Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
This dissection is advocated and can be readily done from one of the
nostrils at a point just beyond the union of skin and mucous membrane.
The dissection under such method can be made more thoroughly than when
done exteriorly, for the reason that the entire field is laid open to
a free use of the scalpel, leaving no visible cicatrix externally. The
dissection may be followed by the immediate injection of the mixture of
paraffin and vaselin, as already referred to, used cold, or the area is
injected with normal salt solution until the intranasal wound has healed,
which usually takes place in about five days. The mucous membrane in
such instance may be neatly but not too tightly sutured with No. 1 silk.
If the operator deems it advisable he may inject the salt solution again
on the third day to prevent the formation of such adhesions as may
interfere with the ultimate hydrocarbon injection. This is rarely found
necessary.
If the post-operative inflammation prove mild, then the adhesions will
not be as tenacious, in which case the surgeon may wait until even the
seventh or eighth day before injecting the paraffin compound, to be sure
of not forcing the intranasal wound apart under the pressure of the mass
injected.
Never should so large a quantity of the mass be injected as to cause
blanching of the narrow strip of skin. This is sure to result in gangrene
of some, if not all, of the skin of the subseptum—a result much to be
regretted, since subsequent correction of the deformity increased by the
contraction of the dermal cicatrix is rendered well-nigh impossible by
reason of this very tissue.
Hard paraffin injected in its molten state is never borne in this part
of the human economy. It is usually thrown off after a few days of very
painful and highly inflammatory symptoms, undoubtedly explained by the
fact that the circulation of the subseptum is principally dependent upon
the delicate branches of the two small septal arteries of the superior
coronary and a hard, ungiving mass would readily cause their obliteration.
DEFORMITIES ABOUT THE MOUTH
=Labial Deficiency= _(Upper and Lower Lip)_.—There are a number of causes
creating deficiencies about the labial orifice. The same causes apply
naturally to both lips, whether the defect be unilateral, bilateral,
or median. Some of these deformities are more often met with than
others, as, for instance, a median deficiency of the upper lip following
cicatricial contraction due to a harelip operation done early in life;
in elderly patients a partial paralysis is found to affect one half
the upper and sometimes a part of the lower lip, giving to the mouth a
drooped and grinning appearance.
Other causes are dental defects, abnormalities of the alveolar processes,
traumatism, and disease.
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