Fig. 203. Fig. 204. Fig. 205.
Estlander Method.
This operation may also be used in the unilateral type of defect. It will be described in the operation of the lower lip, where it is more frequently employed than in connection with faults of the upper lip.
INFERIOR CHEILOPLASTY
Apart from harelip operation, those for the separation of the lower lip are the most common about the mouth. This is due in a great measure to the fact that malignant growths so frequently attack this part of the human economy and almost exclusively in the male. Out of sixty-one cases von Winiwarter found only one female thus affected. It has not been determined whether the habit of pipe smoking has been a factor in establishing this unequal proportion, yet it is acceded to be the fact, so much so that neoplasms of the lip in men have been commonly termed smoker’s cancer.
The ulcerative forms of syphilis and tuberculosis seem to be met with more in the lower than in the upper lip; likewise is this true of burns and acute traumatisms.
Defects in the lower lip are, therefore, due principally to the extirpation of carcinomata or other malignant growths and less frequently to the other causes mentioned.
The classification and extent of such involvement has already been referred to.
In operations intended to extirpate a growth of malignant nature the incisions should be made sufficiently distant from the neoplasm to insure of unaffected or uninvolved tissue to avoid a recurrence of the disease.