The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . ^ which the eyelids are repaired,is oceasionallj^ required for loss of substance—the result of wounds,cicatrices, or operations. It is less satisfactory in its results than mostof the other plastic procedures about the face ; yet it maj, in some cases,improve materially ihe patients appearance. When the upper eyelid requires repair, the flap is taken from the fore-head ; when it is the lower lid, from the cheek or temple. This opera-tion may be performed either by the gliding method, or by twisti
The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . ^ which the eyelids are repaired,is oceasionallj^ required for loss of substance—the result of wounds,cicatrices, or operations. It is less satisfactory in its results than mostof the other plastic procedures about the face ; yet it maj, in some cases,improve materially ihe patients appearance. When the upper eyelid requires repair, the flap is taken from the fore-head ; when it is the lower lid, from the cheek or temple. This opera-tion may be performed either by the gliding method, or by twisting aflap into its new situation. By the gliding method, a triangular flap iscut and partially detaclied (Fig. 590, a), and then drawn gently for-wards until it corresponds to and fills up the gap that requires repair,. Fig. .5S9.—Lines of Incision in Burows Operation. 480 PLASTIC SURGERY OF THE FACE AND MOUTH. when it is there fixed by a few points ofsuture. When the twisting method is em-ployed, an oval flap is detached (Fig. 590,^), except its pedicle, and twisted down, tobe planted on tlie raw surface. Occasionally neither of these methods isapplicable; and then the procedure, that Isuccessfully adopted in a case of whichthe annexed cut (Fig. 591) is a representa-tion, may be followed. In this case, whichwas that of a lady who had received a se-vere mutilation of the face by the explo-sion of a ginger-beer bottle, there was adeep and hard cicatrix across the lowereyelid, causing depression and eversion of its outer portion, and adhe-sion of the inner part to the ball of the eye. After dividing the adhe-sions and removing the cicatrix, I made a semilunar incision so as todissect up the eyelid, and then fixed it by points of suture in its newsituation, when it became firmly adherent (Fig. 592), a
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