If a pedunculated flap is employed, it should be cut in such a way that the twisting or rotation of its pedicle will not be too abrupt, and thus cause gangrene.
The secondary wound is sutured with silk and heals quite readily under proper hygienic care (see matter on mucous-membrane grafting, page 101).
If, for traumatic reasons, a more extensive operation involving the whole lip structure is indicated, one of the harelip operations heretofore given will answer the best purpose.
VERMILION DEFICIENCY
The cosmetic surgeon is often called upon to correct the vermilion borders of the lips, the usual fault being a lack of sufficient of the delicate membrane to give an artistic appearance or form to the mouth, and in some rare cases the absence of the so-called “Cupid’s Bow” of the upper lip.
Surgical means are of little avail to correct or beautify such fault, and the cosmetic operator must resort to other means. The only practicable method at hand is the careful tattooing of the skin with rose pigment introduced into the skin, preferably with an electric instrument made for that purpose. The hand-tattooing method is slow, irregular at best, and much more painful because of this.
The part to be tattooed is first outlined and then tattooed in linear fashion parallel to the vermilion border presenting, working upward to the peripheral line. The color applied should be pale rose at the first sitting, to be gone over after healing has taken place, and repeated even thereafter until the desired shade has been attained.
The method and instruments involved in the above and the tattooing of scar tissue is fully described in a later chapter.