The only difficulty experienced in the case with men is that the bearded surface of this inturned flap offers considerable discomfort to the patient, although in the majority of cases the skin thus inverted soon takes on the appearance of the mucosa, the objectionable hairs falling out and the hair follicles becoming obliterated. [Illustration: FIG. 264. FIG. 265. KRASKE METHOD.] =Israel Method.=—To overcome the above objection Israel makes his flaps from the skin of the side of the neck, the flap being elongated and attached at its upper end, as in Fig. 266. This flap he turns upward into the defects with its epidermal surface facing inward and sutures it into place, as shown in Fig. 267, leaving the outer surface to granulate over and thicken on the sutured margins to heal into place. This requires from fourteen to seventeen days, when the pedicle is severed and the lower or freed portion of the flap is brought forward. The granulation of the entire surface is scraped off and the free end of the flap is turned over upon itself, as it were, and its margins sutured to the descended skin margin, as in Fig. 268. [Illustration: FIG. 266. FIG. 267. FIG. 268. ISRAEL METHOD.] =Bardenheuer Method.=—Bardenheuer has given this subject a great deal of attention, and advocates the use of the skin of the forehead for closing these buccal or oral defects. The skin of the forehead is without hair, is well nourished, and has little adipose tissue underlying it, facts that make it especially useful for these operations. The skin surface he turns into the mouth cavity, while the outer or raw surface is covered with a pedunculated skin flap taken from the region of the intramaxillary region. The secondary wounds of the forehead and below the jaw should be covered with Thiersch grafts at the same sitting. The best cosmetic results are obtained by correcting the entire defect at one sitting, as the subsequent contraction of the flaps do not allow of it in successive operations. The apposition of the raw surfaces of the flap from the forehead and that of the cheek or chin greatly increases their vitality and overcomes markedly the cicatricial contraction. The pedicle of the forehead flap is cut apart about the fourteenth day and replaced. In the case depicted in Fig. 269 a large portion of the cheek and the whole upper and a part of the lower lip had to be removed. A large flap taken from the forehead that turned into the defect (see Fig. 270), and a flap taken from the intramaxillary region, were brought over the major and lower portion of its raw and outer surface. [Illustration: FIG. 269. FIG. 270. BARDENHEUER METHOD.] In Figs. 271, 272, and 273 the various steps of the same operation are more fully shown, including the placing of the Thiersch grafts and the replacing of the pedicle in Fig. 274. [Illustration: FIG. 271. FIG. 272. FIG. 273. FIG. 274. BARDENHEUER METHOD.]