When harelip pins are used, the method of introduction is as follows:—The first pin should be inserted close to the muco-cutaneous margin, and about one centimetre from the edge of the right side of the lip, and its point should emerge on the deep aspect of the raw surface close to the mucous membrane. It should then be passed on through the opposite side of the lip, entering at an exactly corresponding point on the raw surface, and passing out through the skin of the left side at the same distance from the edge as on the other. One or two more pins should be similarly passed at equal distances through the other portions of the cleft. Moderately thick unwaxed silk is now used as a figure-of-8 suture, whilst during this the assistant presses the cheeks, and holds the lip _in situ_. The parts should not be dragged together by this means, but merely retained in the position to which they have been easily brought by the pressure of the assistant’s fingers, as a result of the previous undercutting. A separate silken thread is advisable for each pin. The pins are now cut short by wire-nippers, and collodion painted over all. The plan I now adopt, in common with many others, of suturing the prepared lip is as follows:—Purified silver wire of No. 27 gauge is carefully threaded on special wire needles. I introduce two or three sutures by entering the needle at rather more than half a centimetre from the margin, and bringing out the point on the raw surface close to the mucous membrane as with the pins, taking care to pass the needle in on the opposite side at an exactly corresponding point. The three situations I select for these sutures are, one at the root of the nose or upper part of the cleft; one a little above the muco-cutaneous junction; and the third, if necessary, between the other two. In very young infants and simple cases, only two wires are needed. Having passed the wires and tested the accuracy of their position, the ends are left long and unfastened lying on the cheeks, whilst the fine catgut sutures are being adjusted. By means of small semicircular needles, about two centimetres in diameter, held in a needle-holder, these sutures are inserted, as near to the margin of the cleft as is possible, consistent with their holding. The first two should be placed one at the muco-cutaneous junction, and the other at the nostril aperture as high as is necessary in order to bring about the approximation of the ala nasi to the median line, and thus secure the diminution in the size of the opening, and a symmetrical disposition of the features.[75]