Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
If, after the teeth have been brought back to the normal bite, the
lip still shows an abnormal contour, the surgeon may restore this by
several small incisions in the mucosa, as above advised, at the various
protruding points of the lip.
When the simple vertical-line incisions sutured horizontally will not
accomplish the result, the excision of small triangles or elliptical
pieces of the mucosa may be made, bringing the distal edges of the
wounds together horizontally with silk sutures, which are found best for
suturing wounds about the buccal cavity.
The same methods as above given apply to the correction of upper-lip
deformities.
Where the fault is too great to be overcome by this method, the author
advocates removing an elliptical or diamond-shaped piece of the lip
from the inner surface or mucosa, the whole length of the lip and wide
enough to correct the fault, as shown in Fig. 249, and bringing together
the margins by an interrupted suture, as in Fig. 250. This is the most
satisfactory method to restore either the upper or lower lip to normal
position. The resulting cicatrix of the mucous membrane offers no
objection whatever, and soon becomes obliterated.
[Illustration: FIG. 249. FIG. 250.
AUTHOR’S METHOD.]
If the operator feels justified to remove a triangular piece, with its
base upward, in case of the lower lip, and _vice versa_, from the whole
thickness of the lip he can do so, but the operation has the objection
of leaving a noticeable vertical scar in the skin and a notch in the
vermilion border.
The former can of course be materially hidden by the mustache or beard in
man.
LABIAL ENTROPION
While labial inversion is in most cases caused by the removal of tissue
from the inner or whole lip structure due to disease or other causes, it
may nevertheless be met with in hereditary instances. The condition is
termed microcheila.
It is more common in the upper lip, perhaps because of the frequency of
harelip corrections undertaken with that part of the mouth, but it may
involve both lips or be partial in one or both lips; in the latter case
often the result of the habit of talking, chewing, or laughing with one
side of the mouth, in which the active side is the normal and the passive
side the one showing a lack of development.
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