The first suture is to be placed at the margin of the vermilion border and the skin, so that the unequal sides are placed in normal apposition. The parts are sutured according to the method shown in Fig. 167. [Illustration: FIG. 166. FIG. 167. GRÄFE METHOD.] =Mirault-Bruns Method.=—An excellent method of this class is that of Mirault-Bruns. Their operation is indicated in defects of extensive degree, and usually gives excellent results. As in the former method a semicircular incision is made to include the superior angle, and two other incisions are made somewhat as shown in Fig. 168. The wound made thereby is shown in Fig. 169. The inferior triangular flap of one side is utilized to restore the prolabium, the whole being sutured, as shown in Fig. 170, care being taken to make this flap of sufficient size to give stability and volume to the lower margin of the lip. [Illustration: FIG. 168. FIG. 169. FIG. 170. MIRAULT METHOD.] =Giralde Method.=—This method is intended for defects of the third degree. A vertical incision frees the vermilion border on one side, while an angular cut on the opposite side (see Fig. 171) allows of the bringing together the lip flaps above it. The wound is made to appear somewhat as in Fig. 172, and is sutured, as depicted in Fig. 173. [Illustration: FIG. 171. FIG. 172. FIG. 173. GIRALDE METHOD.] =König Method.=—König advocates two vertical incisions which dispose of the cicatrized borders of the defect. A slanting incision is added at both sides to free the prolabium (see Fig. 174), giving a wound when drawn in position, as shown in Fig. 175. In suturing the wound the vermilion border flaps are turned downward as much as possible to restore the contour of the prolabium. The sutures are placed as shown in Fig. 176. [Illustration: FIG. 174. FIG. 175. FIG. 176. KÖNIG METHOD.] =Maas Method.=—Maas has deviated from the above method somewhat, as is shown in Fig. 177, by making one of the prolabial flaps much larger than the other. His operation is applicable to defects of maximum extent. The lip wounds are thereby made to appear as in Fig. 178, and the sutures are applied as in Fig. 179, with an advantage of leaving a smaller sutured wound to heal by primary union. [Illustration: FIG. 177. FIG. 178. FIG. 179. MAAS METHOD.] =Haagedorn Method.=—Haagedorn’s method does not differ much from the above. The incisions are shown in Fig. 180, the appearance of the freed margins in Fig. 181, and the sutured wound in Fig. 182. The prolabial flaps are somewhat alike in size in this operation, in which it differs only in the method just considered. [Illustration: FIG. 180. FIG. 181. FIG. 182. HAAGEDORN METHOD.] =Geuzmer Method.=—Geuzmer so incised the cicatrized defect that a small prolabial flap is formed from the median border and a larger one from the lateral, the very opposite of the Haagedorn technique.