Plastic and cosmetic surgery

by Frederick Strange Kolle

Sedillot Method.—Sedillot also employs two rectangular flaps, but he cuts them from the region of the chin (see [Fig. 200]).

The advantage of this method lies in the fact that these flaps are lined throughout with mucous membrane, as the incisions are made entirely through the tissues involved, beginning at the angle of the mouth and extending downward to the limitation of the buccal fold interiorly.

The flaps are twisted into position and sutured, as shown in [Fig. 201]. The mucous membrane of the inferior border is dissected up to a required extent and turned outward and stitched to the skin margin without to provide the prolabium. This is an important matter not only for cosmetic reasons, but especially because such mucous-membrane lining overcomes to a great degree the objectionable cicatricial contraction of this free border.

In certain cases the mucous-membrane grafts of Wölfler may be employed to cover the raw edge of these newly made lips, or the Thiersch method of skin-grafting might be employed with the same object.

Where the defect is unilateral, as is usually the case, a single cheek or chin flap need only be employed, and this lined with mucous membrane.

Fig. 200. Fig. 201.

Sedillot Method.

Buck Method.—Buck, in such unilateral defects, employs an interolateral rectangular flap. It contains a part of the lower lip and its vermilion border. This flap is twisted upward, so that its outer and free end comes in apposition at or near the median line as may be, with the remaining half of the upper lip.

This half of the lip is freely liberated by dividing the buccal mucous membrane along the reflecting fold. Should the vermilion border be contracted upward along the median cicatricial line it is carefully cut away from the lip proper down to its normal margin. This strip is retained until the flap taken from the under lip is brought into position, when it is neatly sutured to the prolabium thus brought into apposition. If there be a redundancy of the freed prolabium after the median sutures have been applied it is cut away.