Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
With the model in hand and no expert on protheses within reach, a
skillful surgeon-dentist could easily make a vulcanized rubber nose,
which may then be painted to suit.
Some method of attachment must be provided for, such as one or two soft
rubber plugs or stems to fit into the nasal orifice or permanent fixture
to the bridge of a pair of spectacles. Gums or pastes as advised with
aural protheses may be of service.
Celluloid protheses should never be used because of their inflammable
nature; furthermore, they are easily damaged or cracked. Wax noses are
of little use, although resembling the normal very closely; they crack
easily, and when soiled by dust or friction soon have to be replaced with
new ones.
The following list of authorities shows the various materials employed by
them for nasal protheses:
_Martin_—Porcelain.
_Richter_—Wood.
_Debout_—Rubber or silver covered with colored wax.
_Mathieu_—Aluminum.
_Charrière_—Silver.
NASAL REPLANTING
The plastic surgeon is often, especially in later years, called upon to
attend to traumatic injuries of the nose. Sometimes there is a total
severance of the nose; often a partial loss or injury, practically
involving a loss of a part of the organ. Since the advent of the
automobile such accidents are not unusual.
The author has found that a remarkable history lies back of the
replanting of parts or all of the nose when found detached by accident or
intent.
If the part cut from the nose or face has been not too severely bruised,
it should be cleansed gently in a normal salt solution at about 100° F.,
and be sutured in place as quickly as possible. Partly separated sections
should be treated in the same way. It is remarkable how Nature will take
care of these traumatisms. So well did the executioners in India, where
nasal amputation is a criminal sentence, know this that they destroyed
the amputated organ by fire, so that the victim could not replant it upon
himself.
Chelius successfully replanted a nose after it had been severed about an
hour.
Hoffacker has replanted a number of noses cut off in the duels of
Heidelburg students. In one case one and a half hours intervened between
the accident and the operation.
In partial separations about the nose the flap, still hanging by a
slight pedicle, should be brought in place by suture, and because of the
peculiar hypertrophy that always follows the wounds one or two intraflap
sutures should be employed to fix the part centrally to the deeper
tissues, if any, to prevent the formation of clots that are liable to
organize and encourage such enlargement.
Such sutures are only to be made when the flap is of sufficient size to
necessitate them. If the hypertrophy or hyperplasia cannot be prevented
by this means later cosmetic operations should be employed to make the
parts heal into normal contour.
Public-domain text, read in full here on John Shaqi.
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