If, for any reason, the effect obtained is not as desired, the patient should wait for several weeks and have the treatment repeated.
It is hardly necessary to say that the application used should not get into the eyes. The upper eyelids should not be treated, since no benefit arises from it. If there is a redundancy of tissue, it should be removed surgically, as heretofore described.
CHAPTER XVIII
CASE RECORDING METHODS
Every case, whether of little consequence or of important nature, should be properly and fully recorded in a thorough and systematic manner. Apart from the value of such a record, to the operating surgeon it often proves of the greatest importance in cases where operations of a purely cosmetic nature are undertaken.
Patients who beg us to make them more beautiful, or less unsightly in the eyes of the ever-critical observer, are the most difficult to please, and often complain, after a few days of constant mirror study, of the parts changed by methods that are the result of years of hard-earned experience, that the nose or the eyes or the ears have not been changed as much as they desired—in fact, so little that their closest friends have failed to evoke ecstatic remarks about the improvement.
This is not unusual with the most intelligent patients and is due to the fact that cosmetic operations performed on an ugly though otherwise normal organ have not yet become very frequent, and while friends are inclined to remark a change in lesser defects, they fail to credit this to the cause, owing to a lack of the knowledge of cosmetic surgery, or their ignorance of the art entirely.
Photographs.—Where a pathological defect, wound, or scar or traumatic deformity is to be corrected, the patient is usually kind enough to permit of photographs being made of the parts to be operated on, but where the defect is hereditary, or the result of age, objections are invariably raised by all concerned, for fear their pictures will be used in some outlandish way.
The objection to photographs is obvious, since it usually requires visits to a studio, and the necessary loss of time to the surgeon, whose presence is nearly always necessary to secure the proper negative.
This is especially true of the nose. Very few photographers will make a satisfactory sharp profile picture. It is less artistic, but most desired by the surgeon, and when the patient is presented for a second negative after the operation has been performed, the picture varies more or less in pose from the first taken.