=Zeis Method.=—To overcome the difficulty of sliding this bridgelike flap, Zeis advocates ablating the diseased area in quadrilateral form and forming the lip of unbroken tissue by making the flap two-tailed (see Fig. 241), each flap meeting anteriorly in a bridge of tissue sufficiently wide to permit of the formation of the required lower lip and extending obliquely downward and backward upon the submental surface, having their pedicles as far back and upon the neck as is necessary to allow the two-tailed flap to move forward into position. The parts are slid into position and sutured, as shown in Fig. 242. Unfortunately the tissue of the neck is not very thick, nor is it well nourished, factors that do not make it very satisfactory for cheiloplastic purposes. [Illustration: FIG. 241. FIG. 242. ZEIS METHOD.] =Delpech Method.=—Delpech has utilized the skin of the anterior neck region in the following manner: He ablates the extensive diseased area, as shown in Fig. 243, and dissects up an inverted triangular pedunculated flap of skin from the hyoidean region of the neck, having its raw surfaces brought face to face at its distal extremity sufficiently to line the newly formed lip with skin which eventually would take on the function of mucous membrane. The whole flap was now rotated upward on an arc of 180° and sutured into the labial defect, as shown in Fig. 244. The large wound of the neck was readily drawn together by suture, leaving only a small triangular space to heal by granulation. As has been mentioned, the skin of the neck is not adaptable for this purpose, not only because of its poor nourishment and extreme thinness, but because a flap made therefrom is devoid of muscular structure, contracts easily, and is devoid of a mucous-membrane prolabium, the greatest objection being in the resultant contraction of the lip so formed, which usually constitutes so high a degree of ectropion of the lip as to allow the saliva to escape from the mouth. Apart from the ingenuity of the method it has no practical value, for the reasons given. [Illustration: FIG. 243. FIG. 244. DELPECH METHOD.] =Larger Method.=—Larger restores two thirds of the lower lip after the ablation of an epithelioma, as follows: 1. An incision is made from the union of the left third with the right two thirds of the upper lip, directed toward the alæ of the nose and including the entire thickness of the lip, the _cul-de-sac_, and the buccal mucous membrane.