Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
It is in these very cases that the injections of cold sterile white
vaselin is indicated. After injection the mass may be evenly and
satisfactorily molded out, the mass being soft and readily pressed into
shape in the various cells of areolar tissue without leaving hard and
uneven lumps.
The movement of the lip is not then a source of danger in displacing
the mass, since the acute swelling of the lip tissue prevents its free
movement for several days, which gives the injected mass an opportunity
to establish itself and find its proper place.
Another advantage in using this preparation subcutaneously is that it is
less irritating than hard paraffin, permits freer movement, and creates a
better production of new connective tissue.
While a part of the mass may be absorbed during the replacement period
the lip retains its normal consistency, and if the desired contour has
not been attained a subsequent injection may be made in three weeks’ time
without interfering in any way with the former result.
The only precaution, aside from avoiding the injection of blood vessels,
is to keep the injection from the prolabium or vermilion border. The
latter tissue is very prone to fatty degeneration or to yellowish
discolorations when such a foreign mass has been introduced into or near
its structure.
There is no objection in injecting the lip, upper or lower, in several
places, as the cellular network about the mouth is sufficiently dense to
prevent the escape of the vaselin injected from the adjacent opening if
the distance is not less than a half inch between the punctures.
The injections may be made from above downward in the upper lip and, vice
versa, in the lower. They should be begun at the outer angle working
toward the median line.
The reaction following such an injection is usually more severe than in
any other tissue of the face, owing to the great number of fine blood
vessels, but the swelling is readily controlled in two or three days by
cold applications.
Aristol collodion dressings over each wound suffice to close the
punctures.
In the median variety of defect, where a cicatricial band separates
the lip into halves, it may be found necessary to do a subcutaneous
dissection before a suitable injection can be done, but in cases of
long standing the dividing wall is exceedingly thin and the threadlike
adhesions below are quite easily broken up by the force of the injection.
The later product of new connective tissue will tend to further improve
the contour.
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