Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
It is with the use of paraffin, liquefied by heat and injected in this
state, that such fatal cases as have been placed on record have been
operated. The liquid mass under pressure forced into a soft pultaceous
mass cannot be easily controlled, if at all, and accidents here are of
more serious import than in any other part of the human anatomy, apart
from the direct injection of a facial artery of sufficient size to
produce an alarming embolism and death.
The author cannot speak too forcibly against such irrational procedure.
Other surgeons are beginning to realize the danger of the use of hard
paraffin injections near the eye.
The proper and safe method of improving the stump is to introduce into
it, under local eucain or cocain anesthesia, small masses of the mixture
of vaselin and paraffin in cold state. These injections into the stump
and mucous membrane should be done several weeks apart, always keeping a
respectful distance from the remains of the optic nerve.
The injections should be begun as near to the surface as possible without
breaking down the tissue by necrosis, keeping in mind that one or two of
such successfully introduced masses will do much toward supporting the
artificial eye.
If necessary the mucous membrane back of the palpebral rim can be
injected in like manner to give firmer hold to the eye and at the same
time give support to the usually depressed and atrophied lids.
Wet dressings are applied to allay the reactive inflammation, which
should be proportionate in severity to the amount of the mass injected.
In three cases operated upon by the author excellent results were
attained, and no untoward results had been experienced two years after
injection.
DEFORMITIES ABOUT THE CHIN
=Anterior and Lateral Deficiencies.=—An anterior lack of contour of the
chin is generally regarded as of the receding type. With this is usually
found a bilateral lack of form, especially in men. With a generally
well-formed face such a chin gives it a weak and ofttimes a degenerate
appearance. In women a deficient chin is not as noticeable, because of
the smallness of the face in general and the predomination of the oval
type.
The lack of prominence about the chin may be anterior only, the broadness
being sufficient, due to a lack of development of the mental process, or
it may be deficient laterally with a pronounced mental prominence, giving
it a sharp, protruding, or pointed appearance, or the lack of form is
combined, as is commonly the case.
Such chins may be made to appear normal, and even ideal, by the
subcutaneous injection method. The type of chin most favored by American
men is the square angular, now so plentifully seen in pen-and-ink
illustrations.
The tissue of the chin lends itself readily to the building-up process.
Almost any form may be attained by the judicious employment of the method
under consideration.
[Illustration: FIG. 302. FIG. 303.
PROFILE VIEW, SHOWING CORRECTION OF ANTERO-LATERAL DEFICIENCY ABOUT
CHIN.]
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