Landreau Method.—The direction of the frontal flap is transverse, but the root of pedicle, instead of having a downward direction, is so cut as to have its attachment upward, as shown in [Fig. 335]. This position of the pedicle thus overcomes to a great extent the torsion at this point. The flap must be cut somewhat longer in its transverse axis to allow for the higher position of the pedicle on the forehead.
The distal end of the flap is trident-shaped, as shown.
Fig. 335.—Landreau Method.
Langenbeck Method.—The flap is cut on an oblique line along its left border, running the incision down and across the root of the nose to the right while the right incision begins just under the eyebrow and extends less obliquely upward, as shown in [Fig. 336]. The base of the pedicle is fashioned as shown. The bordering remains of the old nose are removed.
Fig. 336.—Von Langenbeck Method.
In another operation by the same operator the right incision was begun at a point above the eyebrow and carried transversely along to the rising point of the lateral. The left lateral incision was so made that it left an area of skin over the root of the nose, as shown in [Fig. 337], which he dissected away, giving that part of the flap to cover it an opportunity to adhere, at the same time furnishing a nourishing area for its future life.