Both ears sutured, the wounds are cleansed thoroughly, though gently, with fifty-per-cent peroxid of hydrogen and dried and dusted over with aristol powder. [Illustration: FIG. 141. FIG. 142. CORRECTION OF MALPOSED AURICLES. (Author’s case.)] A pad of gauze is placed over each ear and a bandage applied around the head to protect the wounds and retain the ears, care being taken not to tighten too tightly, as this occasions great pain and possible pressure erosion of the skin. The dressing should be changed on the second day, as there is usually some soiling of the dressings at the lower angles of the wounds. They are again powdered, using the pulverflator preferably, and rebandaged. The ears will be found to lie very close to the head at this time, if the operation has been properly done. Anteriorly in the skin of the concha and corresponding to the line of cartilage exsection will be found a crease more or less discolored, according to the severity of injury occasioned by the operation. This should give the surgeon no concern, as the fold will accommodate itself in a few days. There may be a persistence of the fold for some time, however, which, if desirable, can be corrected by a small secondary operation at a later date. The author has never experienced the need of such, however. The patient at this time usually bemoans the position of his ears, and should be assured beforehand what was expected, and that the condition is only temporary. The dressings after this can be repeated every second or third day, as may be required, although these wounds heal surprisingly well. Moist dressings are to be avoided at all times, they soften the edges of the wound and prevent primary union. [Illustration: FIG. 143. FIG. 144. POSTERIOR VIEW OF REPLACED AURICLES.] The sutures are removed on the ninth or tenth day, whereafter the patient may be allowed to go without the head bandage, but is strictly instructed to replace it at night with a band of muslin three inches wide, snugly pinned around the head to prevent the ears from being injured or torn away from their new attachment by sudden movements during sleep. This bandage should be worn at night for at least a month. When only a part of the ear is overprominent the operation undertaken should in the main be according to the methods just described, the incisions being changed in extent accordingly. In the illustrations above, Figs. 143 and 144, are shown the posterior view of the ears before and after operation. At no time should the ears be placed too closely to the head, as is often peculiarly requested by the patient, as it gives an unnatural appearance and predisposes toward the collection of filth in the sulcuses that is hard to remove. The distance from the head to the outer rim of the ear should be about half an inch at its widest part. CHAPTER XI CHEILOPLASTY (_Surgery of the Lips_) [Illustration: FIG. 145. BURCHARDT COMPRESSION FORCEPS.]