Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
=Duberwitsky Method.=—The flap at its root resembles that of Labat, but
at its superior border it formed an oval with an elongated point running
into the hair line, which he divided, as shown in Fig. 326, to form the
subseptum and nasal wings.
At the root the pedicle was about half an inch wide made in the oblique.
The middle section of the superior pointlike projection and intended for
the subseptum was folded upon itself or doubled, as it were, to give
support to the nasal point. The same was done with the alar or lateral
sections, so as to line the nares with epitheliar surface to prevent
contraction. The lower part of the nose was fixed into position by a
harelip pin inserted transversely after all parts of the flap had been
sutured into place.
[Illustration: FIG. 326.—DUBERWITSKY METHOD.]
=Dieffenbach Method.=—The flap is cut very much like that advised by
Lisfranc, being wider only at its upper extremity, as shown in Fig. 327.
He advocates removing the remains of the old nose, almost circumscribing
the nose, as shown in the illustration, except for the deep linear
incision at the base of the nose on a level with the oval fissure,
leaving a bridge of skin at either angle into which the square or septal
part of the superior frontal flap is affixed.
The flap is made so that the right oblique line lies an inch above that
of the left, the latter incision running into the angle formed at the
root of the old nose caused by the ablation.
[Illustration: FIG. 327.—DIEFFENBACH METHOD.]
=Von Ammon Method.=—The flap is cut at its superior border, similar to
that of Keegan, but made in the perpendicular; the point of beginning,
at the end of the right eyebrow, lies about an inch above the end of the
incision of the opposite side, but in line with it (Fig. 328). The same
method of removing the remains of the old nose advocated by Dieffenbach
is followed as well as the lobial incision to receive the septal section.
The shape of this flap permits of bringing the secondary wound on the
forehead more readily than where square exsections are resorted to.
[Illustration: FIG. 328.—VON AMMON METHOD.]
=Auvert Method.=—Like the method of Keegan, the frontal flap is made at
an angle of forty-five degrees instead of the perpendicular, the flap
being cut to the left of the median line. Its outline is shown in Fig.
329, and differs little at its superior extremity from that of Labat,
except that it is made longer and narrower. The left lateral incision
runs into the superior border of the old nose at the median line.
[Illustration: FIG. 329.—AUVERT METHOD.]
=Von Langenbeck Method.=—The flap is fashioned like that of Duberwitsky,
but the left lateral incision enters the remains of the old nose, as
Dieffenbach advised. The superior border was shaped, as shown in Fig.
330, to form the alæ and columna.
[Illustration: FIG. 330.—VON LANGENBECK METHOD.]
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