=Roe Method.=—Roe’s method requires a submucous extirpation of the redundant cartilage at the tip through a necessarily small opening within the nasal orifice, also the division in several places of the anterior fold of the lower lateral cartilage with the object of reducing the undue convexity of the alæ. The latter is, we might say, impossible, since the cartilages will be reduced by such a method, even under pressure dressings, which are likely to cause gangrene of the skin of the wings; or if this be avoided, the cicatrix resulting from such division usually restores the very fault that it is expected to overcome, while the mucous lining of the alæ becomes thickened and more firmly tied down than previous to the operation. One is tempted to exsect the major curvature of the lower lateral cartilage, but this leads to a flattening of the wings of the nose, partial atresia of the nasal orifice, and a decided lack in its symmetry. Secondly, in Roe’s operation there is always a lack of knowing how much or how little to remove of the cartilage of the tip, a second cosmetic operation being made necessary after the parts have contracted and healed, a common fault with most cosmetic plastic operations performed under local anesthesia, owing to the immediate edematous enlargement following its hypodermic use. =Operation as Commonly Practiced.=—The operation heretofore most commonly practiced is one in which an elliptical piece of skin is cut from the tip of the nose, followed by the extirpation of the anterior prominences of the lateral cartilages, and amputation of the septal cartilages. Unfortunately, the result, at first quite satisfactory to the eye, culminates in the pulling apart of the cicatrix formed by bringing the sides of the wound together along the median line with a later depression of the tip in this median line, occasioned by the outward traction of the lower lateral cartilages. Even a second or third operation does not overcome this result entirely, and at best leaves an ugly irregular gash in the median line of the tip and the columna. In one of the cases here cited this same operation had been unsuccessfully tried twice by another surgeon, with very unsatisfactory and unsightly result. (Case II.) The ideal operation for all of this type of cases from the view of the surgeon is to leave as little disfigurement as possible, and the method to be here considered, when properly followed, leaves no scar whatever, except for a slight white line across the columna of the nose, where it is out of view, and when contracted offers no objection on the part of the hypercritical patient.