The flap thus formed will be seen to have a pedicle at this point. It is dissected away from its mucous attachment and is rotated upward, jumping it over the triangular spur, which has also been mobilized by a sliding dissection. The flap is sutured into position, as shown in Fig. 238. Unfortunately, the flap does not permit of lining the raw margin of the wound with mucous membrane turned outward from within, hence it is best to take sufficient of the mucous membrane from the cheeks to accomplish this, or the vermilion border of the upper lip may be carefully cut away from the lip at its outer sections just above the prolabial line, and elongated by stretching upon the raw surface of the under lip, to which it is sutured. [Illustration: FIG. 237. FIG. 238. VON LANGENBECK METHOD.] =Morgan Method.=—For an extensive loss of the lower lip Morgan operates in the following manner: After a thorough elliptical extirpation of the diseased area, he makes a curved incision in the tissue under the chin, conforming in its curvature to the incision made below the diseased area of the lip (see Fig. 239). The length of this incision is about twelve centimeters. This bridging flap is carefully dissected up from its basement membrane. Any infected glandular tissue encountered in the meantime is removed thoroughly. The whole bridge of tissue is now crowded upward, until it displaces the defect in the lip. It is sutured on either side, as shown in Fig. 240, to hold it in position. Several sutures are introduced along its inferior margin, to tie it to the tissue of the anterior jaw border and to prevent its sliding downward. Strips of borated gauze are laid into the fold between the raw surface of the flap and the jaw. The secondary elliptical submental wound is drawn together by suture as far as possible; the remaining raw surface is either allowed to heal by granulation or is covered immediately with Thiersch grafts (Wölfler, Regnier). The objection experienced with the method just considered is found in the difficulty with which the bridge flap is carried upward over the prominence of the jawbone. It is very essential, therefore, to give as much freeness to this flap as possible, a fact necessitating considerable injury to the flap by handling and cutting, although the result of the operation, if carefully done, is excellent; the lip, owing to its solid form and undisturbed mucous membrane, does not contract as readily as with the average lip operation, and consequent ectropion is overcome to a great extent. [Illustration: FIG. 239. FIG. 240. MORGAN METHOD.]