Fig. 324.—Labat Method.
Keegan Method.—Utilized a flap, shaped as in [Fig. 325]. The pedicle occupies the internal angle of the eye, care being taken to preserve the angular artery. The flap is mapped out obliquely, not perpendicularly. To get the best results he advises pasting a paper model upon the forehead to guide the operator in making the flap, which includes all the tissue down to the periosteum. Horsehair sutures are employed to approximate the parts accurately. The pedicle is divided in about twenty days, and a wedge-shaped piece of skin is excised at the root of the nose to prevent the tuberosity at this point of the new nose, so commonly observed with Indian-flap methods.
Fig. 325.—Keegan Method.
Duberwitsky Method.—The flap at its root resembles that of Labat, but at its superior border it formed an oval with an elongated point running into the hair line, which he divided, as shown in [Fig. 326], to form the subseptum and nasal wings.
At the root the pedicle was about half an inch wide made in the oblique.
The middle section of the superior pointlike projection and intended for the subseptum was folded upon itself or doubled, as it were, to give support to the nasal point. The same was done with the alar or lateral sections, so as to line the nares with epitheliar surface to prevent contraction. The lower part of the nose was fixed into position by a harelip pin inserted transversely after all parts of the flap had been sutured into place.
Fig. 326.—Duberwitsky Method.