Plastic surgery; its principles and practice . Fig. 639.—Result of enlarging the buccal orifice after atresia following a burn of themucous membrane.—i and 2. The outer margin of the vermilion border around the entiremouth had been burned, together with the surrounding skin. The mouth could be openedonly wide enough to admit a teaspoon. The constriction being somewhat like a puckeringstring. The photographs were taken six months after the excision of the constricting band,with plastic reconstruction of the commissures and vermilion border. Wernecks first and second operations seems to be the b
Plastic surgery; its principles and practice . Fig. 639.—Result of enlarging the buccal orifice after atresia following a burn of themucous membrane.—i and 2. The outer margin of the vermilion border around the entiremouth had been burned, together with the surrounding skin. The mouth could be openedonly wide enough to admit a teaspoon. The constriction being somewhat like a puckeringstring. The photographs were taken six months after the excision of the constricting band,with plastic reconstruction of the commissures and vermilion border. Wernecks first and second operations seems to be the best for assuringthe commissures and avoiding recurrence. I have not found any groupof patients who are more grateful than those who have been relievedfrom marked atresia of the Fig. 640.—Microstomia following severe infection.—i. Note the shortening of theupper lip and the narrowing of the mouth. 2. Result of lengthening the upper lip byshifting in lateral flaps. The angles of the mouth were then lengthened, and the com-missures were lined with mucous membrance. Another type of narrowing of the buccal orifice, which follows noma,is more difficult to correct. There is loss of substance and destructionof the neighboring buccal mucosa. The orifice is narrowed and the SURGERY OF THE LIPS 551 cheeks are bound down to the jaws by dense cicatricial bands whichlock them. The adherent portions must be separated and the cheeklined by one of the procedures described elsewhere. The mouth maythen be made as broad as is desired. ABNORM.\LLY LARGE MOUTH (MACROSTOMIA) The mouth may be abnormally large fcongenitally) and in somecases it is necessary to reduce the distance between the slight correction may be accomplished by making a V-shaped incisionon each
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
