=Bruns Method.=—Bruns advocates making two lateral flaps from the cheeks, as shown in Fig. 198. He preserves the inferior margin of these flaps, which contain a cicatricial border which must take the place of the prolabium. This border can, however, be made up of the vermilion border of the lower lip, as shown later in the performance of stomatoplasty, to establish a better cosmetic effect. The rectangular cheek flaps are sutured, as in Fig. 199, leaving two small triangular wounds at either side of the alæ to heal by granulation. The cheek flaps referred to must be dissected up from the bone, and be rendered as mobile as possible for a successful issue. [Illustration: FIG. 198. FIG. 199. BRUNS METHOD.] =Dieffenbach Method.=—The method of Dieffenbach is very similar to the above. It has been described on page 157. In this the lateral flaps are made by two curved incisions encircling the alæ of the nose. Should these be insufficient, two other curved incisions are added, as shown by the dotted lines in Fig. 183. =Sedillot Method.=—Sedillot also employs two rectangular flaps, but he cuts them from the region of the chin (see Fig. 200). The advantage of this method lies in the fact that these flaps are lined throughout with mucous membrane, as the incisions are made entirely through the tissues involved, beginning at the angle of the mouth and extending downward to the limitation of the buccal fold interiorly. The flaps are twisted into position and sutured, as shown in Fig. 201. The mucous membrane of the inferior border is dissected up to a required extent and turned outward and stitched to the skin margin without to provide the prolabium. This is an important matter not only for cosmetic reasons, but especially because such mucous-membrane lining overcomes to a great degree the objectionable cicatricial contraction of this free border. In certain cases the mucous-membrane grafts of Wölfler may be employed to cover the raw edge of these newly made lips, or the Thiersch method of skin-grafting might be employed with the same object. Where the defect is unilateral, as is usually the case, a single cheek or chin flap need only be employed, and this lined with mucous membrane. [Illustration: FIG. 200. FIG. 201. SEDILLOT METHOD.] =Buck Method.=—Buck, in such unilateral defects, employs an interolateral rectangular flap. It contains a part of the lower lip and its vermilion border. This flap is twisted upward, so that its outer and free end comes in apposition at or near the median line as may be, with the remaining half of the upper lip.