Plastic surgery; its principles and practice . Pig. 647.—Contracture of the chin with ectropion of the lip following a burn. Dura-tion nineteen months.—i and 2. A thick keloid-like scar involves the lips, chin and The scar on the chin was excised and a flap from the neck with pedicle below was shittedupward and sutured to the lip. shifted upward may be supported. The technic can be clearly under-stood from the diagram. All varieties of incisions have been made for relieving the eversionand each case will require the one appropriate to it. Those that Ihave mentioned may be regarded si
Plastic surgery; its principles and practice . Pig. 647.—Contracture of the chin with ectropion of the lip following a burn. Dura-tion nineteen months.—i and 2. A thick keloid-like scar involves the lips, chin and The scar on the chin was excised and a flap from the neck with pedicle below was shittedupward and sutured to the lip. shifted upward may be supported. The technic can be clearly under-stood from the diagram. All varieties of incisions have been made for relieving the eversionand each case will require the one appropriate to it. Those that Ihave mentioned may be regarded simply as suggestions. Skin graftshave been used to fill the defects after relief of the ectropion, and SURGERY OF THE LIPS .>^:>. Fig. 648.—Contracture of the chin, continued.— i. Profile view of the flap with pediclebelow. 2. Seven months later the pedicle was cut and the flap was shifted upward. Thedefect below was closed by undercutting and sliding. 3 and 4. Three years later the anglesof the mouth were raised and the scar on the neck was excised. The use of a flap fromthe neck of this type is, as a rule, not to be advised. However, by waiting until it isthoroughly contracted and then dividing it transversely and shifting it upward as far asdesired, it can be utilized with success.
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