Various operators give this period between six and twenty days. The apparatus should be so constructed that dressings can be easily made without discomfort to the patient, and without doing damage to the parts, and also to expose the face of the patient as much as possible. The various operations employed to perform total rhinoplasty by the Italian method may now be considered. =Tagliacozzi Method.=—This surgeon resorted to four steps to accomplish his operations, which were: I. Massage of or stretching the skin of the part from which the flap is to be made. II. Cutting the flap, and allowing the same to cicatrize. III. Freshening the flap and suturing in place, and use of apparatus. IV. Cutting the pedicle and making the subseptum. The various details of these steps should be considered here, since the methods are practically the same for all other operations of this kind, except in certain particulars as to time and mode of procedure. I. Massaging the tissue of the arm to render it supple. This is of some consequence, in some cases, where the skin is tense, but requires no especial description. II. He then compressed a fold of the skin with a large forceps at the lower half of the biceps. Upon opening these forceps he forced a bistoury under the skin fold and cut down toward the elbow-joint a distance sufficient to form a flap. This gave him a piece of raised skin, attached at either end, double the size of that required to make the nose. Under this he introduced linen mesh dressings in the form of a seton, with the object of irritating the skin to encourage the circulation, and render it thicker by consequent suppurations and granulations. This was continued for fifteen days, when the skin was detached at its upper end, leaving it attached by the lower or wider pedicle intended for the base of the nose. The flap was now turned down and both flap and wound were allowed to cicatrize. III. When the flap had become dry he fitted the linen bandage apparatus to retain the arm. Then the borders of the old nose were freshened. Thereafter he cut a paper pattern as a model for the new nose, upon which the margins and shape of the flap were cut. The flap was finally sutured in place, and the apparatus was tightened to prevent movement of the parts. IV. After twenty days he cut the pedicle. The latter was then cut into, to divide it in three parts, which he formed into the subseptum and nasal wings, which were sutured in place, metal tubes being employed to keep the nares open. =Dieffenbach Method.=—This surgeon followed seven steps to complete the operation, as follows: I. The pattern of the new nose, cut one third larger, is fixed upon the skin of the arm, with the basic pedicle just above the fold of the elbow. Skin is now raised sufficiently to permit of its being incised, the incisions being made laterally, as shown in the dark lines in Fig. 347.