous fine furrows.
The correction of the defect under consideration may be readily overcome
by repeated and careful injections of a hydrocarbon of low melting point.
The author prefers the use of sterilized vaselin injected in its cold
state. The use of paraffin of high melting points or its compounds is not
advisable, and if employed leaves the temples uneven or lumpy, due to
the unequal organization or new tissue formation caused thereby, at the
same time causing sagging of the skin of the adjacent parts, particularly
the upper eyelids, owing to the added weight of the new tissue growth
occasioned by such preparations.
Contrary to general expectation, this part of the face is readily
injected and corrected.
The skin should be pinched up with the thumb and forefinger of the left
hand and the needle introduced with the right hand in such way as to
exclude the puncturing of blood vessels.
To assure the operator against such difficulty the needle may be
withdrawn after insertion, and if blood does not trickle from the wound
it may be reintroduced without pain to the patient and the injection
begun.
It is not advisable to correct the defect at one sitting. One third or
one half of the depressed area may be overcome by one injection. The
resultant tumefaction must then be thoroughly molded out, until little
seems to have been accomplished by the injection.
The operator trusts in these particular cases more to the development of
new connective tissue than in any other part of the face, except perhaps
in the correction of an interciliary furrow. It is surprising how much is
attained by the most conservative injections in and about the temples.
The molding of the injected mass must be done in a superio-posterior
direction to avoid forcing it into the upper eyelids, resulting in the
same overdevelopment previously referred to.
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