Plastic and cosmetic surgery

by Frederick Strange Kolle

The disposition of the parts at this period is shown in [Fig. 414].

Fig. 412.—First step.

Fig. 413.—Disposition of flaps.

Fig. 414.—Ultimate placing of pedicles after division.

Bayer-Payr Method.

Ch. Nélaton Method.—This author in cases of extensive destruction of the point of the nose advocates the lining of an Italian flap with skin flaps made in similar manner, as in the foregoing operation.

The lining flaps are taken from the nasogenian furrow, placed and sutured as just described, without twisting of their pedicles, and are sutured at the median line and at their free ends to the freshened septal stumps.

The Italian flap is placed over those two flaps immediately, or the Italian flap is first made to unite to the raw margin of the defect, and the two nasogenian flaps are made and employed at a later sitting by subplanting.