The practice of surgery . ppear as a partial or complete lossof substance of the nose. Rarely the condition is congenital; but syph-ilis is a common acquired cause; sometimes the cause is tuberculosis, or PLASTIC OPERATIONS ON THE EACE 545 there may have been an injury. Operations for repair consist in turningdown various flaps to fill in the vacancies. Flaps are taken from theforehead, the cheeks, and the side of the nose, as illustrated by theaccompanying cuts. The cuts, however, give one little notion of theend-results. The defects may be closed in, the patient rendered morecomfortable, and
The practice of surgery . ppear as a partial or complete lossof substance of the nose. Rarely the condition is congenital; but syph-ilis is a common acquired cause; sometimes the cause is tuberculosis, or PLASTIC OPERATIONS ON THE EACE 545 there may have been an injury. Operations for repair consist in turningdown various flaps to fill in the vacancies. Flaps are taken from theforehead, the cheeks, and the side of the nose, as illustrated by theaccompanying cuts. The cuts, however, give one little notion of theend-results. The defects may be closed in, the patient rendered morecomfortable, and his visage less hideous, but the resulting scars areextensive and extremely ugly. Ectropion, or eversion of the lower eyehd, is not uncommon, and mayarise from a burn, ulcer, or injury. There are various operations forits relief, which certainly improve the patients appearance. Not onlythis, but they remedy the serious distress which the patient suffers fromectropion, as the everted lower lid continually pours out Fig. 358.—Method of rhinoplasty (Linhart). Defects in the cheeks are remedied by some such operation as thatof Schimmelbusch, who reflects upward a flap from the neck. Theneck is a favorite region, when suitable, from which to take a flap, forthe cervical skin is thin and elastic. In performing all these plasticoperations, however, one should take pains not to fill in a normallyhairless area, like the forehead or upper portion of the cheek, with ahairy flap. Cheeks and chins extensively scarred by bums are com-monly subjected to these operations. Powder face is a frequent misfortune, and is due to a close-rangedischarge of black gun-powder, which forces the powder grains into theskin. If the patient is seen at once before the grains have healed in,most of the particles can be removed by vigorous scrubbing with a stiffnail-brush, the patient being under ether. After the grains have healed 35 546 THE FACE AND NECK nur^(.„-<L^
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1910
