A manual of operative surgery . A I A B FIG. 264.—RESTORATION OF THE LOWER LIP: ESTHLANDERS OPERATION. [After Lobker This flap is then turned downwards, so that its apex comes tooccupy the lower angle of the defect. It is here fixed by sutures. The gap left in the upper lip is closedby suitable stitches (Fig. 264, b). Both in this and in the preceding measure a lining of mucousmembrane is obtained for the new lip edge. 148 OPERATIONS ON HEAD AND NECK [part hi (c) Brims Operation.—Brims method may be carried out whenthe whole breadth of the lower lip has to be restored, as shown inFig. 265. Her


A manual of operative surgery . A I A B FIG. 264.—RESTORATION OF THE LOWER LIP: ESTHLANDERS OPERATION. [After Lobker This flap is then turned downwards, so that its apex comes tooccupy the lower angle of the defect. It is here fixed by sutures. The gap left in the upper lip is closedby suitable stitches (Fig. 264, b). Both in this and in the preceding measure a lining of mucousmembrane is obtained for the new lip edge. 148 OPERATIONS ON HEAD AND NECK [part hi (c) Brims Operation.—Brims method may be carried out whenthe whole breadth of the lower lip has to be restored, as shown inFig. 265. Here two quadrilateral flaps are fashioned out of the whole thick-ness of the cheek and upper lip, and are placed one on each side ofthe mouth. They will receive a liberal blood supply from the facial arteries.


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