=Tripier Method.=—Tripier refashions the prolabium of the mouth by means of a mucous strip taken from the inner surface of the lip. This strip is left attached at both ends, forming a bridge flap of mucous membrane, the pedicles of the ends giving nourishment to the whole. The bridging strip is slipped into place and is sutured to the outer skin by its superior border, so as to restore the normal appearance and thickness of the lip. Antisepsis must be carried out scrupulously and a strip of iodoform gauze be placed between the lips operated upon and the gum. In forty-six cases operated upon by this method forty-two were successful, while in two of the unsuccessful cases there was partial gangrene of the flap. =Macrostoma and Overdevelopment of the Lips.=—In the cosmetic correction of macrostoma there may be an overdevelopment of one or both lips as well as the wide oral fissure. In such cases the lip structures is to be reduced by the methods heretofore given, before shortening of the mouth line is undertaken, because of the greater freedom allowed the surgeon to correct the deformity. If possible the operation at the oral angles above referred to should be avoided because of a certain amount of scarring of the skin at either side of the mouth and the resultant stiffness of the parts due to the surgical interference; therefore, when practicable, or when the deformity is of moderate extent, the angles of the mouth should be advanced toward the median vertical of the lips. In such case it is best to do such operations before any labial corrections are undertaken. =Author’s Method.=—The method advised by the author is the employment of the Dieffenbach procedure as follows: A V-shaped incision, its apex pointing inward and its distal ends a half inch from the prolabial line, is made quite deep through the mucosa and muscular tissue, as shown in Fig. 253. The part included in the V is now drawn toward the median line of the lip, causing the wound to gape. The latter is then sutured with deep and superficial silk sutures in the form of a Y, as shown in Fig. 254. The same operation is repeated at the other angle of the mouth. [Illustration: FIG. 253. FIG. 254. AUTHOR’S METHOD.] THE CORRECTION OF MICROSTOMA When the oral orifice has become lessened, as is frequently the result of cicatricial contraction following ulcerations or operative interference, but which may, too, occur congenitally, the condition is termed microstoma. =Dieffenbach Method.=—Dieffenbach advocates the following operation for the correction of this abnormality: Two lateral incisions are made outward from the mouth across the cheeks and through their entire thickness, extending in length a little beyond the intended angle of the mouth (see Fig. 255). The mucous membrane from within is brought forward and is sutured superiorly and inferiorly to the skin with fine silk sutures.