This branch of plastic surgery has to do with the correction of deformities of the lips. These deformities usually involve one lip only, and are dependent upon direct traumatism, operative interference in the extirpation of malignant growths, particularly carcinomata, the correction of cicatricial disfigurement following tubercular or syphilitic ulceration or congenital faults, commonly met with in harelip. Operations for the latter condition have usually been considered under a separate heading, but since the restorative procedures involve methods purely plastic they are included under this their proper classification. Owing to the great number of blood vessels in the lips, it is advisable to resort to the bloodless method, where the defect to be corrected involves more than the superficial structure. This is accomplished: 1. By compressing the coronary arteries at both angles of the mouth by digital pressure, suitable clamps or compression forceps. The fenestrated oval forceps, illustrated in Fig. 145, and designed by Burchardt, or the harelip clamp of Beinl, Fig. 146, will be found to meet the purpose well, the latter having a sliding lock by which the pressure upon the tissue can be regulated to a nicety. [Illustration: FIG. 146.—BEINL HARELIP CLAMP.] 2. By clamping off the site of operation with specially made cutisector forceps. Its smooth parallel jaws should be curved outward, so that the diseased area can be fully excluded by their concavities. 3. By employing the indirect ligature of Langenbuch. This is accomplished by including the site of operation with several strong silk threads firmly tied in loops upon the skin surface, each loop including a given amount of tissue, the next encroaching upon it up to the center of this area, and so on until the entire site is rendered anemic. The advantage of this method is that with the anemia a certain amount of anesthesia is produced at the same time; a fact to be remembered when the patient is to be operated under local anesthesia, the anemia enhancing the efficacy of the latter. HARELIP A congenital defect of the upper lip caused by the lack of proper union of the maxillary, globular, and frontonasal processes _in embryo_. Treves states that from the buccal aspect of the maxillary process of either side the palatal processes arise, passing inward to combine with each other to form the soft palate and all of the hard palate, except the intermaxillary portion, and that from this same source are formed the cheeks, the outer or lateral parts of the upper lip, and the superior maxillary bones, while the external nose, the ethmoid, the vomer, the median portion of the upper lip, and the intermaxillary or os incisivum are derived from the frontonasal process.