In five weeks the two nasal bones united, end to end, and three months after the operation the space made by the removal of the bone had become filled with hard tissue, that eventually ossified in about seven months. [Illustration: FIG. 404.—Second step. FIG. 405.—Position nasal bone occupies. OLLIER METHOD.] =Langenbeck Method.=—A median incision is made through the remaining skin of the old nose, dividing it into halves. The incisions about the base and the shape of flap to be brought down from the forehead are shown in Fig. 406. The skin over the nose is dissected up, moving toward the cheek, exposing the bony frame of the nose. From the lower border of the pyriform aperture two elongated triangular plates of bone are made, being attached posteriorly to superior maxillary bones. They should be made about one sixth inch wide. By their subsequent displacement they are made to lie antero-posteriorly. With a saw the nasal bones are separated from their maxillary connection from below upward, making a median bone plate, which is raised with a levator to the height desired for the new nasal bridge, remaining attached to the frontal bone, as shown in Fig. 407. A frontal flap is taken from the forehead and sutured to the freshened raw margins of the lateral flaps. The bone plates are fastened to each side of the frontal flap by suture. The nasal base is preferably made of the tissue remaining of the old nose, as depicted, to prevent closure of the nostrils, the only difficulty being to keep the poorly nourished tissue from dying. When used the raw surface is brought in contact with that of the frontal flap. The objection in this case is that the median third anterior line usually falls in rapidly, leaving the nose dished or saddled, and unless there be sufficient tissue to construct the base, the objections so often referred to heretofore will occur. [Illustration: FIG. 406.—First step. FIG. 407.—Showing separation and elevation of nose flaps. LANGENBECK METHOD.] =Ch. Nélaton Method.=—This author uses an osteo-cutaneous flap taken from the forehead. The shape of the latter is shown in Fig. 408. The lateral incisions are to be made the width of a finger from the margins of the old nose, extending upward in curved fashion through the inner edge of the eyebrows and meeting at a point on the forehead, becoming slightly oblique near the border of the hair. The flap is dissected up from the borders inward, including the periosteum, leaving a strip of bony attachment at the median line. The dissected sides of the flap are held up by an assistant while the operator proceeds to chisel a thin bony plate from the frontal. The bony plate ends just above the root of the nose. The dissection is now carried on downward until the bones proper of the nose appear, and latterly, so that the saw does not injure the soft parts, and to act as a guide for the course of the latter. The position of the flap and the saw in position is shown in Fig. 409.