Dieffenbach allowed these secondary wounds to heal by granulation. [Illustration: FIG. 218. FIG. 219. DIEFFENBACH METHOD.] =Jäsche Method.=—Jäsche’s method is to be preferred to that of the foregoing author. After a cuneiform excision of the defect he adds two curved incisions extending downward at either side to insure mobility of the parts, as shown in Fig. 220. In bringing the wound together, as shown in Fig. 221, he overcomes the large secondary defects of the operation last considered by suturing the skin margins. [Illustration: FIG. 220. FIG. 221. JÄSCHE METHOD.] =Trendelenburg Method.=—Trendelenburg has modified the method of Jäsche by shortening the curve of the cheek incisions so that their outer borders were made to lie anterior to the facial artery (see Fig. 222), the parts being approximated and sutured, as shown in Fig. 223. To obtain sufficient mucous membrane to cover the superior margin of the two flaps when brought together he made the cheek incision only down to the mucosa, dissected up the latter a short distance from the upper part of the cheek, and divided it about one half centimetre above the line of the external incision. This flap of mucous membrane on either side was used to line the lip in place of the prolabium. [Illustration: FIG. 222. FIG. 223. TRENDELENBURG METHOD.] =Bruns Method.=—Bruns excises the defect when not involving the whole lip in quadrilateral form, and takes up a flap from the anterior region of the chin to cover it, as shown in Fig. 224. This flap is rotated upward into the wound made, and is sutured in place, as shown in Fig. 225. The secondary wound is brought together by suture. [Illustration: FIG. 224. FIG. 225. BRUNS METHOD.] In cases where the entire lip is removed he cuts two square flaps from the upper anterior region of the cheeks extending as far upward as the alæ of the nose (see Fig. 226). He rotates these flaps into the open wounds and sutures them into place, as shown in Fig. 227. The border of the lip is lined with the mucous membrane of the cheek flaps then brought down. If the latter has become too stretched longitudinally, he relieves it at its base by transverse incisions. [Illustration: FIG. 226. FIG. 227. BRUNS BILATERAL METHOD.] =Buchanan Method.=—Buchanan’s method consists of removing the diseased area by an elliptical incision _A_, _B_, _A_. A second oblique incision _B_, _C_, and a third of the same obliquity _B_, _C_, is made downward and outward upon the anterior chin. From the points _C_, _C_, two curved incisions parallel to the upper incision _A_, _B_, _A_, and equal to their lengths, are made to the points _D_, _D_, as shown in Fig. 228. The latter incisions provide two flaps, as shown in Fig. 229. They are dissected off from their attachment to the lower jaw and raised upward so that their upper line _B_ is raised on a level with the former margin of the lip _A_, _A_.