Plastic surgery; its principles and practice . ngles 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 desi
Plastic surgery; its principles and practice . ngles 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 side through the full thickness of the cheek at the proper dis-tance from the angles. The apex should be outward and on a level withthe commissures. The triangular flap between the legs of the V is. Fig. 641.—Deformity following luetic ulceration of the mouth.—i. The ulcer in itsactive state. 2 and 3. Taken eighteen months later, after salvarsan and local the enormous size of the mouth and the extensive infiltration with scar tissue. then shifted toward the median line, and the wound is sutured in theshape of a Y. In marked cases, whether congenital or acquired, it isnecessary to separate the tissues and suture them in layers—mucousmembrane to mucous membrane, etc. Great care should be taken toline the newly constructed commissures with mucous membrane orskin. ECTROPION OF THE LIPS By ectropion is meant the eversion of the free border of the lip sothat the mucosa is permanently exposed to the air^. The deformity is 552 PLASTIC SURGERY usually caused by contracted scar on the skin surface of the lip. Everygradation is encountered, from partial eversion of a portion of the lipto complete eversion of the whole lip,
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
