It is advisable to inform the patients of this symptom beforehand to avoid unnecessary alarm on their part. Patients are easily frightened when cutting operations around the eye are undertaken, and should be apprised of what is to be done, and what to expect, especially when the operation has been done as a purely cosmetic one. After the sutures are removed the patient is instructed to allow the plasters to remain until they fall off, which occurs usually in about two days, unless there be reasons for dressings for discharges due to infection, the result of carelessness in operating. Should at any time, from carelessness or accident, the wound be torn open, the parts need only be brought together with adhesive silk plaster. Healing will go on, giving practically as good a result as with the suture. Bardeleben does not suture these wounds at all, yet the author believes it a safeguard and a psychological necessity in most cosmetic cases. CHAPTER X OTOPLASTY (_Surgery of the Ear_) This branch of surgery has to do with the corrective and restorative operations of and about the external ear. Traumatisms of the auricle, owing to the exposed position of that organ, are frequently met with and are commonly the result of stab wounds, direct blows, shot wounds, and human bites, especially in Spaniards and Italians, who follow this queer kind of revenge upon one another. Such wounds of the ear may involve only part of or the whole of the auricle. Loss of auricular substance may also be the results of gangrene following freezing or the direct result of burns. Fracture of the cartilage of the ear is exceedingly rare (Schwartze). Where the injury is one of incision or laceration without loss of the part, the site should be cleansed gently but thoroughly with a boric-acid solution, and the free torn edges brought together with fine silk sutures. If the cartilage projects unduly into the line of union it should be trimmed away with a fine pair of scissors (Roser). Wounds of such character usually heal well, even if the pieces hang loosely by threads of skin, a linear indent of cicatricial tissue usually marking the traumatic separation of the cartilage. In the negro where razor cuts about the ear are often seen, a hypertrophic scar or keloid is liable to result, even to the extent of involving the punctures of the suturing needle. It is advisable to save all that is left of the injured member, even if entirely severed, with the hope of obtaining union, since the rebuilding of even part of an ear is by no means an easy matter, owing to the complicated formation of the cartilaginous frame.