Fig. 490. Fig. 491.
Author’s Case.
Case V.—Miss L. W., aged twenty-seven. Presented herself for operation and cast ([Fig. 492]) made August 4, 1906. Uneventful recovery in ten days. Cast of result made August 18, 1906 (see [Fig. 493]).
In each of these cases the patient was discharged highly satisfied and well pleased with the result of the operation, although in Case V the patient was requested to return in about one month for an operation to reduce the width of the wings of the nose, which was not attempted at the first sitting, but could have been with little difficulty by beginning the primary incision at E, [Fig. 483], higher up, and cutting out a triangular section on either side of the flap A, the apex of each triangle being at point E, and the base along the line D. The wounds are sutured along the dorsum of the nose with No. 1 twisted silk, after exsecting much of the lower lateral cartilages of the wings, as can easily be reached in the triangular point formed by the raw dorsal border and the inferior edge (F). The latter method, however, would be likely to leave a slight cicatricial line on either side of the nose. This could be much overcome by making the incision from point E to B obliquely to the plane of the skin, likewise the posterior sides of the triangles mentioned, just as the incisions at B, and across the columna at C, are made. Recovery should be complete in five days.
Fig. 492. Fig. 493.
Author’s Case.
DEFICIENCY OF NASAL LOBULE
Where there is a lack of lobular prominence it may be enlarged and brought forward by a subcutaneous prothesis if the skin is flexible enough to permit of injection, as has heretofore been described. If this cannot be done, the following operation may be employed to advance the point of the nose, and reduce the width at its base so commonly observed with these cases.