Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
The wound is then powdered with a suitable antiseptic powder and covered
with antiseptic adhesive silk plaster moistened with an antiseptic. The
form of the plaster should be of suitable shape, not too wide, and nicked
so as to permit of proper application.
There is more or less edema following the operation, associated with
or without discoloration, which disappears usually without treatment
in forty-eight hours. It is advisable to administer a saline laxative
each morning following the operation for several days. Small doses of
magnesium sulphate answer the purpose very well.
The sutures are withdrawn in from twenty-four to forty-eight hours
after having been carefully softened with warm boric-acid solution, or
a ten-per-cent peroxid-of-hydrogen aqueous solution. The early removal
of the sutures prevents stitch cicatrices. The part is again powdered as
before and covered with the adhesive silk plaster, which answers both
purposes of protection and splinting.
The resulting cicatrization is so surprisingly little as to be almost
invisible in the great majority of cases. In patients of blond complexion
the redness of the scar disappears as early as three weeks, but is more
prolonged in persons of darker type. It is not advisable to do both upper
and lower eyelids in one operation to avoid the discomfort of the edema
which usually follows.
In rare instances there appears a hypertrophy of the scar line, which is
best treated with strips of thiosinamin plaster mull, twenty per cent,
applied nightly and removed the next morning. If irritation results the
plasters should be discontinued for a day or two.
XANTHELASMA PALPEBRARUM
A yellow discoloration of irregular patchlike formation in the skin of
the lids, usually about the region of the inner canthus.
The condition may involve both upper and lower lids symmetrically. The
patches are generally slightly elevated and vary in size. They make their
appearance usually late in life, and are due to the infiltration of the
deeper layers of the skin with groups of cells overburdened with fat.
They are best removed by excision, following the method of the preceding
operation. There may or may not be a recurrence of the disease at an
indefinite period, when the tissue must again be removed.
_Remarks_
All of the above operations in blepharoplasty can be done under
local anesthesia, using either the two- or three-per-cent cocain or,
preferably, Beta-eucain solutions.
About ten minutes after each operation a sharp stinging sensation is
experienced in the eyelid operated upon, which lasts for almost an hour
or more, and indicates nothing alarming except the absorption of the
anesthetic and a return to the normal state. A sponge dipped into cold
sterile water relieves the parts considerably at the time.
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