Plastic and cosmetic surgery

by Frederick Strange Kolle

Fig. 160. Fig. 161. Fig. 162.

Von Langenbeck-Wolff-Sedillot Method.

Malgaigne Method.—The method of Malgaigne differs in technique in that he utilizes a semicircular incision, which is made to include the upper angle of the defect. Both ends of this incision are continued horizontally outward to a required extent (see [Fig. 163]). The freed prolabial flaps are drawn downward, as in [Fig. 164], and sutured vertically, as shown in [Fig. 165]. Two retention sutures are shown in the latter figure to overcome the tension of the lips post operatio.

The semicircular incision should be preferred when the defect will permit it, since the unequal lengths of the two lip halves may thereby be more uniformly approximated, while the prolabium in being crowded downward overcomes the notchlike scar so common with the vertical-incision method.

Fig. 163. Fig. 164. Fig. 165.

Malgaigne Method.

Gräfe Method.—This method, as shown in [Fig. 166], is, therefore, to be preferred when the defect is one of the first or second degree.

The first suture is to be placed at the margin of the vermilion border and the skin, so that the unequal sides are placed in normal apposition. The parts are sutured according to the method shown in [Fig. 167].