Plastic surgery; its principles and practice . cially important that the commissuresshould be lined with mucous membrane, and that mucous membraneshould be sutured to the skin in the formation of the new lip, for if 510 SURGERY OF THE LIPS 511 (his can be done, cicatricial contracture is prevented, and much sub-sequent discomfort avoided. In all of these operations in which flaps through the full thicknessof the cheek are used the mucous membrane should be divided aboutI. cm. (-5 inch) above the skin incision, thus giving a flap which canbe sutured to the skin to form the new vermilion border.
Plastic surgery; its principles and practice . cially important that the commissuresshould be lined with mucous membrane, and that mucous membraneshould be sutured to the skin in the formation of the new lip, for if 510 SURGERY OF THE LIPS 511 (his can be done, cicatricial contracture is prevented, and much sub-sequent discomfort avoided. In all of these operations in which flaps through the full thicknessof the cheek are used the mucous membrane should be divided aboutI. cm. (-5 inch) above the skin incision, thus giving a flap which canbe sutured to the skin to form the new vermilion border. In planningflaps to reconstruct a lip they should be wide enough to cover theteeth, and long enough to be sutured into position without tension. In the restoration of the lips three methods may be used either aloneor in combination, (i) By simple gliding with traction of the pedicle(French method); (2) by a flap from neighboring tissue with more orless twisting of the pedicle (Indian method); (3) by a flap from distantparts (Italian method).. Fig. 557.—Hemangioma involving the vermilion border of the lower lip and the mucosalining the lip.—i. Before operation. 2. After operation. An elongated ellipse of tissuewas removed parallel to the length of the lip, and then a broad V-shaped area was from the first defect to the gingivolabial fold. The edges were then recurrence has followed. In addition, skin grafting is often used to cover the raw surfaceafter the correction of ectropion, but the results are seldom as satis-factory as when more radical procedures are employed. The restoration may be done immediately, or after healing has takenplace. Immediate Restoration.—Defects following operative proceduresshould be repaired at once whether on the upper or on the lower lip,and repair should ordinarily be undertaken immediately in wounds inwhich there has been loss of tissue. In these cases the surgeon dealswith normal tissues. Secondary Restoration
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
