The raw surfaces of the two flaps, if properly brought together, healed upon themselves readily, as has been referred to in the lining or doubling in of the basal sections to form the nostrils and subseptum.
The method of lining the nasal flap in this manner is never sufficient to give a satisfactory result in total rhinoplastic cases, but may be of great service in restoring parts of the nose, as will be shown later.
The requirement is that of support, whether it be organic or inorganic, and these methods will be considered presently.
Volkmann Method.—This surgeon fashioned the frontal flap as shown in [Fig. 354]. This resulted in leaving a triangle of skin at the root of the nose, which he dissected up, down, to and inclusive of the periosteum, and turned downward so that its raw surface faced upward, as in [Fig. 355]. The flap was sutured into place to retain it.
The frontal flap was brought down, so that the two raw surfaces came together.
This method overcame the contraction of the flap over the nasal bridge or superior third of the new nose, and an excellent adhesion of that part of the flap to the denuded bone and flap resulted, but the same faults about the base were not mitigated.
Fig. 354. Fig. 355.
Volkmann Method.