MANAGEMENT of the many annoying postoperative problems in otorhinologic plastic surgery demands a broad knowledge of general medicine, careful diagnostic methods and the exercise of mature surgical judgment. One must never lose sight of the fact that one's patient is an indivisible entity and that one is fundamentally a physician.
A careful medical history may elicit nothing regarding blood dyscrasia and nothing regarding acute or chronic disease, metabolic or otherwise; the complete blood count, serologic reactions, bleeding time, coagulation time and results of urinalysis may be within normal limits; yet one patient may show tremendous postoperative ecchymosis and swelling, whereas a second patient, subjected to the same careful technic, with sharp instruments and an experienced operator, and the same preoperative medication, will show negligible ecchymosis and edema. Unquestionably, as a surgeon perfects his technic and becomes more deliberate in each movement, the incidence of these annoying factors becomes less common;