Three new plastic operations on the nose and thorat / ny John Edmund Mackenty.
- MacKenty, John Edmund, 1869-1931.
- Date:
- 1911
Licence: In copyright
Credit: Three new plastic operations on the nose and thorat / ny John Edmund Mackenty. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![all the subcutaneous tissue, as it strengthens the Hap during the subsequent manipulation. The dis- section is continued backward, using scissors and scalpel, until the ridge of bone on the floor is reached. Here the periosteum is incised and, as the dissection continues backward over the ridge, is included in the raised flap. With small chisels and Kerrison’s bone forceps the bony ridge is re- moved over the full width of the opening and down- ward until the whole floor of the nasal cavity lies on the same plane. Then with a sharp, straight chisel the base of tbe se])tum (nasal spine and intermaxil- Fig. 2. lary crest) is shaved down, beginning well forward and extending well back of the crescentic ridge, but the whole thickness of the septum must not be removed. Then the flap, which is quite thick in front, is thinned down by removing all the fat and areolar tissue from its under surface until noth- ing but the true skin and mucous membrane remain. Now if the work has gone successfully we find that the new nasal floor lies about Yz to 2/3 cm. below the old one, and that the skin and mucous membrane flap is too short to lie upon it. In my earlv cases I incised the flap from before](https://iiif.wellcomecollection.org/image/b22480705_0008.jp2/full/800%2C/0/default.jpg)
