Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
=Nasolabial Furrows= _(Unilateral and Bilateral)_.—This condition in the
bilateral form is exceedingly common in adults beyond middle age. It is
also found in those individuals suffering from inanition, due to whatever
cause. The unilateral form is found principally in patients suffering
from semifacial paralysis in which the tissue lacking the proper neurotic
supply droops or sags down, causing a deep furrow to appear from the
attachment of the alæ to the angle of the mouth, associated more or less
by a flattening of the cheek contour of that side of the face.
The method of correction advocated by the author varies entirely from the
technic advanced by other surgeons.
The usual method has been to introduce the needle of the syringe at the
outer or lower extremity of the furrow and from one of such punctures to
inject the whole line of depression.
While this seems right theoretically the method does not give the desired
result. Owing to the free movement of the upper lip the mass, at first
neatly restoring the contour, is crowded upward into the inferior malar
region and very often downward toward the angle of the mouth, where it
settles in a hard lump which is not only obnoxious to the sight but
interferes with the proper use of the parts concerned in mastication
and vocalization. Invariably the operator is called upon to remove the
disfigurement.
It can be readily understood that hard paraffin itself, in such case,
would prove more objectionable than a softer mass which, upon early
discovery, could be molded or massaged into better position, while
nothing less than excision would prove efficacious with paraffin.
As with the lip, then, the author advocates the use of either the cold
mixture of paraffin, as heretofore described, or the cold white vaselin
according to the operator’s opinion in overcoming the extent of the
fault. For all ordinary cases white vaselin alone is necessary.
The technic of injection as used by the author is as follows: In the
ordinary case when the furrow is not too pronounced one sitting only
is required. Two needle punctures are made above the upper line of the
defect, the first being made about one half inch from the wing of the
nose and the other about one inch outward and downward.
The needle is pushed downward under the skin until its opening
corresponds to the median line or deepest part of the furrow. Enough cold
white vaselin is injected to bring the depressed area slightly above
the plane of the skin of the upper lip. The second puncture is made
perpendicular to the first and the injection made in the same manner.
With the tip of the indicis over the first needle opening the mass is
molded out evenly by a gentle rocking or rubbing movement. The same is
done with the second mass.
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