The operator may substitute the gown with a rubber apron of the Triffe pattern, reaching as high as the collar, but continuous washing quickly ruins them. See Fig. 11. [Illustration: FIG. 10.—VON BERGMAN OPERATING GOWN.] [Illustration: FIG. 11.—TRIFFE RUBBER APRON.] PREPARING THE PATIENT GENERAL PREPARATION The patient for all plastic operations should be carefully examined as to general health and past history. His healing powers should be at their best, as much depends on primary union. If he presents a syphilitic history, it is well to place him under treatment, for a time, at least, before an operation is undertaken. The bowels should be regular. Sulphate of magnesium should be given each morning, before breakfast, for at least two days prior to operating, while his general condition may be improved by the employment of bitter and alterative tonics. Nux vomica with tinct. cinchonæ com., associated with essence of pepsin aromat., or lactopeptone, are very useful. This treatment is also carried on for several days, _post operatio_. The success of an operation depends, first, upon the selection of the case; second, the selection of the method employed, and, third, upon the hygiene under which the patient undergoes convalescence. The patient must be given to understand, in many cases, that it is often necessary to reoperate, even to the extent of seven or eight operations, to bring about the desired result. The first result obtained with many cosmetic operations is not at all gratifying to the patient, and unless this is explained to him beforehand he may become discouraged awaiting the next operation and disappear, thus losing the opportunity of being pleased finally, while the surgeon is misunderstood and underestimated by narrow-minded judges and the ever-willing friendly advisers and critics—a consummation much to be avoided. PREPARATION OF THE OPERATIVE FIELD The part to be operated upon should first be closely shaven. The oily secretions of the area are next rubbed off with an absorbent cotton sponge saturated with alcohol or ether. Next, the skin is washed with hot water and soap or three-per-cent synol suds, then rinsed, and finally rendered aseptic with a bichlorid solution. If the operation is to be done about the face a rubber cap is so adjusted as to cover the hair. If this is not obtainable sterilized bandages can be employed. In operations about mucous membranes, as in the nose and mouth, the parts must be cleaned at short intervals with a solution of permanganate of potash or boric acid. The teeth must be cleansed with antiseptic soap, tartar is scraped off, and the mouth rinsed with a proper disinfectant. The corrosive sublimate, or carbolated solutions, owing to their toxic qualities, cannot be used. The preparation of wounds for reoperation, or where an operation is secondary to injury, is referred to later.