Fig. 301.—Untoward Effect of Paraffin Injection about Lobule and Anterior Nasal Line. Scar lines on nose indicate the various attempts made to reduce the resultant hyperplasia.
While a great many workers with paraffin deny any beneficial results from the employment of sterile white vaselin for subcutaneous injections, the author claims that in this particular class of deformity it is almost exclusively required.
The vaselin in cold state should be injected directly under the skin overlying the deepest point of the cleft and be slowly continued until the lobule assumes its normal contour. The puncture may be made below the point of the nose.
One such injection usually suffices to correct the fault. The reactive symptoms are not severe if proper technic has been applied, and cold compresses usually relieve it within twenty-four hours.
Should the skin be adherent about the anterior aspect of the lower lateral cartilages, it can be forced away with a small, dull, round-pointed knife resembling an eye spud, the opening for which need not necessarily be greater than that made for the needle. The latter is inserted through the same opening, which must be closed over in this event with a drop of contractile collodion into which aristol is introduced with the pulverflator, which not only embodies an antiseptic, but at the same time hastens its hardening.
Alar Deficiency (Unilateral and Bilateral).—The contraction about the nasal rims may be due to hereditary causes or the result of intranasal disease. The defect is usually bilateral, involving the entire alæ or only their lower half or third.
The fault should be corrected by several injections made along the rim of the nasal wing, using a fine needle, preferably of the hypodermic size. Vaselin only should be used and two or three drops, according to the extent of the deformity, be injected into the cellular tissue at the point of each needle insertion.
Three of such punctures may be made along the rim, one beyond the other in each wing. According to the defect the injection may be carried higher or lower above the margin of the rim by shoving the needle upward and toward the inferior border of the lower lateral cartilage.