=Author’s Method.=—The method of the author is as follows: Given a nose, typified by the illustration in Fig. 482, the skin above the site of the operation is thoroughly cleansed with soap and hot water, then rinsed with alcohol, ninety-five per cent, and vigorously scrubbed with gauze sponges, dipped into hot bichlorid solution, 1 to 2,000, followed with a thorough lavage with sterilized water. Both nostrils are now cleansed with warm boric-acid solution by the aid of small tufts of absorbent cotton wound over a dressing forceps. The patient is then instructed to breathe through the mouth during the operation. A number of small round gauze sponges dipped into sterilized water and squeezed dry are placed within reach of the assistant. About one drachm of two-per-cent Beta Eucain solution is now injected about the tip of the nose, the columna, and the alæ, as far back as their posterior fold. [Illustration: FIG. 482. FIG. 483. AUTHOR’S METHOD.] A thin bistoury is then thrust into the nose from right to left, entering at the point _E_ (Fig. 483), and brought down parallel to the anterior line of the nose, and emerging below the tip in a line with the anterior border of the nasal orifices. This procedure leaves a strip (_A_) about one quarter inch wide, laterally, rounded at its inferior extremity, and attached superiorly to the nose. Next the round inferior tip (_B_) is cut away obliquely, sloping inward toward the nose by the aid of a small angular scissors. Each blade of the angular scissors is now placed into each nostril, the tips of the blades inclined forward, and the columna or subseptum is divided at _C_, also the septum along the line _D_ up to a point a little above the first incision made externally at _E_. The two arterioles of the columna are controlled by the use of mosquito-bill forceps. The two projecting folds of the lower lateral cartilage in the columna are next severed as deeply as possible to give mobility to the stump, a step necessary to overcome the changed position, otherwise resulting in a droop, which would have to be corrected at a later sitting. The next step is to give the needed shape to both wings. This is accomplished with a specially designed scissors, so curved on the flat that its convexity facing upward corresponds to the normal curvature of the orificial rim. A clean cut with these scissors, beginning at _G_ and ending at the point _E_, is made, leaving the base of the nose, as shown in Fig. 484. The anterior flap _A_ is now bent backward to meet the stump of the columna at _C_. If it does not fall readily into place a little more of the septal cartilage is removed along the line _D_ until this is accomplished. It may be necessary to shorten the flap _A_ in cases where a very prominent hook is to be corrected. [Illustration: FIG. 484. FIG. 485. BASE OF NOSE AFTER EXCISIONS.]