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续前The second principle was “to restore to their places things which are displaced.” Whether applied to a congenital deformity, such as a cleft lip, or an acquired deformity, as in trauma, this principle required recognition of normal parts and diagnosis of the abnormal position.原则2、 还原或复位移位的组织 具体应用时，对于先天抑或后天畸形（如唇裂或后天创伤），要求掌握正常的解剖位置，仔细辨别确认不正常何在。Likewise, the third and fourth principles, “to separate tissues which are joined together,” and “to join those tissues which are separate,” also required the ability to conceptualize a hypothetical norm.同样，原则3、 分离病理的粘连或非正常的解剖连接；原则4、连接可连接的分离的组织 均要求我们能够预先想象到它们的（修复后所能达到的）正常形态 Indeed, a given defect could often be determined accurately only after distorted tissue was returned to its normal shape. This was true whether applied to a congenital defect, such as syndactyly, or an acquired defect, such as a burn contracture.事实上，某个特定的缺损常常能在它们的畸形矫正后进行精确的测量。把它们应用于诸如并指的先天缺损或是烧伤疤痕挛缩类后天缺损的修复，往往都没错。Finally, the fifth principle, “to supply the defects of nature,” also required the ability to visualize restoration to a normal state. 最后，原则5填充（修补）缺损，还原它们的“本来面目”这也要求我们具备能够充分想象修复后还原于正常形态空间构想能力。页面提取自－ Practical Plastic Surgery46-67.pdf(284.66k)
续前Modern Plastic Surgery: Gillies and Millard Building upon these early ideas, Sir Harold Gillies and D. Ralph Millard took the principles of Paré to the next level. Recognizing that the remodeling of human tissue was different from clay, Gillies and Millard took as their founding principle that “plastic surgery is a constant battle between blood supply and beauty.” That is to say, the reshaping of human structures demanded that its vitality as living tissue be respected. Drawing upon the wisdom of his mentor, Sir Harold Gillies, Millard produced one of the most widely recognized efforts to outline the principles of reconstructive surgery. 现代整形外科之父：Gillies and Millard基于上述这些早期理念，Harold Gillies先生和Ralph Millard博士把Paré的这些原则拓展到更高的水平。认识到重塑人体组织远远不同于陶艺，Gillies 和 Millard把“整形外科----血供与美之间永不停止的斗争”这一理念作为他们的工作指导原则。这一原则意味着你必须把你所重塑的某一组织结构看成是有独立生命力的个体来尊重。启发于先辈的䜭智结晶，Harold Gillies和Ralph Millard两位整形外科泰斗提出了一个普遍公认，广受欢迎的整形外科原则。In 1950, Millard codified rules learned from Gillies and published them as the “ten commandments” of plastic surgery (Table 10.1). 首先，1950年，Millard整理Gillies先生提出的整形外科规则，把它们规划为整形外科“十戒”。Table 10.1. Gillies’ ten commandments of plastic surgery 1 Thou shalt make a plan. 2 Thou shalt have a style. 3 Honor that which is normal and return it to normal position. 4 Thou shalt not throw away a living thing. 5 Thou shalt not bear false witness against thy defect. 6 Thou shalt treat thy primary defect before worrying about the secondary one. 7 Thou shalt provide thyself with a lifeboat. 8 Thou shalt not do today what thou canst put off until tomorrow. 9 Thou shalt not have a routine. 10Thou shalt not covet thy neighbor’s plastic unit, handmaidens, forehead flaps, Thiersch grafts, cartilage nor anything that is thy neighbor’s. 1、指定详细的计划2、创造自己的风格3、珍惜正常的组织，归位于正常的位置4、不要轻易切除、毁弃有活力的组织5、不要掩饰自己的缺陷、自欺欺人6、与其过分担忧继发缺损，不如审慎处理原发缺损7、提供给自己一个可以挽救的余地8、不要匆匆处理那些可以延期处理的事情9、不要循规蹈矩、落入俗套10、不要贪用邻近的整形解剖单位以及任何邻近的支持组织、前额皮瓣、断层皮片、软骨等页面提取自－ Practical Plastic Surgery48.pdf(127.0k)
续前Shortly thereafter, the pair expanded these ideas to 16 principles that would apply not only to plastic surgery problems but also to a philosophy of life in general. Millard went on to develop the concept of principles still further in his classic tome, Principalization of Plastic Surgery. Divided into four broad sections, this work offered 33 commonsense rules to help plastic surgeons fashion answers to a variety of surgical problems. 之后不久，两位大师把“十戒”进一步扩充延伸为16个原则，他们不但把它们作为整形工作的基本原则，同时把它们作为为人处世的普遍哲学。而后，Millard有更进一步，把这些理念扩充拓展为他的经典巨著《整形外科原则》。该书分为四大部分，共包含33个浅显易懂的、常识性的工作原则，为整形重建外科医生解决了工作中的大量专业性问题。Preparational Principles Millard’s first 12 principles fell under the framework of “Preparational Principles”-that is, principles to keep in mind before making the opening incision.准备原则米拉德的前面12个原则奠定了日常工作的“准备原则”，也就是说，在你动刀之前，必须时刻谨记这些原则。 The first principle was to “correct the order of priorities.” Applied broadly, this could mean emphasizing integrity and ethics; it could mean prioritizing function over form; and it could also mean performing a blepharoplasty before a facelift since the latter could affect the former but not vice versa. The bottom line was that whether in life or in a specific procedure, each part needed to be considered in the context of the whole.原则1 （优化程序）----确立正确的处理程序概括来说，这意味着工作中应强调遵循道德和整体思维；优先考虑功能而非外表；（同时行面部除皱和睑成形术时，）优先安排睑成形术，因为后者能够影响前者，而不是相反（面部除皱影响眼睑形态，先行面部手术，止血效果会更加满意）。其根本原则是无论是生活还是具体的工作程序中，做每一步之前都应该全盘整体考虑。（ ）内容直接参考借用广东科技出版社出版翻译的米拉德《整形外科原则》，以下同