The method is shown in [Figs. 155-157].
Fig. 155. Fig. 156. Fig. 157.
Nélaton Method.
Fillebrown Method.—Fillebrown has devised a method where the vermilion border of the lip is entirely preserved, as in the preceding operation. His method can only be employed where the cleft is not extensive. He commences his incision at the red border at the outer left line, cutting upward and inward toward the median line a short distance (see [Fig. 158]), then downward to the red border of the lip, then upward and outward to the right of the median line, corresponding to the incision just made to the left of the median line. The upper angle of the cleft is now drawn down by its red border and the wound sutured, as shown in [Fig. 159]. This operation does not project a small triangle of the white skin into the vermilion border and gives excellent results.
Fig. 158. Fig. 159.
Fillebrown Method.
Von Langenbeck, Wolff, and Sedillot Methods.—The methods of von Langenbeck, Wolff, and Sedillot are somewhat similar to that of Nélaton. An incision is made slightly above the prolabium, following the angle of distortion and reaching outward to either side of the median line almost to the angle of the mouth. The raw edges corresponding to the defect are brought together by suture and a section of the prolabium is removed to overcome its overprominence, but not enough to entirely flatten the vermilion border (see [Figs. 160-161]). The latter is sutured horizontally to such part of the angular defect as has not been utilized in the median line, and also vertically as far down as its free border, as shown in [Fig. 162].
