history of rhinoplasty
Plastic Surgery.The history of rhinoplasty.At this time, rhinoplasty continues to evolve and there becomes a great advance the use of free transplantation of bone and cartilage to recover the skeleton of the nose.James Israel (1896), the first piece of bone transplanted to form a backrest sunken nose.At the site of the greatest depressions he made a longitudinal section through which exfoliates the skin from the remaining skeleton of the nose and cut hems brimming piriform aperture to spread the skin of the nasal bridge.In the prepared bed, he put the plate of 3.5 cm in length, carved from the iliac crest.
history of rhinoplasty.In 1893, Yu R. Pensky the world's first transplant carried out joint.It should immediately be noted that in clinical practice, such transactions (in Russia and abroad) have become widely perform only 15 - 20 years after the work of J. R. Pensky.In 1900, Friedrich Mangold (18
As for aesthetic surgery, at the beginning of the XX century the first operation for tightening facial tissues was performed.The first publication on this subject appeared in 1908.Its author S. Miller from Chicago performed excision of the skin in the temporal, pre- and BTE areas, as well as in the neck.Here we should mention the European and American surgeons Erich Lexer (1910), N. Morestin (1915), J. Joseph (1921), T. Hollanger (1912), E. Loxe (1916), B. Passot (1917), for whichfacial rejuvenation is usually excised small strips of skin behind and in front of the ear at the hairline.At the beginning of the XX century began to develop a modern and blepharoplasty, when a large number of messages about the removal of excess skin from the eyelids with periorbital fiber (J. Bonrguet, 1921, A. Noel, 1926, A. Bettman, 1928).
Technique lift linden by J. Joseph
Despite these significant advances, plastic surgery performed in limited numbers and only an outstanding surgeon.
How was the development of plastic surgery in the First World War?
First World War (1914) has made a big change in the character and battle tactics, which naturally affected the structure of sanitary losses.They began to use artillery weapons often causing significant damage.Other military equipment, such as flame throwers, caused extensive burns.Injuries to the head due to the "trenches" character of the war has become increasingly common, and with the use of helmets frequent extensive wounds of the face.For the rehabilitation of the victims at this time, especially in England, quickly began to establish hospitals plastic surgery.There were preconditions for the emergence of new ways of closing large defects, disfiguring his face.
At this time, the vertex cover plastic surgery has become widely used tissue round the stem of Vladimir Petrovich Filatov.Russian physician Vladimir Filatov (1874 - 1956) used this method in 1916 for the primary replacement of the lower eyelid defects after removal of a cancerous tumor.
Vladimir Filatov (1874 - 1956)
method was first described them in 1917 in the "Bulletin of Ophthalmology" in the article "Plastic on the round stem."
Scheme recovery operation century stalk graft from the original article Filatov in the journal "Vestnik ophthalmology" for 1917
It should be noted that the prototype of this method may have been the method of G. Tagliacozzi, in which the flap is in the process ofmaturation itself partially folded.
after Filatov in 1920, a similar method of plastic surgeon wrote English Garold Gillies (1882 - 1960), Major British Army and then, Sir, and already the founder of modern plastic surgery in the world.It was he who extended the ideas on the round plastic stalk around the world and subsequently recognized the priority of Filatov in his invention.
Garold Gillies (1882 - 1960) in the form of a major British Army during the First World War (1916)
history of rhinoplasty.Filatov's method consists of several steps.First, the skin of two parallel cuts and outline otseparovyvayut from the underlying fascia flap so that both ends of it remain unseparated.Then, the two free edges turn inwards and ligated to each other in such a way that a tube (stem) is covered on all sides by skin.The remaining wound surface shrinks seams or heal under a bandage.Thus, the flap is powered through the remaining bridges.After 10 - 14 days, one of the ends of the bridge gradually over several days, with compressed elastic bandage in order to transfer all power to another bridge flap.After 2 - 3 weeks after the end of this intersection is obtained free edge flap, which can be moved towards the defect.At the new location make the cut, which sewed the cut end of the flap.According to engraftment in a new place after 10 - 15 days, cut off the end that was still connected to the original place of location of a skin graft, and sew it to the new location, which is closer to the defect.Thus the flap gradually adjusted to the defect site, and there he finally prizhivlyaetsya.Care must be taken when harvesting the flap, especially if need long stems, so the most safe ratio of length and width of the stem was considered the ratio of 2: 1.
Stages of formation of the stem by the method of Filatov
Filatov method has great advantages over other methods of skin grafting, as it allows you to close the extensive and deep defects are at a considerable distance.The advantage of the method is the fact that the patient did not have a long time to be in a forced position, as, for example, with pribintovyvaniem hands to her face for the nose plastic on the Italian method.In the method of Filatov flap is well nourished and protected from infection.
treat the effects of severe facial injuries crippling the area was busy professor Jacob Lewin Joseph from Berlin.
Jacob Lewin Joseph (1865 - 1934): A - on photographic portraits;B - at work in the operating
J. L. Joseph no widely regarded as one of the founders of Aesthetic Plastic Surgery.For the implementation of cosmetic surgery for protruding ears, he was even dismissed from the University Orthopaedic Clinic, but reinstated when his fame has become truly international.
invention dermatome (ES Padgett, 1930) led to the decision of a large part of the problems associated with the closure of extensive wound surfaces, and has had a huge impact on the treatment of patients with thermal lesions.Previously, for the taking of skin grafts used a sharp knife calibration proposed Finocchiett, (1920).Later, in 1938, a knife with adjustable blade was perfected and popularized Graham Humby.