=Estlander Method.=—Estlander corrects a unilateral defect by excising the neoplasm in triangular fashion, and cutting out a triangular flap from the upper and outer third of the upper lip, leaving, however, the prolabium intact, which answers for the pedicle (see Fig. 212). This triangular flap is rotated downward, and is sutured into the opening in the lower lip, as shown in Fig. 213. Where this method can be employed it does very well, as it overcomes the secondary defect so common with most of these operations, while a small operation may be undertaken later to correct the mouth formation if necessary. [Illustration: FIG. 212. FIG. 213. ESTLANDER METHOD.] =Bruns Method.=—Bruns removes the defect in quadrilateral form when the disease involves one half or more of the lower lip, as shown in Fig. 214. He encircles the mouth by two curved incisions to aid in mobilizing the edges of the wound, which he sutures, as shown in Fig. 215, leaving two crescentic wounds at either side of the mouth, which are allowed to heal by granulation. [Illustration: FIG. 214. FIG. 215. BRUNS METHOD.] =Buck Method.=—Buck has corrected a unilateral defect by employing the wedge-shaped incision, as shown by _B_, _C_, _D_ in Fig. 216. After removing the triangular infected area he detaches the remaining half of the lip from the jaw as low down as its inferior border and as far back as the last molar tooth. A division of the buccal mucous membrane along the same line more readily permits of sliding the remains of the lip over to meet the raw surface opposite. If the latter was not possible he obtained additional tissue by making a transverse incision from the angle of the mouth across the cheek to the point _A_, or within a fingers breadth of the muscle. A second incision is made downward from _A_ and a little forward to the point _E_. This quadrilateral flap thus formed, with its upper half lined with mucous membrane is dissected up from the jaw except at its lower extremity. It is glided forward edgewise to meet the remaining half of the lip, where it is sutured into place, as shown in Fig. 217. To cover the triangular raw space occasioned by the sliding forward of the flap _A_, _B_, _C_, _E_, another transverse incision is made through the skin continuing the line _A_, _D_, Fig. 217, to the extent of one inch. The skin is then dissected up as far as this incision will allow and is stretched forward until the edge meets the outer skin margin of the quadrilateral flap, to which it is sutured. A later operation for the restoration of the mouth has to be made. [Illustration: FIG. 216. FIG. 217. BUCK METHOD.] =Dieffenbach Method.=—Dieffenbach’s method is very similar to the above, but is applicable only to cases where the entire lower lip is involved and is extirpated (see Fig. 218). The wound is sutured as in Fig. 219. The secondary wounds are either sutured as in Buck’s method or they are covered immediately by Thiersch grafts (author’s method).