Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
From an experience of twenty-two cases the author believes these
conditions most amenable for correction by the injection of sterile oils
in preference to any other substance. Even white vaselin does not here
seem to answer the purpose, owing to its stimulating property of causing
the resultant growth of connective tissue.
While vaselin injected in the lids causes less of this new tissue to
be formed, such tissue is never of the consistency required. This is
especially true of the upper lids.
The oil injected, sterilized sperm oil being employed by the writer, is
prone to absorption of more or less degree, but the result is gratifying,
and lasts from six months to one year, leaving no untoward effect.
If the absorption has been sufficient to leave the parts as before the
operation, a subsequent injection of the same character may be undertaken
six months from the time of the first or even later, as the patient may
choose.
The tissue of the eyelid is prone to swell immediately the oil is
injected, and this swelling is entirely out of proportion to the
quantity introduced. This edema, due to a retardation by pressure of
the blood supply, is very misleading, the operator believing the parts
overinjected. A screw-drop syringe is therefore absolutely required.
A fine hypodermic needle is used, and after a few drops of the foreign
matter have been injected, the lid should be massaged gently with the tip
of the indicis, employing the circular movement.
The injection should be made at the outer end of the lid about one fourth
inch above or below the canthus for upper or lower lid respectively.
The needle, slightly dulled, should be long enough to reach the full
length of the part to be injected. Its course can be readily seen under
the thin, overlying skin.
As the injection progresses slowly and evenly the needle is withdrawn.
A second puncture or injection should not be made at one sitting; if the
parts are underinjected the operation is repeated as soon as the swelling
of the lid has subsided, which is about the end of the fourth or fifth
day.
The reaction, apart from the edema, is very little, although there may be
more or less discoloration of the parts, as the result of the obstruction
offered the blood vessels.
This is always an alarming symptom to the patient, but passes away
completely in the usual manner in several days.
The post-operative dressings may be collodion or silk protective.
Cold or hot applications, as may be best borne by the patient, can be
used; they tend to reduce the puffing and lessen the ecchymosis. The
patient should be instructed to lie with the head higher than usual for
the first two nights to retard the edema.
Public-domain text, read in full here on John Shaqi.
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