Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
It will be found, then, that the two masses are made to meet at about the
center of the furrow, leaving a slight wall of tissue between them. This
wall has the virtue of preventing the falling down of the upper mass, at
the same time dividing the quantity of the injected mass into two, and
lessening the weight.
If the condition is bilateral both sides are operated on at the same
sitting. If subsequent injections are needed they are done three weeks
later, the punctures being made between the former first and second
punctures and the second and outer border of the furrow. In this way the
entire site is filled with a series of injections.
If the surgeon desires he may increase the number of these needle
punctures at the first sitting, making them nearer together in that event.
It will be found necessary in some cases to inject the cold mixture of
vaselin and paraffin into the furrow directly below the wing of the nose,
since the integument at that point requires a mass somewhat harder than
vaselin to force and hold it up.
The rest of the furrow must, however, be injected with vaselin alone, for
the reasons already given in parts that are movable.
The reaction is rarely very marked and subsides in about three days.
Gentle massage may be permitted above the site of injection to keep
the mass from crawling into the cheek. This is done by gently stroking
the skin from below upward toward the nose on a line an inch above the
original depression.
The dressings are the same as before mentioned, although collodion
painted over the needle openings is most serviceable after having sponged
off the sites with absorbent cotton dipped into absolute alcohol to
remove the vaselin that may have exuded from the openings during the
molding-out process.
=Oral-Angular Furrow.=—These furrows occur at the corners of the mouth,
running downward upon the anterior chin. Small as these defects appear,
they are found difficult of obliteration, for the reason that the tissues
are more or less under constant movement during the waking hours.
Repeated injections, each of small quantity, are necessary. Hard paraffin
is contra-indicated.
The injections are made from above the defect downward at right angles to
the defect.
It will be found difficult to keep the mass from being expelled on
account of the movement, there being more or less oozing from the
puncture, but if the openings can be controlled for at least twenty-four
hours this danger may be overcome to a great extent.
Ethyl chlorid may be sprayed over the part immediately the needle is
withdrawn to set the mass and followed with a drop of collodion. The
patient is advised to keep the mouth as immovable as possible for the
rest of the day.
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