The Washington times., 1919-06-08

Dn GuC "O4ACh VI ANS" AS-NN'
The perfection of Cleopatra's nose is
said to have decided the fate Of the ancient
world and our American women are eager
for world power to-day.
The wisdom of having the nose altered
simply for identifying purposes may be
seriously questioned, but it is apparent
that many women are undergoing a COM
plicated and expensive operation just for
the sake of gaining a dignihed straight
nose line, a desirable curve or tilt, accord
ing to circumstances and tastes
The surgical method Of removing an I'm.
slightly hump from the bridge Of the nose
has recently been described in these
pages. An operation, quite as much in
favor and considerably more complicated is
to fill up an unsightly depression in the
bridge with bone taken from some other
place.
Everybody knows that a nose badly
pushed in and depressed at the bridge is a
highly unattractive feature. There are a
dozen or more different types of defective
bridge, varying from absolute fairness 10
small depression that merely gives you a
commonplace look. If the depression is
such as to interfere with nose breathing,
any nose and throat surgeon will en-
deayor to open up the passage, but when
it is a question Of improving external
looks then a specialist of a more limited
type is needed. A New York surgeon who
has been very successful in performing
such operations described that of bridge
building to the writer.
The patient is put through the usual sur
gical steps with regard to cleanliness and
asepsis. The face and area to be operated
on are thoroughly cleaned with antiseptics.
The hair and body are covered with cloths
20 prevent infection.
On the surgeons table lie heaps of saws,
chisels, scalpels, seizure forceps, hammers.
tweezers, knives, rasps, scissors and other
implements.
The operation is performed with local
anesthesia alone. Cocaine is used to pro
duce insensibility, and adrenalin to check
bleeding.
In the first place an incision is made in
the mucous membrane Qining) Of the nose
with a delicate knife. All the steps of the
operation are performed within the nose
without destroying any of the mucous
membrane, which is cut through, and with
out iniuring the exterior of the nose in
any way.
Through the incisions in the mucous
membrane chiseI is passed and the nasal
bones are completely detached from the
nasal process of the frontal bone 1.-THE
forehead) and from the corresponding part
of the upper jawbone. The nasal bones
are then elevated sufficiently to raise the
bridge of the nose to the desired ideal
angle.
small strip of antiseptic game is in
serted underneath the detached nasal
in rOCi-
ton. The tissue covering the nose is de-
tached from the forward edge Of the sep
tum Cpartition) of the nose. The mucous
surface lining the left side Of the sep
tum is lifted up and the patient is then
ready for the insertion Of the new bone,
which will keep her nose permanently
lifted mp to the desired height.
A piece of bone including its periosteal
covering is removed from the nose of an
other patient. This bone is usually taken
from the yOmer or bony structure OF the
septum or partition of the nose. The vo-
mer is frequently cut away to enlarge the
passage through the nOstrils, and pieces
Of it can easily be spared.
The surgeon picks up the delicate bOny
morsel with pair of tiny fOrceps, inserts
il into the space between the detached
mucous membrane and the nasal septum
Cpartition) ard places it in position so that
the forward edge of this piece of new bone
projects sufficiently to form the proper
base of the new nasal bone.
Thus the original nose bridge is raised
to its proper height by bony prop under
it's foundation.
within two weeks the transplanted
bone usually grows into place" said the
surgeon who performed this operation. 81
have found no changes in an operated
nose after years"
A common condition that interferes with
beauty is a one-sided nose. This condition
may exist at the same time as one of the
other defects and be cured by an operation
at the same time as the other, or it may be
the principal defect to be remedied in the
patient.
To cure the one-sided condition, the
surgeon takes his chisel and his saw and
dislOcates part Of the bOny structure Of
the nose from its foundation. The next
step is to separate the upper part of the
bony partition Of the bone from its tissues.
This is said to be very essential, as other
wise pushing the nose sideways might
crack the "cribriform plate of the ethmoid
cartilage" part of the base of the skull,
which cracking might have disastrous con-
sequences.
When he has Ioosened up everything
so that it can be moved with safety, the
beauty surgeon, with practised eye, pushes
the nose towards the central line until it
occupies the ideal position of straightness.
After the nose has been moulded into the
desired shape, a strip of gauze is inserted
through the first incisiOn and is kept there
for one or two days in order to establish
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