8. Transposition of Lateral Flaps Below the Prolabium 119

OF LATERAL
TRANSPOSITION
FLAPS
BELOW THE PROLABIUM
II
44
NY
CLEFT LIP
AND THE
CENTURY
ON WHAT
PRIMARILY
PROLABIUM
IF
IN
THE MIDDLE
ENOUGH
TO
AS
PORTION
PINS
BOLSTERING
WILL
IS
SHORT INADEQUATE
REFERENCE
IN
VERY
THE
SEEMED
LESS
COMPONENT
ING
HIGHER
THE
BILATERAL
OUT
THIS
POUNDED
BECAUSE
CLEFT BY
AS
NOT
ERROR IN
LENGTH OF THE CENTER
ON
FRONTO
THE ENTIRE
RELEASE
INSIGNIFICANT
KIND
OF SURGEONS
DOUBLING
THE PROLABIUM
TO
4J
WITH APPARENT
PRINCIPLE
THAN TWICE
EXERTED
AND
OF LABIAL
NEITHER COMPONENT BEING
HOST
THEIR
WAS
RESULT
COMPROMISE
COURAGED
OF
ASSETS
THE BASE OF THE SHORT COLUMELLA
PERMITTING
WITH AN
SHARING OF TISSUE
444
NOT BE LONG
THE INTRODUCTION
AFTER
VERTICAL
FORM THE COMPLETE
DOWNWARDPULL WAS
TIP
SHOULD
TWO IMMEDIATE
REALIZE
TO
OF THE LIP
NASAL
OF THE
FROM THE
THE PROLABIUM FROM BELOW WITH SKIN FLAPS
TO
BIT
II
PROLABIUM
OF THE LETTER
THE SHAPE
WAS NOT FORCED
RIDE
CASE
WOUND LEFT
THE PROLABIUM WAS LENGTHENED
NASAL
FOCUSED
THE HANDLING
TO
COMMONLY THE
MARGIN
HAVE
ELEMENTS
LIP
COMPONENT
THE
CLEFT LIP
BILATERAL
REACH THE LAHIAL
THE HARELIP
LATERAL
1844
IN
OF
CONSCIOUS
TWENTIETH
TO BE
APPEARED
STATED
AS PANCOAST
OF THE
SHORTNESS OF THE FRONTONASAL
VERTICAL
OVERALL
HALF
FIRST
OF THE NINETEENTH
OF THE LAST HALF
SURGEONS
THEIR
BEING
BILATERAL
BUT
CENTURY
CLEFTS
IN
COMMUNAL
THIS
TEMPT
ADVANTAGES
EN
IN
THE
TO
ADAPT
LATERAL FLAP
UNILATERAL
CORRECT
NASAL
SATISFIED
INADEQUATE
OVER
OF THE DEPRESSED
UNILATERAL
AS
IT
TURNED
CLEFTS
THE DAMAGE BEING
FAR
COM
MORE
MUCH
119
II
JALAQUIER
1880
LJ
SI
MAAS
1882
HAGEDORN
120
IC
JJ
1884
SI
IX
ROSE OF KINGS COLLEGE
WILLIAM
HIS
DESCRIBED
TO
SHOULD BE CARRIED OUT ACCORDING
THE
HARELIP OPERATION
LATERAL
AND THE
CURVED
THE APEX OF THE CENTRAL PORTION
1891
FOR
THE SINGLE
VSHAPED MANNER
FTOM ABOVE DOWN TO THE
UPWARDS AND INWARDS ONLY
THE COMPLETED LIP
THE
LONG
OF THE WIRE STITCHES AND THE SHORT ONES OF
REPRESENT THE POSITION
LINES
IN
INCLUDED
IS
PARED IN
INCISIONS
AND THEN OBLIQUELY
MUCOCUTANEOUS JUNCTION
CROSS
IS
IN
HE WROTE
AS
ENUNCIATED
THE PRINCIPLES
CENTRAL RUBERCLE
BY
SEGMENTS
WHICH
CLEFT LIP
TO BILATERAL
APPROACH
LONDON
HOSPITAL
SUTURES
THE CATGUT
ROSE 1891
HE
LATERAL
ADVISED
FREE
THE
UNE
DRMININ
DETACHMENT OF THR
FIRST
STEP
AND
THIS
FROM THE MAXILLAE
LIP
MUST BE ACCOMPLISHED
BY UNDERCUTTING
THOROUGHLY
SHOULD BE
THESE BILATERAL
IN
CASES
ROSE
DEFENDED
ALSO
THE
TREATMENT
THE
FIRST
PLACE
THE
OF HIS
LOGIC
USE OF THE
OF THE CENTRAL PART OF THE UPPER LIP DEMANDS SPECIAL
IT
IS
QUITE
EVIDENT
THAT TO ATTEMPT
TO
DRAW
EXTENT BETWEEN THE FLAPS WOULD HAVE THE EFFECT OF DEPRESSING
NOSE AND PRODUCING AN UNSIGHTLY
BE REMEMBERED THAT THIS
LATERAL
IT
AND
IS
THIS
IS
DILATATION
OF TISSUE
STUNTED PORTION
NOT ONLY THE CENTRAL PART OF THE LIP
QUENTLY
PROLABIUM
ONLY THE EXTREMITY
EFFECTED BY CUTTING
THEN BE BROUGHT TOGETHER
IN
IT
DOWN
PHILTRUM
VSHAPE
THE MEDIAN
IN
TO ANY
THE POINT OF THE
OF THE NOSTRILS
REPRESENTS IN
BUT ALSO THE COLUMNA NASI
OF THIS
INTO
IT
NOTICE
FO
IT
MOST
MUST
CASES
CONSE
WHICH NEEDS PREPARATION
THE
OUTER SEGMENTS CAN
LINE
121
JI
THERE WAS
SIMILARITY
BETWEEN ROSES APPROACH AND THE
LATER
THOMPSON METHOD
THOMPSON
THEN
BINNIC
1912
BINNIC
DESIGNED
AN EVEN
MORE FRIGHTENING
PROCEDURE
1916
ONESTAGE VEAU
11
AS
DIAGRAMMED BY
HOLDSWORTH 1951
BARSKY
ARTHUR BARSKY HAS LONG BEEN KNOWN
TO BERNARD
SIMON ONE
EXEMPLIFIED
GIVE
MAN
EAT FOR
AT
ARTHUR BARSKY
YORK
BURNED
PRECAUTION
122
FISH
OF HIS STUDENTS
TEACHING
ACCORDING
BARSKYS PHILOSOPHY
WAS
THE SAYING
AND HE
WILL
EAT FOR
DAY TEACH
MAN
TO FISH
AND HE
WILL
LIFETIME
NEW
GIRLS
BY
FOR HIS
IN
MT
THE
OF HAVING
SINAI
HOSPITAL
HIROSHIMA
WHILE
TREATING
ATOMIC BOMBING
TWO TEAMS OF JAPANESE
THE JAPANESE
HE
TOOK THE
SURGEONS WORKING
HIM THEN
WITH
1966
IN
AWARE OF THE RAVAGES OF
ACUTELY
WAR
HE
OLD PROVERB
FOLLOWED THE
IT
BETTER TO
IS
AND
STARTED
AND
STAFFED
CHILDRENS
WOU1D
HE SAID
OWN
HIS
MINOR
WAY
IN
LATERAL
SKILL
AND
ZEAL
WITH
ANOMALIES
THE
FOR
TEACHING
IN
BACKFIRED
POSSIBLY
OF THE
UNION
ACHIEVED
WHICH
IN
BOOK BARSKY
GOOD 1938
HIS
THE INFERIOR
FLAPS BENEATH
OF THE
EDGE
BY THE METHOD OF
OF THE PREMAXILLA
AFTER REPOSITIONING
WHO
SOMETIMES NOT ALWAYS ADVISABLE
DESIGN
LIP
SKIN AND VERMILION
PROLABIUM
THE TREAT
EASTMAN SHEEHAN
WITH
CLEFTS
BILATERAL
TO
VIETNAMIZATION
ANYTHING
TRY
BUILT
DESIGNED
DEVOTED
SAIGON
CONGENITAL
TRAINING
EARLY
BILATERAL
PUBLISHED
IN
OF WAR AND
ARTHUR BARSKYS
HE
INTERNATIONAL
HOSPITAL
EVENTUAL
PLAN OF
ULTIMATE
CURSE THE DARKNESS
TO
RELIEF
CHILDRENS
MENT OF VICTIMS
PLUS
THAN
CANDLE
LIGHT
VON BARDELEBEN
AG
AA
BBC
FROM 1952
AT
MT
SINAI
TEACHING
IN
FOR
AND
HOSPITAL
THE
NEW
UNNATURAL
PERPETUATING
THIS
WITH
KAHN AND
SIDNEY
SLIGHTLY
SPECIAL
CALLING
MENTION
THE PROLABIUM
PRINCIPLE
IT
THAT
LATER AT ALBERT
YORK
BILATERAL
SURGEONS TREATING
OF PLASTIC
CHIEF
YEARS BARSKY WAS
MANY
THE
AREA
CLEFTS
AND WAS
PARTLY
BERNARD
SIMON
BARSKYHAGEDORN
FLAPS
WAS USED
REMAINED THE SAME
SO
DID
RESPONSIBLE
IN
FOR
BOOK
HE CHANGED THE DESIGN
OPERATION
AND MADE
WERE RECTANGULAR
FOR LINING
IF
THE RESULTS
BB
123
ON MANY
1964
IN
HIS
HOSPITAL
INFLUENCE
GREAT
APPROACH FINALLY
THE LATERAL
VERMILION
HAD
EINSTEIN
SURGERY
IN
SHAPE
NEEDED AS THE
AND BROWN
BLAIR
THE
OF CLEFT LIP
SURGEONS AS PREVIOUSLY
MAJORITY
WITHOUT GOOD REASON HAD BEEN FORCING
OR
ON
BILATERAL
CLEFTS WITH
MODIFIED
BLAIR
JOINED
DUCED
PAIR
BANDWAGON
OF TRIANGULAR
FLAPS
UNILATERAL
LESS UNSATISFACTORY
AND BROWN MODIFIED
MIRAULT
THE ST LOUIS
MORE OR
THEIR
WITH
MENTIONED
DESIGNS
WHEN
RESULTS
MOST SURGEONS
BLAIR
AND ALONG WITH BROWN INTRO
UNDER THE
INFERIOR
BORDER OF THE
PROLABIUM
IN
BROWN MCDOWELL
1947
THE SURGICAL REPAIR OF DOUBLE
AND THE
CLEFTS
PRINCIPLE
THE PROLABIUM
OSIRION
BROWN
THIS
ARE
ABOUT
LIPS
IS
HALF AS
ABOUT
THAT
TWICE AS DIFFICULT
AS IN
SINGLE
GOOD
THEY STATED
IS
THE CENTRAL SEGMENT OF THE LIP
THE CLOSURE
THE
UPPER PART OF
IT
IS
AND MUST BE USED
SOMETIMES ADVANCED
INTO THE COLUMELLA AT THREE OR FOUR YEARS OF
AGE BUT
ARIL
BARRETT
IN
RESULTS
CLEFT
AND BYARS ADMITTED
IT
IN
THIS
SECOND
BEST NOR TO DO
IS
PRIMARILY
OF THE FEATURES
MANY
CLEFT LIPS
OF THE MODIFIED
WERE ADAPTED
FOR CLOSING
MIRAULT
OPERATION
FOR SINGLE
THE DOUBLE CLEFTS
NO
DESCRIBED
THEY
WHEN THE
UNDER
IT
PROLABIUM
MIGHT
RESULT
VARIATIONS
IS
UNUSUALLY
LARGE
IN
TOO LONG
LIP
FROM THE BOTTOM OF THE PROLABIUM
LATERAL
124
FLAPS
MAY BE DESIGNED
IN
OR LONG SO THAT THE MIRAULT
OR
TO SHORTEN IT
MM OF SKIN
IF
THE PROLABIUM
RECTANGLE TO ELONGATE
FLAPS
CAN BE EXCISED
THE
LIP
IS
TINY
THE
IN
DOUBLE
BYARS
PROBABLY
ARE
FOR
GREAR TENDENCY
LATE
ITIE
DETORMITY
BOWAND
THE TRIANGULAR
IT
LIP
LEFT
SCAR
AND
DOUBLE
PARTIAL
OPERATIONS
TO
DEFORMITY
WHISTLING
WHEN COMPARED
RESULT
TO THE
THE
ORIGINAL
LACKED
LIP
CO
TO NEAR
IN
WAS NOT
WAS
NORMAL LENGTH
AT THE EXPENSE
OF
ADMIT
DID
AND LOOSE LOWER
HAVE TIGHT UPPER LIPS
TO THE CONTRARY
SHORT OF IDEAL
LITTLE
WAKE MCDOWELL
ITS
TOO LONG IN
USUALLY
IN
LIPS
AND IMPROVEMENT WILL
OF
SPITE
FROM
RESULT
FLAPS
CLARITY
IN
METHOD EVER
ALL
SINCE
WAS AND
WHEN
1950
FROM
STUDENTS
ATTRACTED
HAVE CLUNG TO THE
ST LOUIS
MONOPOLY ON THE
VEERED FROM THE DOUBLE
TROLLED
SERIES
TREATED
IN
IF
CLEFTS OF
TRIANGULAR
YOU WISH TO
ST LOUIS WHEN
SEE
NOW
THESE
ALL
HE
YEARS
HAVING
NEVER
20YEAR CON
HAS
BILATERAL
CLEFT LIP
BROWNS
BARRETT
DENMARK AND
HOW
WAS IN
FOGHANDERSEN
OVER
FLAPS
WAS THE
IT
OVER THE WORLD AND
EVIDENTLY
DOGMATIC TEACHING WAS DEEPLY INGRAINED
HAS HAD
TAUGHT WITH
BROWNMCDOWELLBYARS APPROACH
SIMPLIFIED
BLUEDOT
MANY
CLEFT
ALL
THE LIP
EITHER THE
SURGICAL INTENTIONS
THIS
BILATERAL
TO INCOMPLETE
CONTOUR BUT BECAUSE OF THE SMALLNESS OF
AT LEAST
FLAPS
PATIENTS WILL
OCCASIONAL
CROSSLIP
BROWNMCDOWELL
WERE REASONABLE
RESULTS
HAD BEEN ELONGATED
MIDLINE
ALL
OF BILATERAL
CASES
GENERALLY PLACED IN THE WRONG DIRECTION
CLEFTS
NATURAL
DIMENSION
OR
OF
SINGLE OR DOUBLE
BILATERAL
COMPLETE
CUPIDS
REFERENCE
THE MOST DIFFICULT
HAVE ATTENUATED VETMILION
IN
IN
FLAPS
TRIANGULAR
LATE
BY THE 1947
TREATED
YEARS
SIX
STATED
CLEFTS HE
CLEFTS
23
TO
13
CLEFTS
THESE
FRANK MCDOWELL REVIEWED
1966
CLEFTS
MECCA
WERE ONCE
TAKE
TO
TRIP
WONDERFUL WONDERFUL COPENHAGEN
IN
BAUER TRUSLER AND TONDRA HAVING
1959
APPROACH
FOR YEARS
VERMILION
THINNING
DISCARD
THIS
PADGETT
IN
CC
125
CIC
TCC
LATE
RESULTS
AND STEPHENSON
THE MIRAULTBLAIR
4CC
HORIZONTAL
AND
WHICH
VERTICAL
FINALLY
BROWN
SHORTNESS WITH
FORCED
THEM
TO
METHOD
SCHOOL OF MEDICINE
PROLABIUM
CITED
USED THE
IN
ENDORSED
DESIGN
1948
AT
OF KANSAS
THE UNIVERSITY
THE SAME PRINCIPLE
BUT
WHICH PLACED MORE SKIN
ADVOCATED
BENEATH
THE
4C
VA
HOLDSWORTH
BASINGSTOKE
WHILE
1951
IN
WHAT HE
DIAGRAMMED
AT
STILL
ROOKSDOWN HOUSE
ONESTAGE VEAU
CALLED
II
NOTING
THIS
FEASIBLE
IS
OPERATION
THERE
IF
NASAL DEFORMITY
LITTLE
IS
LEMESURIER
HIS
OLLOWING
1946
DRAMATIC
WITH THE HAGEDORN
LEMESURIER
ON
ENTRANCE
BEGAN
THE PLASTIC
FLAP IN
QUADRILATERAL
BILATERAL
CLEFTS
THE DISTAL END OF EACH LATERAL QUADRILATERAL
PRODUCE THE
SLIGHT
EFFECT OF
AN
CLEFT LIP
BY DOUBLING
THEORETICALLY
FLAP SLIGHTLY
SHAPING
WIDER COULD
CUPIDS BOW AND GAVE THE METHOD
ARTIFICIAL
EDGE OVER OTHER
UNILATERAL
THE SAME PRINCIPLE
TO APPLY
AGAINST THE PROLABIUM IN
SURGERY SCENE IN
SIMILAR
PROCEDURES
LEMESURIER
EVIDENTLY
LEMESURIER
CLEFTS QUICKLY
SINGLE
OF THIS
APPROACH
EMPLOY
LATERAL
UNNATURAL
SCARS
FLAPS
AND
USUALLY WITH EXCESS
126
IT
ADAPTED
WAS THE SAME
SKIN
TRICK
AND ACTUALLY
KEPT HIS
NARROW SURGEONS WHOWERE PLEASED WITH
LATERAL FLAPS EXTREMELY
IN
DID NOT USE THIS
TO
AS
DOUBLE
OF
ALL
CLEFTS
THE
CRITICISM
OTHER METHODS
TRANSPOSED BELOW THE PROLABIUM
INFERIOR
VERTICAL
TRANSVERSE
LENGTHENING
IT
WHICH
IT
NARROWING OF THE
LEFT
LIP
PALATE
CLEFT
AT THE 1973
AND
FROM
FLAP
QUADRILATERAL
THE
SNOWWHITE HAIR LINDSAY
FOR SUCH
LONGTERM
TREATED
CASES
PALATE
PODIUM
DOUBLE
HIS
BY
FROM
TWINKLE
WHIMSICAL
HIS
THAT
II
CASES AS HE HIMSELF
HE
RESULTS
WAS TOO YOUNG
OF THE
GENERAL GRADING
REPORTED
OF THE LIP AND NOSE AS 18 PERCENT
APPEARANCE
LEME
OF
REFLECTED
AS LIGHT
WITH
EXPLAINED
LEMESURIER
THESE WERE MOSTLY
4C
FOLLOWUP EVALUATION
LATE
CLEFT LIP
BILATERAL
SURIERS
COPENHAGEN WILLIAM
IN
CONGRESS
OF TORONTO GAVE
LINDSAY
LEMESURIER
MEASURES
LINDSAY
GOOD 64
PERCENT FAIR
SIDETOSIDE
AND 18 PERCENT POOR THE UPPER LIP OFTEN REVEALED
FLATNESS AS COMPARED TO THE
AND
AN UNNATURAL QUALITY
TIGHTNESS
PROTUBERANT LOWER LIP
RELATIVELY
NOSES WITH
THE
LENGTH OF THE LIP
THE VERTICAL
HE DID NOT FIND
BLUNTNESS
TYPICAL
IN
SURPRISINGLY
WIDENESS
OF THE TIP
AND
LESS WELL
RATED
BE
LONG LIP WITH HIS FLAPS CAN
FOR PREVENTING
HIS
EXCERPTS FROM
IN
DECIPHERED
OF THE AIAE
FROM THE YOUNG ADULT PATIENTS
WERE THE SOURCE OF MORE COMPLAINTS
TRICK
NORMAL
LONGER THAN
AND BOTH SHORTNESS AND WIDTH OF THE COLUMELLA
LEMESURIERS
LEMESURIERS CASES
II
BOOK
1962
II
BUT
IN
SOME
THE LIP
CASES
LONGER TO AVOID
THIS
AND MAY
MAY BE MADE TOO LONG
EXCESSIVE LENGTH
SHORTER THAN THE AVERAGE BUT
THE VERTICAL
BY MAKING
CUTS
DOES NOT HAVE TO BE KEPT
FREEING ON BOTH
CUT SIDES
SIDES
TO
10MM WITH
WITH
HAVE TO BE LONG
HRLY SHORTER THAN
HERE
ARE PHOTOGRAPHIC
BILATERAL
HOSPITAL
OUT AT AGE SIX
127
THIS
WITH
TENSION
NO GREAT
PATIENT
EVEN
IF
BUT THE PROLABIUM
VERTICAL
THE PROLABIUM
FULLNESS
CUT AS
DO NOT
FLAPS
MADE
OF THE LATERAL
LENGTH
FORWARDED BY LINDSAY
HIMSELF
TORONTO THE OPERATION
LATER THAN USUAL
THEN AT 11
IS
CAN USUALLY BE
LEMESURIER
ON BY
TO THE
CAN BE SUTURED
NARROW THE
THE LIP
RECORDS KINDLY
MONTHS WHICH WAS
FASCINATING
OF THE LIP
TO INCREASE LATER IN
CHILDREN
DAYS POSTOPERATIVE
GIVES
LITTLE
YEARS
OF
MOST CASES WITH EXTENSIVE
IN
THE FLAP OPERATION
CLEFT LIP OPERATED
FOR SICK
WIDE
AND
WAS
OF
AT THE
CARRIED
THE FOLLOWUP
FINALLY
AT
QTTK
THESE CUTS
OF THE FLAPS
THE USABLE PARTS
THE PROLABIUM FAIRLY
AVERAGE
AND NO GREAT TENDENCY
AT 13
TO MAKE
PARTICULARLY
WITH
CAN BE DONE
THIS
THE CLEFTS REASONABLY SHORT
THE TWO LATERAL PARTS
OF THE PROLABIUM
NARROW AS
PARTS
TO
STILL
SHOULD BE MADE
OPERATION
LENGTH TO COVER THE CUT END OF THE PROLABIUM
SUFFICIENT
ON
LATERAL
AT
ACCEPTABLE LIMITS
WITHIN
DOWN FAR ENOUGH
HAVE TO EXTEND
SLIG
STILL
THE LIP
BECOME
LATER
1812
YEARS
OF HIS OPERATION
PROGRESSIVE STUDY OF THE RESULT
1T
RW
MONTHS
13
DAYS POSTOPERATIVE
18
OF
COURSE
LEMESURIER
METHOD WAS
ABLE
HIS
FOR
QUADRILATERAL
TRANSVERSE
COLUMELLA
LIP
UNDUE
WIDTH OF HIS
SKIN
FLAPS
VERTICAL
LATERAL
MANY
OTHERS USING
OF HIS
LENGTHENING
FLAPS
HIS
LIPS
YET TRANSPOSITION
OF
BELOW THE
PROLABIUM NOT ONLY ACCOUNTS
BUT
TIGHTENING
LENGTHENING
UNLIKE
HIMSELF
TO AVOID
BY THE CONSERVATIVE
YEARS
THE LIP
DEPLETES
AND EXPLAINS
THE
FLAT
SKIN
BANK
NOSE AND SHORT
FOR
WIDE
COLUMELLA
EMPHASIS
AS
IN
HIS
UNILATERAL
SAINTANTOINE
IN
JEANLUCIEN
FOR
THE
EXPRESSED
128
HIS
INFERIOR
HIS
FEELING
GRIGNON
OF H6PITAL
STATED
PARIS
THEN TURNED
GNGNON
CLEFTS
CORRECTION
OUR HANDS THE
MIRAULTLEMESURIER QUADRILATERAL
SATISFYING
JEAN
ON ALAR
PART OF THE
ATTENTION
THAT
TO
THE
FLAP
APPEARED
PARTICULARLY
LIP
THE
NASAL
PERSISTENTLY
DEFORMITY
FLARING
ALA
HE
CAUSED
BY
THE
RETROFLOSITIOFL
ORIGINAL
INCREASES
THE MAXILLA
OF THE AIAR BASE ATTACHED TO THE CLEFT SIDE
WITH GROWTH AND GIVES ARGUMENT
INSERTION
OF
INCISIONS
FREE
ITS
TIP
INTO
NOTCH
SUBCOLUMELLAR
THE ALAR BASES FROM THE LIP
ELEMENTS
EN
PRINCIPE
EN
REALILE
HIS
OF THE ALA AND
UP
OF THE ALAR BASE HYPERROLLING
DISINSETTION
TOR
OF
CIRCUMALAR
THEN
AS HE
XPLAINED
MUCOPERIOSTEUM
NASAL
LATERAL
ATTACHED
BONE SEGMENT EDGE
AS
TO THE ALA
INCISION
HE
MAKES
TIP
OF THE ALAR BASE AND SAYS
NOTCH OF WHICH THE DEPTH
THIS
FOR
THE CLOSURE RECEIVES
IN
ONE PRIMARY
THE
LIP
IN
INCISIONS
THE ALA AND FIXES
AND
IT
SUITABLE
IN
ADVANCES
CLEFT
HE CHOOSES
BELOW THE PROLABIUM
THE
LENGTHENING
PLACING
SCARS
LIP
THEM
ROLLING UP POSITION
INCURRING
ALAR BASES
FROM
SUBCOLUMELLAR
INTO
HE CAN ACHIEVE
TO INTRODUCE
VERTICALLY
UNNATURAL
IN
COMPLEMENTARY LOCK
ESTABLISHES
NARROWED NOSTRILS BUT WITH ONLY MINIMAL
FLAPS
THE ADVANCEMENT OF THE
GRIGNON DETACHES THE
THE BILATERAL
UNFORTUNATELY
THE ALA
CLARIFICATION
VARIABLE
IS
PROCEDURE
MAXILLA
AND
IN
FOR
AND
CUT ALONG THE PYRIFORM
BE ROLLED UP WITH
TO
SUBCOLUMELLAR
IS
AND
SYMMETRICAL
COLUMELLA
LENGTHENING
LATERAL
QUADRILATERAL
THE SAME DISADVANTAGES
TIGHTENING
IT
LIP
OF
AND
HORIZONTALLY
POSITIONS
OBUKHOVA
IN
1955
LIDIYA
OBUKHOVA
FLAP TO BILATERAL
TRIANGULAR
OF SAMARKAND ADAPTED
CLEFTS
AFTER TRIMMING
HER LONG LATERAL
THE PROLABIUM TO
BOX SQUARE AND WITHOUT DOWNWARDTENSION ON
TRANSPOSED TWO TRIANGULAR FLAPS BELOW
OBUKHOVAS
ALTHOUGH
FLATTEST
IT
IS
THE GRANDEST
129
CONJECTURED
IN
ALL
BILATERAL
THAT
NASAL
HER LIPS
OF RUSSIA
IT
IT
SHE NOT ONLY
BUT INTERDIGITATED
TIPS
WOULD
NOT
MUST BE THE LONGEST
THEM
BE
THE
IF
NOT
LIDIYA
OBUKHOIA
LIMBERG
PROFESSOR ALEXANDER
CREATED
PLASTIC
OF ENTHUSIASTIC
THE
HABIT
LEAST
THREE
OF THIS
LIMBERG AN
OF
LENGTHENING
INGENIOUSLY
BLING
CUPIDS
BOW
FLAP
IN
IS
AND
THE
EVEN
COMPONENTS
LIP
THE
FOR THE
FIRST
NASAL
PLACE
SCARS
HIS
AND
FLOOR
WITH SKIN
FACT
THIS
IN
ASPECT OF THE PROCE
TOO LONG IN
SKIN
ROOM
CATEGORY OF OPERATIONS
LATERAL
ELSE
ONE
IN
WAS
PATIENT
FLAP FOR THE LIP
POINTED
BOW DESERVES
LIP
COLLIS
WHATEVER
CREATION OF AN INFERIOR
CUPIDS
THE
BROWNE AND
THOSE OF DENIS
OWN DAUGHTER HE
IMPRACTICAL
ARE USUALLY
CREATES
SPARKED WITH SATELLITES
WORKING
THE MOST ARTISTIC
SMALL MIRAULTBLAIRBROWN
ATED
TABLES
CLEFT
THOUGH THESE ELEMENTS
DESIGN
HIS
ORDER OF LENIN
OF THE
LENINGRAD
WOMEN INCLUDING
LIP PLAN OF
ENTAILS
IN
ONE HELD
AT
PROBABLY
DURE
SURGERY UNIT
OF KEEPING
INVARIABLY
BILATERAL
LIMBERG WINNER
RESEM
BROWNETYPE EXAGGER
OPERATION
THE
THE CENTER OF THE
IN
TRIANGLE
ACHIEVES
CONSIDERATION
1J
IJ
IF
THE MOST
TO BE THAT
CONSERVATIVE
PRESENTED
CENTER AT
MEDICAL
MODIFICATION
IN
LEAST
1970
HE DEEPITHELIALIZED
TO THE
ACCREDITED
DENUDED
THE
TO
VERMILION
HIS
INSTEAD OF INTRODUCING
130
IN
AND INTRODUCED
OF PROLABIUM VERMILION
SIDES
UNIVERSITY
HE INTRO
MODIFICATION
HIS
PRECEPTEE
FLAPS
MUCOSA AND SKIN FROM THE
DUKE
THE SKIN
PRINCIPLE
METHOD DESCRIBED BY CRONIN
VARIATION
TRIANGLE
IN
SEEMS
GENERAL DESIGN
BY GEORGIADE OF
DUCED BELOW THE PROLABIUM
SIMILAR
OF THIS
1957
ESPECIALLY
CRESSWELL
THEM
LIP
THE
WHICH
BENEATH
GEORGIADE TURNS DOWN
OF THE LATERAL
IS
FLAPS
OF
ELEMENTS YET
THESE FLAPS BELOW THE
PROLABIUM IN
TOTO HE
MILION
AND
BOLSTER
THE
HAVE
INUCOSA
MUSCLE
AND
PROLABIUM
THE
LIP
THE
ILL
BEEN
HAS NOT
IS
VISIBLE
STILL
HYBRID
QUICK
OF THE
JR
YARINGTON
OF
DEPARTMENT
OF NEBRASKA MEDICAL
CENTER
OTOLARYNGOLOGY
OMAHA MY GREAT
RESPECT
TO RESERVE FINAL
ME
TEAMS CAUSED
THE RECENT NEBRASKA FOOTBALL
MY
ME
WAS UNKNOWN TO
THE AUTHOR
RELIEF THAT
OTO1A
OF
COULD NOT BELIEVE
PERUSAL OF THE DIAGRAMS
AND FOUND WITH
IY
THE ARCHIVES
IN
WAS PUBLISHED
LIP
CLEFT
OF BILAT
REPAIR
SINGLESTAGE
ENTITLED
AN ARTICLE
MARCH 1973
PATCH OF PROLABIUM
AND
LENGTHENED
HAPHAZARD
II
LATERAL
BEHIND
UNITED
AND
BORDER VERMILION
FREE
THE
DEFORMITY
BEEN
NOT
FLAPS
THE
OF
PORTION
WHISTLING
PREVENT
LATERAL
HIS
INTERDIGITATES
CENTRAL
PROLABIUM VER
HALF WAY UNDER TO
THE
PORTION TURNS UP
THE SKIN
DE EPITHELIALIZES
UAGMENT
YARINGTON
STARTED
OUT
BY CRONIN AND PENOFF IN
CITED
WELL BY
QUITE
IKE
SO
MUCH
GRANTED HE
FOR
AND THEN
THEM WORSE HE IGNORED OTHER
SURGERY PRINCIPLES
PLASTIC
RULES
EIGHT
CLEFTS
FOR BILATERAL
1971
TO BREAK AT LEAST FOUR OF
INORE FUNDAMENTAL
THC
NOTING
WHICH CRONIN WOULD
WOULD NEVER EVEN BOTHER
ENU
TO
ATE THEM
LER
STUDY THIS
TTEMPT
HYBRID
TO INCORPORATE
OF IRREVERSIBLE
AZE
ARE
AT
THE
ULCUS
PHSTERED
J4
SCARRING
TRIMMED
YARINGTON
THEN
AS
TO
HERE
PREMAXILLA
CREATING
AS
IS
THAT
OBLITERATING
ANY
PROLABIUM VERMILION
ORSE THAN ALL OTHER UNFORTUNATE
PS
EFT
BELOW THE PROLABIUM
ON
THE LESS
SEVERELY
MANLY
THEN COMES
AT
METHODS
EVEN
HIS
DEFORMED
THIS
POINT
IS
THE UNBELIEVABLE
LABIAL
THE PLAN
THAT INTRODUCE
TO
TURNDOWN
IS
NO
COMPOSITE
NEXT STEP COULD PASS
SIDE
STILL
IS
TRANSPOSED
OTHER BELOW THE
THE
SQUARED PROLABIUM AND OVER
OF INFERIOR
IA
IN
GINGIVALLABIAL
TRUE UPPER
ARE
CLEFT
TOGETHER
THE PROLABIUM
AND MUCOSA
OF SKIN
FLAPS
AND MUCOSA OF THE
SKIN
SUTURED
FLAPS AND ARE
REFERS
LOOSELY
LATERAL
THE
LINING
MISCONCEPTION
THE
TO
FRANTIC
BE
PROCEDURE WHICH SEEMS TO
LITTLE
BIT OF EVERYONE AND ENDS UP WITH
THE
CLOSED IN
STRAIGHT
UNILATERAL
ZPLASTY
LINE
I1
OF TRIANGULAR
FLAPS
TRANSPOSITION
IS
ON
APPLIED
THE
MORE
SEVERELY
DEFORMED SIDE
YARINGTON PRESENTED
RESULTS
COLUMELLA
LABIAL
WITH
CASE
ALREADY REVEALING FLARCD ALAE
AND WIDE PROLABIUM
WITH UNNATURAL
THE METHOD
SECONDARY SURGERY
SEVERE BILATERAL
TRULY
MONTHS LATER
THREE
JUST
ONE
HAS NOT
HIS
SHORT
SCARS
CAN
OE
QUITE
LOT
OF
CREATED
USABLE
UPPER
HAS NOT
PLANNED CORRECTION OF THE SHORT COLUMELLA
HAS NOT FASHIONED THE
PROLABIUM AS PHILTRUM HAS NOT PLACED THE
SULCUS
SCARS IN
COLUMN POSITIONS
PHILTRUM
SHOWN COMPLETE
HAS
WHICH
SYMMETIY
IS
DISRESPECT
EVEN
POSSIBLE
YARINGTONS CONCLUSION GIVES
TIONARELY
REFER
CUREALL
IT
READS
THIS
TYPE
ALTHOUGH
DESCRIBED
REPAIR
SAFE
METHOD OF
THAT THIS
IN
ASYMMETRICAL
IN
OR IN
REVIEWS
MIGHT
REPAIRS
IS
NOT
DO NOT KNOW THE
GENTLEMAN
ENT
THE SAKE OF
ANY
THIS
BOOK AND
MIGHT
MUST BE TRAINED
ART UNTO
TION
IN
AFTER
EXPRESSED
HIS
IN
THESE
CONSIDERABLE
CHANGE THEIR
WELL
EXTREME IMPORTANCE
132
ALL
TO
IT
IS
FOR
AND THAT
THE
OF
OVER
MILDLY
OMAHA
CLEFTS
CLEFT
PLASTIC
ESSENTIAL
OF
AS
FOR
SPECIFICALLY
SERIOUSLY
AND
WHO READ
SURGEONS
SURGERY
FOR THE
AN
IS
CORREC
BODY
TO
CRITIQUE
INDIVIDUALS
AND
YARINGTON
HIS
AS
RESPONSE
TO
PUBLISH
IN
MEDICINE
FROM OTHERS SO INDEED
PROCEDURES
INSTANCES
LIP
OMAHA
AND OPPOSITION
ALTER THEIR
MANY
CLEFT
WAS ENCOURAGED BY
UNIQUE
OF THE PRINCI
OF VARIOUS METHODS OF
TO CLOSE
REGIONS OF THE
FROM
MANY
INCLUDED
IS
SURGERY PRINCIPLES
EXCERPTS
CRITICISM
IN
DESIGN
COPY OF THIS
MINDS AND
TAKEN
TIRADE
APPLICABLE
MEDICINE
JR
DETERMINED
HIS
REBUTTAL
DO NOT BELIEVE THAT
ARE
IN
FORWARDING
REQUESTING
FIND
PLASTIC
OF DEFORMITIES
MY
MEN
TAKE
BUT BOTH
ITSELF
ON
PERSONAL ATTACK
UNAFFEC
FOLLOWING RERROPOSIRIONING
THE PREMAXILLA
THIS
CLEFTS
BE USEFUL TO THOSE
DESIRING
REPAIR OF THE BILATERAL
SINGLESTAGE
BILATERAL
TONE THAT
INCORPORATING
THEIR
OF
ROTATIONADVANCEMENT OF
SIMPLE
CLOSURE
OF ALL
CHARACTERISTIC
OF VERBAL
UTILIZES
PRESENTATION
SINGLESTAGE
PREMAXILLA
THE COVETED
SORT
AND YULES
BY MILLARD
WE BELIEVE
PROTRUDING
OF REPAIR
FOR
HIS PRESENTATION
ONE OF
AS
AND STRAIGHTLINE
TRIANGULAR FLAPS
PIES
TO
BUT MOST IMPORTANT
BELIEVE
TO
THAT YOUR POINTS
DO AGREE THAT
SYMMETRY
PROLABIUM
SHOULD
BE
AND
LATER
FASHIONED
IS
AS
OF
PHILTRUM
AND THAT THE
SHOULD BE PLACED IN
FIND
MOST RECENT CASES
IN REVIEWING
BEEN
SCARS
WHILE
OBTAINED
WHICH
MUDIFICATIONS
GENERAL BRING
IN
NOT AN
IN
OF SKIN
IS
PROLABIUM
DAMAGE
THE
IS
AND MUCOSA
LENGTHENED
SCARS
UNNATURAL
IT
CAN
PRINCIPLE
THE
LIST
133
THE
IS
BE
AMOUNT OF SKIN WITH
THIS
TO THE PRINCIPLES
WITH
INFERIORLY
AND
UNNECESSARILY
SIDETOSIDE
STILL
SAID
EGG
OFTEN
TO
TIGHTNESS
METHODS
IS
FLAPS
THE
EXCESSIVELY
NORMAL LINES
SHORT DESERVING
THAT
LATERAL
THE
SCRAMBLE
REALLY
THE COLUMELLA ALTHOUGH
LENGTH
QUITE SO VIGOROUSLY
ALTHOUGH
SUBJECT
WHICH YOU
REBUTTAL
PRODUCED AGAINST
ARE
IRREVERSIBLE
VERTICAL
HAS BEEN
DESCRIBED
OPERATION
METHODS BOLSTERING THE PROLABIUM
CONSISTING
AS
CLOSER
IT
WRTTE
SEE NO REASON TO
OUTLINED
MOST INSTANCES THESE GOALS HAVE
THAT IN
THE PROCEDURE
COLUMN POSITION
PHILTRUM
AND
THIS
EXAGGERATED
NOT
FURTHER
BY
DRAWN DOWN
LENGTHENING
INTRODUCING
THE
LEAST
THE LATERAL FLAP PRODUCED THE BETTER RESULTS
SHOULD EXCEPT
OF RECOMMENDED
FOR RARE INSTANCES
PROCEDURES
BE
STRICKEN
FROM