The method is purely of the Hindu type, and the results are not, therefore, very satisfactory.
Fig. 394. Fig. 395.
Steinhausen Method.
Neumann Method.—This author cuts down the remains of both lower margins of the old nose, as in the Steinhausen operation. A wedge-shaped section is cut from the entire thickness of the upper lid and turned upward to form the subseptum, and is sutured to the lateral parts brought down by the former incisions, to which it is sutured at the median line, as shown in [Fig. 396].
Two lateral flaps are now made from the sides of the remaining nose retaining their cartilages, as shown in the illustration, A, B, C, D, showing one of them. The two flaps remain attached, anteriorly along the median line over the bridge of the nose. These two lateral flaps A, B, C, are turned down from the point A, which represents the pedicle, and are sutured at the median line by their lower borders, A, B, the borders B, C, being thus brought down, fall before the fresh borders taken from the margins of the old nose, to which they are sutured, as shown in [Fig. 397].
This procedure will leave two exposed areas at either side of the nose, which are permitted to heal by granulation.
Fig. 396. Fig. 397.
Neumann Method.