Plastic surgery; its principles and practice . hisincision a perpendicular cut of the desired length is made and theflap of skin is separated from the tarsus. The ectropion is correctedand the upper edge of the flap is trimmed to fit the tarsal border. Fromboth corners of the flap small pieces are excised, so that when it is SURGERY OF THE EYELIDS 367 sutured, the skin will be drawn more tightly transversely. The sutureson the tarsal border are left long and are fastened to the foreheadwith adhesive plaster or collodion and gauze. In this way overcor-rection is obtained until the healing is we
Plastic surgery; its principles and practice . hisincision a perpendicular cut of the desired length is made and theflap of skin is separated from the tarsus. The ectropion is correctedand the upper edge of the flap is trimmed to fit the tarsal border. Fromboth corners of the flap small pieces are excised, so that when it is SURGERY OF THE EYELIDS 367 sutured, the skin will be drawn more tightly transversely. The sutureson the tarsal border are left long and are fastened to the foreheadwith adhesive plaster or collodion and gauze. In this way overcor-rection is obtained until the healing is well started (Fig. 335). This operation can be used for extensive ectropion of the lower lid. Operation of Wharton Jones.— From a point near each commissuretwo converging incisions are made to include the scar and meet beyondin the shape of the letter V. The triangular flap is dissected up to theroot of the cilia and the surrounding skin is undermined. The lid isthen pushed up and overcorrected and the edges are sutured to forma Y (Fig. 336).. Fig. 336.—Wharton Jones operation for ectropion (Beard).—i. A V-shaped incision ismade; the eyelid is released by undercutting the flap; the surrounding skin is The skin edges are sutured in the shape of a Y. This very useful operation is designed for either lid, but in myhands has not been satisfactory on the upper. The same procedure isused for ectropion of the lip. In severe cases of long standing, in addition to the operations de-scribed for cicatricial ectropion, it is often necessary to shorten the freeborder of the lid in order to remove the excess tissue. This may bedone by the methods used for atonic ectropion, and can be readilyfollowed on the diagrams of the operations of Adams, von Amnion, andKuhnt (Figs. 337-339)- The operations just mentioned are for the relief of ectropion aloneand cannot be used for the formation of a new eyelid. 368 PLASTIC SIJRGERY The Flap-sliding Operation of Dieffenbach.—In excisin
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