Plastic and cosmetic surgery

by Frederick Strange Kolle

In these ten subdivisions much can be done to bring about a normal appearance of the nose.

PRECAUTIONS

In selecting a case for subcutaneous injection the operator must well consider the methods to be employed, his successes with such methods, the importance and gravity of the operation, the condition of the patient, the extent of the deformity, the peculiarity of the patient and, particularly, the state of mind of the patient.

While at this date of the use of this method of beautifying parts of the human face we may feel certain of the happy outcome of an operation undertaken by the operator, he must not lose sight of the hypercritical person upon whom the work is to be done; even with an outcome gratifying in the extreme from a surgical standpoint, the patient will insist, and that in eighty per cent of all cases, to still further improve them in spite of the fact that a normal appearance has been attained, often leading the operator into doing what he should not do, and eventually undoing his own excellent efforts.

The author does not mean to imply this as a weakness on the part of the surgeon, but cannot impress too deeply upon him the unreasonable demands of a person insanely bent upon having the alabaster cheek ideal of the poets, the nose of a Venus, the chin of an Apollo, the neck of swanlike form, etc.

The patient believes it lies in the power of the cosmetic surgeon to do with their malformations as a sculptor would model in clay and will insist upon gaining their ideal beyond all reason.

Let the author warn the operator against the “beauty cranks,” especially of those who are just about to engage in great theatrical ventures, circus performances, or “acts,” and very desirable marriages. These are patients who are not only difficult to deal with, but the first to harm the hard-earned, well-deserved reputation of the surgeon and to drag him into courts for reimbursement for all kinds of damages, especially backed up by events, losses, and sufferings largely imaginable and untrue, and ofttimes entirely impossible.

In all cosmetic surgery this branch is the most dangerous from that point of view; therefore the operator should take his case well in hand, proceed with an unshakable determination and give the patient to understand his position, even to explaining what disappointments there might be and what dangers, if any, he might look forward to. The author believes it no unjust demand to have an agreement made with the one to be treated in which these matters are fully considered. Such an arrangement will save him much worry and will tend in the majority of cases to keep his patient satisfied.

On the other hand, the operator should not undertake to do an operation of a cosmetic nature unless he has a fundamental and practical experience of long standing in this branch of surgery, and is ready at all times to cope with such post-operative conditions as are likely to arise, which will be described later.