Plastic and cosmetic surgery

by Frederick Strange Kolle

INDICATIONS

The indications for the protheses of either method are the same, except where the author advocates the use of either one or the other or a combination of the two from an experience with over five hundred personally conducted cases.

The advantages of the Gersuny method is that the operation is practically painless, causes no scar if properly performed, and corrects a deformity that could not be overcome otherwise in some cases, while in others it would entail not only difficult surgical interferences, but subsequently unsightly cicatrices that would render them more objectional than the very defects which were intended to be corrected.

This is particularly true in the cosmetic correction of depressions about the forehead resulting from direct violence or frontal sinus operations, for obliterating habit furrows, or frowns, between the eyebrows; also to restore the symmetry of the face in hollows of the cheek due to the removal of malignant growths, the maxillæ, or when caused by facial hemiatrophy or a congenital or long-acquired sinking in of the cheeks; while it may also be employed with excellent result to prevent post-operative adhesions about the face after mastoid operations and even to restore the form of the breast after operation for malignant disease and the raising of smallpox pits.

Numerous other uses may be mentioned, such as elevating an undue depression at the root of the nose, raising sunken furrows below the eyes, obliterating nasolabial folds, angular droops about the chin, rebuilding weak or pronounced oval or peaked chins, filling hollows about the neck and shoulders, and in fact anywhere about the body to restore the contour.

In correcting the deformities of the nose, whether congenital or acquired, this method has met an urgent and most useful demand, so much so that many rhinoplastic operations of extensive delicacy have been thrown aside for this simpler, rapid, and gratifying means of surgery.

Not only has it been employed to restore the nasal line in saddle noses, but also in many other deformities of that organ which do not require the removal of superabundant tissue.

According to the appended classification of nasal deformities, given by Roe, it will be seen that many faults of that organ may be overcome by the method.

Deformities of the nose	{ Bony Portion	{ Vertical	{ Concave.
			{ Convex.
		{ Lateral	{ Spatulated.
			{ Defected.
	{ Cartilaginous Portion	{ Tip	{ Excessive or Deficient Tissue.
			{ Deviation from Median Line.
		{ Wings	{ Collapsed.
			{ Expanded.

From the above arrangement, and taking each division separately, the author enumerates the applicability of the subcutaneous prothesis, adding such as are not included in the above.