38. Lengthening the Columella with Central Lip Tissue 481

38
LENGTHENING
WITH
CENTRAL
IF
LI
THE LIP PROBABLY
IN FACT IN
TIME
PROLABIUM
ABOUT
ASPECT
THIS
LATERAL
WIDE
AND
THE ABSENCE OF MUSCLE IN
REPAIR
IS
HOPE
FOR
MUSCLE
WILL
VEAU
VICTOR
RESULTS
OBTAINED
IN
COMPLAINED
BILATERAL
CLEFT
THE PROLABIAL SEGMENT OF THE LIP
ONE
THIS
LONG EMPHASIZED
LEAST
THERE
IS
EXTRA
LIP
THE NORMAL ONLY IF THE LIP
FACT
THE
MUSCULAR
THE
WHEN THE
LIP
UPPER
COLUMELLA
IS
THIS
TISSUE
AVAILABLE
DIRECT
SIDETOSIDE
ADAPTED
TO
AND
DAVIS
FOR
CONTAINS
OF THE
STERILITY
THE
LENGTHENING
GENSOUL THIS
BOTH DAVIS
IS
IT
AMPLE
PROLABIUM
CAN SUPPLY
CLOSURE OF THE
CORRECTIONS
SMITH
CREDIT
POSSIBLY
AND SMITH
FOR
LIP
AS
WAS USED
OF THE PREMAXILLA
THE
WAS
PRINCIPLE
ATTRIBUTING
THIS
THIN
FACT DAVIS
THE
LENGTHENING
CENTER
COLUMN
VERTICAL
SIMULTANEOUSLY
TO
BECAUSE
MISINTERPRETATION
GENSOULS METHOD CORRECTLY
ALSO ILLUSTRATED
LATER
APPROACH
OUT OF THE CENTER OF THE
PROLABIUM AND NOT THE ENTIRE
IN
AND
PESKOVA AND FARA GAVE
LANGUAGE
DESCRIBE
FLAP FOR LENGTHENING
PROLABIUM
ALONG WITH EXCISION
SECONDARY
FERRIS
TOTAL
FLAP CAN BE THE ENTIRE
BY BARON DUPUYRREN
481
LIP
CAN
COLUMELLA
SHIFTING
TO
THE
STRETCH
SEGMENT
PROLABIAL
BIUM
LENGTH
WIDTH AND LENGTH
ELEMENTS
LIP
FLAT
CONTOUR AND SHAPE APPROACHING
HAVE
INTO THE FULL VERTICAL
HAVE ADEQUATE
CAUSE OF THE MEDIOCRE
THE PRINCIPAL
SHORT
WILL
THE MUSCULAR
MUSCLELESS
THE
LIP
THE PROLABIUM WAS INCORPORATED
OF THE LIP
AT
TISSUE
THE
IN
PROLABIUM
THE COLUMELLA
AS
PROLA
COLUMELLA
EXCISION
WITH
GENSOUL
THE
11
GILLIES
ME
TAUGHT
AND
HAVE USED
NASAL
AND
REPLACEMENT
IT
MANY
ITS
WAKE AND
CAN BE QUITE DRAMATIC
SCHOOLTEACHER PUBLISHED
1963
482
IT
USUALLY
IN
PLASTIC
AND
IN
CERTAIN
AN
CIRCUMSTANCES
IN
CASES
SECONDARY BILATERAL
REQUIRES
THE RIGHT
AS DEMONSTRATED
IN
PROIAOIUM
OF COMBINED
TYPES
CORRECTIONS
LABIAL
IN
IN
THE ENTIRE
TO SHIFT
ABBE
THE CASE OF THIS
RECONSTRUCTIVE
FLAP
THE RESULT
YOUNG
SURGERY APRIL
WHEN AND HOW
WHEN
THE COLUMELLA
TO THE LOWER
TAKES
COLUMELLA
EXTENSION
AND
THINNED
THE
FIRST
EXCISION
STAGE
SECONDARILY
TO SPLAY
NASAL
TO THE
IT
FLOORS
AS
IF
CAN
SEVERAL
EXAMPLES
OF THIS
BELOW
THE MOST
FLAP
MALEK
AGAIN
DOUBLE
ELUCIDATED
HE PREFERRED THIS
ONE
THERE
THESE CASES
HEIGHT
IT
SEPRAL
PROLABIUM CAN BE
WILL
TO SHORE
STRUTS
CARTILAGE
OR SECONDARILY
SHOWN LATER
BE
OF ADVANCEMENT OF THE ENTIRE
THE UPPER LIP DEFECT WITH
FILLING
OF THIS
APPROACH
COLUMELLA
SECONDARY CASES IN
IS
EXISTS
FROM
WHICH
NECESSARY TO UTILIZE
THE MEDIAL
PART OF THE LIP
IS
SCARRED AND THE MUCOCURANEOUS
RIDGE
TRANSVERSE SHORTENING
HOLY WATER BASIN
IS
DIAMOND
THE ALAR BASES ACROSS THE
ACTION
ELEMENTS
HEIGHT THE PROLABIUM
VEAU
IS
REGIMEN
IS
DISTURBED
FILL
TENDS TO
VERTICAL
OF THE
TO
GRACEFUL COLUMN
WITH
THE TYPE OF BILATERAL
OR MORE OF THE FOLLOWING
IS
INTO
OF THE END OF
JOIN
1973 ADVOCATE
WHO WHEN TAKING
TOO SHORT IN
VICTOR
THE
RECENT
OF PARIS
FROM
PROLABIUM
OF THE PROLABIUM
BASE TO JOIN
USE THIS GENERAL PRINCIPLE
REN
WAS
SUTURES
REVISED
PROLABIUM INTO THE COLUMELLA AND
ABBE
RELEAS
HANGS
THE REMAINING
THE BOTTOM END
SILLS
AFTER
TURN THIS
AND COLUMN CAN BE USED PRIMARILY
TIP
AN
COMPONENT
DOES NOT FORM
IT
BE
UNIT
AS
PROLABIUM CAN BE USED
BEGINNING
COLUMELLA
AS NOSTRIL
UP THE
OTHERS
WITH
ITSELF
SMOOTH TRANSITION
RESIST
SPLIT
ON
COLUMELLA
TRUE
IN
ROLLED
THE
NECESSARY
BY LATERAL VESTIBULAR
THEN
INCISIONS
RELATION
TAILORING
FLAPS AT THE TOP OF THE
THE LATERAL VESTIBULAR
IS
PINGPONG PADDLE TO
OF CLEVER
IN
TIGHT
OF THE LOWER LIP
EXTENDED
INCISION
BIT
LIP
OUT OF THE UPPER LIP
OF THE NOSE LIKE
THE TIP
UPPER
THE COLUMELLAPROLABIUM
INCISIONS
THE
SHORT AND THE
TAKEN
IS
MEMBRANOUSSEPTAL
ING
IS
REDUCTION
LIP
PROLABIUM
TOTAL
SHIFT
PROLABIUM
TOTAL
THE
TO
APPEARANCE
AN ABBE
OF THE LIP
IN
CAUSING
THE PROFILE
FLAP
ACCORDING
VIEW
THE PROLABIUM
IN
TO
ALL
GIVES ADDED
TO THE COLUMELLA
GENSOUL
MORE
POPULAR
COLUMELLA
LENGTHENING
APPROACH
FOR
CENTURY WAS THE USE OFA FLAP TAKEN OUT OF THE MIDVERTICAL
483
OVER
PORTION
IN
OF THE PROLABIUM
AND
KNOWN
VY
UPWARD BY
SHIFTED
WITH THE BASE OF THE COLUMELLA
CONTINUITY
AUDACIOUS
HE WAS THE
AN IMPERTURBABLE
TO CONCEIVE
SECONDARY LIP
FIRST
PRINCIPLE
BECOME
FINE
DEXTEROUS EXPLO
SANGFROID
VY
SCARRED
1833
THE
HAVE USED AND MODIFIED
SURGEONS SINCE
DOUBLY
IN
TO LENGTHEN
ADDED
THERE WAS ONE MAJOR DRAWBACKIT
THE ALREADY
SCAR TO
WAS
PARIS
SURGEON WITH
COLUMELLA AND MANY
THIS
HAS
GENSOUL PRINCIPLE
AS THE
JOSEPH GENSOUL OF H6RELDIEU
SIVE
THIS
ADVANCEMENT
THIRD
LIP
JOSEPH GENSOUL
UK
USED IT
GILLIES
THE
NOSE IN
ONE
COMMON
SOCALLED PROLABIUM
IS
DRAGGED
THEN
ITS
DOWN WITH
IF
ONE MIGHT
THE COLUMELLA
JOINING
EF
CASES
OF
SUTURE
IT
DOWN DRAWN
FOUND
TO
IN
OF DOUBLE
CASES
DOWN THE
LIP
DIMENSIONS
VERTICAL
SHOULD
LIP
OF THE PROLABIUM VARY
PART OF THE LIP
IT
PROLABIUM
THE UPPER
LIP
PLASTIC
TO NO SECONDARY
LEAD
IT
LIP
POINT
AS
THAT PORTION
FREE
ARE
NECESSARY TO DIVIDE
OF VIEW
IT
THE LIP
SKIN
OUR OF THE
BORDER OF THE SEPTUM AS WILL
THE MEMBRANOUS SEPTUM WITH
THE
THE BASE OF THE ALA ARE CAREFULLY
MENTS
484
BURIED
SKIN OF THE LIP
IS
INSERTED
ALL
IN
LIP
AND
ALLOW THE RIP
TO
OF
ENSURE THIS
SCISSORS WHICH
THERE REMAINS
THE FLOOR OF THE VESTIBULE
UNDERMINED
CATGUT SUTURE
SKIN
OF THE
IMPERATIVE
IS
CARRIED EVEN OVER THE ANTERIOR BORDER OF THE SEPTUM
VSHAPED GAP IN
DEFORMI
THE
MIGHT BE BETTER TERMED
TO TAKE THE PROLABIAL
NOSE TIP
THE
THAT THE LOBULE OF THE
NORMAL POSITION
THE NOSE TO COME FORWARDS AND UPWARD INTO
MAY BE
LIP
FOR
HARELIP
OF THE PROLABIUM WERE TRULY
DESCRIBE
UPON THE
SO HIGH
IS
THE
THE
IN
FROM
SUPRALABIUM
II
IT
THE SKIN
INCORPORATION
TIES
FAULTS
OFTEN PLACED SO FAR
IS
CONSIDERABLY
CLEFT
OF THE BILATERAL
TREATMENT
LANCET
1932
OF THE MOST
NOSE
DESCRIBED
AND KILNER
GILLIES
AND
TO LOOSEN THE FALSE ATTACH
TO GATHER
THE
DEEP
TISSUE
TOGETHER TO SUPPORT
FROM BELOW AND BEHIND THIS
THE COLUMELLA
AND SO IMPROVES
THE ALAR BASES
IN
THE NOSE
DRAWS
STITCH
FURTHER BY NARROWING
STILL
THE
NOSTTIL5
SOME
IN
THERE
CASES
AND
THE NEW TIP
TO
THE
THAT
UNLIKELY
RCQUIRCD LARCR
IS
IT
ALSO
1928
IN
MUNICH
OF CARTILAGT
GRAFT
WHO SUCCEEDED
LEXER
DEVELOPMENT TO GIVE PROMINENCE
SEPRAL
SUPPORTING
USED
LEXER
ERICH
INSUFFICIENT
IS
SAUERBRUCH
USED
GENSOUL
THE
FLAP
WHO
LEXER
GRANDIOSE
AS CHIEF
OF SURGERY IN
IT
SEEM
MIGHT
REVELED
IN
ARTERIAL
AND JEJUNODERMATO
ANEURYSMS ARTHOPLASRIES JOINT REPLACEMENTS
WOULD EVEN NOTICE
SHORT COLUMELLA
ESOPHAGOPLASTIES
HE DESIGNED
OF IT
ONLY TOOK NOTE
NARROW THE
SAME TIME
THE
OF GREAT
AS TESTIFIED
1E
FLARING
BY HANS
WOUND AT
ALL
TIMES
WAS AN OFTEN QUOTED REQUEST OF HIS
THE
FINGERS
OUT OF THE
AND
IT
AT
SOMEWHAT OVERPOWERING
MAY WHO WAS
NEVER HAD MORE THAN TWO ASSISTANTS
THEIR
NOT
MAE
STRENGTH LEXER
PHYSICAL
TO CORRECT
PROCEDURE
HE
ONE OF
HELPING
LIKE
HIS
STUDENTS
HIM AND
THEY HAD TO KEEP
TO BE ALONE IN
OF ORDINARY
HANDLING
WOUND
THE
INSTRUMENTS
WAS CALLED FOR BY SIGN LANGUAGE AND CONVERSATION AT THE OPERATING
TABLE
KEPT
MINIMUM
AT
ON
WEEKEND HE INVITED
ONE OF
HIS
ASSISTANTS
TWOOAT BOAT ROWING ON LAKE CONSTANCE
WAIST
AND EXHAUSTION
AND
BOTTLE
YET LEXER
STUDIED
THE
SO
485
EYE AND NEVER USED
AS THE
EXPLAINS
HIS
HIS
TO THE
BURNS
BALANCE
FLUID
RULER
AND COULD USE THE PAINTERS
AS MASTERFULLY
LENGTHEN
HE
BRUSH OR
SURGEONS KNIFE
ENJOYMENT OF
PLASTIC
HAD
THIS
SURGERY AND
COLUMELLA
MCINDOE
MCLNDOE OF
HOSPITAL
MAYO
MEDICINE
CHISEL
TO
DID
VICTORIA
FL
HAD AN
PROBABLY
SIR ARCHIBALD
THE
TO
ARTISTIC
SUFFERED
IN
TUB OF ICED WATER
OF CHAMPAGNE
ART BEFORE
WILLINGNESS
THE ASSISTANT
REPLACE
HIM
HOURS STRIPPED
FOR
HE WAS TREATED BY IMMERSION IN
SCULPTORS
FACILITY
SUN AND WHEN
THE BLAZING
IN
TO JOIN
CLINIC
149
HARLEY STREET
EAST GRINSTEAD
WHERE
IT
TRAINED
WAS REPUTED
LONDON AND QUEEN
IN
GENERAL SURGERY AT
HE COULD
PERFORM
AS ADROITLY
CHOLECYSTECTOMY
OF HIS
FROM
ALSO
NEW
WAS KNIGHTED
AIRMEN DURING
THE
FOR HIS
MCIND
OF
OF
IT
WITH
YORK
TOM
REES
DAYS WITH
WHO HAS
READY
TO
SIR
ARCHIE
TACKLE
COMING
YEARS
TOM REES
MODIFICATION
OR
PROLABIUM
TIP
AND WITH
THIS
AND SAWED
CHISEL
AND THE
CLOSED
LIP
PHILTRUM
AN ELITE
TO
PILGRIMAGED
RECENTLY
OF
CLIENTELE
NEW
MCLNDOES
HARLEY
REMINISCED
ON
HIS
IN
HIS
FULL
NEW WEEK
LITERALLY
TO THE
ROLLS
QUEEN VICTORIA
ROYCE
IN
HOSPITAL
WHICH
OF GOOD CHEER AND GENERALLY
IMMEDIATELY
TEAR
UPON
ARRIVAL
ON MONDAY
WOULD BE IN
HE
FEELING
AT
THE
JUST
TO
GET
THE TROOPS IN LINE
AND
HOSPITAL
THE PLACE APART WHICH HE ADMITTED
HE DID ON PURPOSE
FIR
TO
FOR
ME
THE
WEEK
CERTAINLY
486
LATER
1959
ARCHIBALD
MOOD
HOWEVER HE WOULD
SEVERAL
OF THE
WAS THEN ADVANCED
PIECE
ATTRACTED
LONDON
IN
PARTICULARLY REMEMBER DRIVING
MERRY
THE
HUMP WITH
WITHOUT
ALAS
ROOMS
CONSULTING
COMPLETELY
OFFICER
USING
THE COLUMELLA
INTO
THE ONE THAT
TO
MORNINGS WITH
THE BURNED
STUDENTS
ELEVATED
THE PROLABIUM
OUR OF THE LIP
SIMILAR
STREET
EARLY
REMOVED THE
ZPLASRYBUT
SUAVE
AN
TRAPDOOR BASED ON THE NASAL
LIKE
OSTEOTOMIES
COMPLETELY
OF SIR
TUTORSHIP
THE WORLD IN
SURGERY IN
OF HIS FAVORITE
THEY
PRINCIPLE
OPEN DOOR EXPOSURE
BILATERAL
AND
GRAND AND SYNCHRONOUS SECONDARY
TO DESCRIBE
GENSOUL
PORTION
LAST
OF SURGEONS AND WAS UNDOUBTEDLY ONE OF THE TOP
NEW YORK
THE
THE
OF GILLIES
WORK ON
BECAME
CORRECTION OF CLEFT LIP AND NOSE DEFORMITIES
OF
DURING
RELATIVE
GREAT
OF BRITAIN
BATTLE
MCLNDOE CONSORTED WITH ONE
ARCHIBALD
DISTANT
AND SHOWMEN OF PLASTIC
TECHNICIANS
AT THE CLINIC
CAME UNDER THE
HE
ZEALAND
HAROLD GILLIES
YAL COLLEGE
SIR
ANYONE
ROCHESTER
IN
SEVEN YEARS
AS
ARCHIE
HAD GREAT CHARISMA
HE WAS AWARE
OF THIS
AND WAS ABLE
TO
MUCH
IN
MAGNETISM
HIS
EXERT
FAMOUS POLITICIAN
THE SAME WAY AS
KNOW HE HAD ENORMOUS HAMLIKE
MOVIE STAT AS YOU
AND
INTRICATE
COULD DO THE MOST
SEVERAL
RATHER
OPERATIVE
NOSE AND RECONSTRUCTION
WITH
RESTORATION OF THE LIP
DELICATE
COMPLETE
OR WITHOUT
DO
ARCHIE
TO THE SECONDARY DEFORMITIES
DOWN OF
TAKE
AN
ABBE
ELEMENTS
ALL
SUBMUCOUS RESECTION
WITH
WHICH HE
WITH
HELPED
SURGERY
APPROACHES
WHICH HE DID
NOSE IN
CLEFT LIP
LIP
RADICAL
HANDS
OR EVEN
OF
OF THE
AND
NASAL PLASTIC
FLAP
TRIFOIL
VILRAY
BLAIR
PRIME
WAS
OF WASHINGTON
CALLED
UPON
INCISION
RELEASING
TO AS THE TRIFOIL
THE
IN
FLAP
WITH
LATERAL
WHO
LOUIS
DO MANY SECONDARY
TO
THE GENSOUL PRINCIPLE
MODIFIED
ST
UNIVERSITY
CLEFT
HIS
CORRECTIONS
EXTENSIONS
MEMBRANOUSSEPTUM BY WHAT
THIS
IN
TO
FILL
HE REFERRED
PROCEDURE TENDED TO SHORTEN THE VERTICAL
LENGTH OF THE LIP
ALSO USED
BLAIR
THE
BATWING
FLAP
SECONDARY
EFFORT
TO
DESCRIPTION
IN
1930
THE BARWING THE MATERIAL
PORTION
FORWATD THIS
OBLIQUE
SLANT
HERE
PLASTIC
TIP
IT
HE
WITH
THE
INCREASE
ARE
TO THE
IS
TYPICALLY
20S
HIS
IT
TRIFOIL
NASAL
TIP
USED
30S AND
40S
LUCID
COMES FROM THE NOSE AND COLUMELLA BY CUTTING
OF THE COLUMELLA AND NASAL TIP AND SUTURING
BRINGS
THE
TIP
OF THE
NOSE
THE MESIAL
FORWARD GIVES
MOTE
NOSRTIL AND NARROWS THE COLUMELLA
TWO CASE EXAMPLES PUBLISHED
AND
THE
CALLED
HE
AN ADVANCEMENT ON TOP OF AN ADVANCEMENT
THROUGH THE CARRILAGES
IN
THE NASAL
TWO MANEUVERS MANY TIMES DURING
THESE
IN
IN
PRINCIPLE
AND OFTEN COMBINED
PROCEDURE
CONSECUTIVE
AS
REFINEMENT
HIS
THEVY
RECONSTRUCTIVE
SURGEIY
BY BLAIR
JANUARY
AND LETTERMAN
1950
487
II
FLEURDELIS
IN
1941
SLEEKER
BROWN AND MCDOWELL
WITH
FLEURDELIS
NOSE HERE AGAIN
BUT
UPPER LIP
REDUCED BLAIRS
LATERAL
EXTENSIONS
THE DONOR AREA ADDED
THE PROCEDURE
TRIFOIL
TO
SMALLER
NEAR THE FLOOR
THIRD
VERTICAL
DID PRODUCE COLUMELLA
OF THE
SCAR IN
THE
LENGTH WITH
ELEVATION
TIP
71
IN
1947
FLEURDELIS
BROWN MCDOWELL AND
BYARS ACKNOWLEDGED THAT THEIR
COLUMELLA
AT THREE
OFTEN REQUIRED
FURTHER
LSHAPED
IN
ELEVATION
CARTILAGE
OF THE
PRESERVED
NOSE
PATIENTS
WILL
GROW
THIS
1941
488
NOW THAT
THE AGES OF
CLEFT
COLUMELLA
CONDITION
COLUMELLAS SO SHORT THAT THE TIP
BETWEEN
BE
SIX
OF AGE
YEARS
OBTAINED
IS
WHEN
DESIRABLE
THEIR
LATE RESULTS
THE SHORT COLUMELLA
OF MINIMAL
THE
OF THE NOSE
THESE SHOULD
AND
HALF YEARS
BY
AN
AND NOTED
CLEFTS
THE DOUBLE
REQUIRE NO SURGERY FOR
ESTABLISHED
MAY
AT
AND
TRANSPLANT
CARTILAGE
COMPLETE
FURTHER PROBLEM IN
THE
SUPPORT
FRANK MCDOWELL REVIEWED
1966
THE BILATERAL
IN
LENGTHENING
ABOUT HALF OF
NORMAL LENGTH
OTHER HALF WILL CONTINUE
IS
SNUBBED
DOWN IR
HAVE SURGICAL ELONGATION
AND
WILL
RO HAVE
SEEMS WELL
OF RHE COLUMELLA
YEARS THE METHOD WE USED WAS PUBLISHED
IN
OF THESE
STUDY
NOSE
HOOK THE
CENTRAL
WHEN
FLEURDELIS
AS LATE
COLUMELLA
MIDLINE
THIRD
WAS NOT
WAS LENGTHENED
THE TIP
LIFT
AND
THE
BY
AND
ADEQUATELY
IT
SCAR
LIP
BROADBENT AND WOOLF WERE ADVOCATING
1974
AS
THE
THE COLUMELLA
SHORT ENOUGH TO DRAG THE
TIP
JUST
DID NOT ALWAYS
IT
CREATED
INVARIABLY
YET
WAS OFTEN
IT
LENGTHENED
WHEN
REVEALED THAT
CASES
VY
MINOR DEGREES OF DEPRESSION CAN BE IMPROVED WITH
PROCEDURE
ON THE
AND TIP
COLUMELLA
VY
MANEUVERS ACTED
THEIR
TINY
PETIT
GENSOULS DEPENDING ON
AS
OMBREDANNES
PETIT
THE
DIRECTION
OF THE
AND
THEY
STATED
MINOR AND MODERATE DEGREES OF DEPRESSION ASSOCIATED WITH
NASAL
CAN BE IMPROVED BY SPLITTING
DEFORMITY
HALVES AND COVERING
THE
CASES
MUCHSCARRING
LATERAL
1954
IN
COLUMELLA
CLEFT
LIP
WHICH
AT
THE
CASES THE
TIMES
SHAPE OF THE UNDERLYING
LATERAL
BILATERAL
IS
OUTER SURFACES
THE
THE NOSTRILS
IS
489
ALAR
DIMENSION
NASAL TIP
THE
AMOUNT
MARGINS
OF TIP
NORTHERN
IN
TO
RELEASE
ENGLAND
THE GENSOUL OPERA
IS
USUALLY DEPRESSED WITH
NONEXISTENT
IS
SIMILAR
TO
THE
FLAT
ARCH OF THE ALAR CARRILAGES
THIS
IS
INTO
THE
SHORT
DUE TO THE
SHORT MEDIAL
UNILATERAL CASES ONLY
IS
FLATTENED AND THE
ARE FREQUENTLY ROTATED INFERIORLY
ARE SEEN PROJECTING
OBSTRUCTION
FLAPS
CARRILAGES WHICH HAVE EXTREMELY
PORTIONS OF THE CARTILAGES
ITS
EXTENDING
PROBLEM
COLUMELLAR CRURA THE CONDITION
THE CONDITION
LIP
VYS
SEEMS ALMOST
ALAR
CLEFT
TYPE OF FLAP AND SEEMED TO
FOR THE LIMITED
CORRECTIVE
HE OUTLINED
BILATERAL
OR LOCAL
POTTER OF STOCKTONONTEES
JOHN
FIRST
THE COLUMELLA
GRAFTS
VESTIBULAR
ADDED AN IMPORTANT
TION
FREE
VY
USED
THEY PRESENTED
PRODUCE TOO
IN
THE DEFECTS WITH
BILATERAL
NOSE CAUSING
AND SO
THEIR
DEGREE OF NASAL
TEND TO BE EVERTED LATERALLY THE APPEARANCE
LOW AND WIDE INSTEAD OF HIGH
AND NARROW
OF
OBTAINING
IN
THE AMOUNT
OF PHILTRUM
ON EACH
INCISION
SIDE
THEN
CARTILAGE
THE
IS
WITH
CARTILAGE
CORRECT POSITIONS
THIS
AREA
PHILTRUM
IN
ALONG
AND RH
RAISED
IS
MM
LINE
FLAPS
EACH CASE TO GIVE
REQUIRED
SUTURED
AROUND THE
INTO
OF SUCCESS
LATERAL
CIC
II
BORDER
TO THE
POSTERIOR
OF THE ALAR
UNDERMINED
ALAR
THE
BY SUTURES
ATTACHMENT
FOR
INTO
LATERALLY
SKIN FLAP
THE PHILTRUM
IN THE ALAR SULCUS AND
IS
CARRYING
SHORT DISTANCE
IN
BETTER
HAS
CHANCE
SURGEONS CONTINUE
MANY
DEFORMITY
THE
SUTURED
COLUMELLA
DEFECT IN
SOUND AND PROBABLY
IS
ARE
RAW AREA
IS
THE
CARTI
THEN FREED FROM THE SKIN
IS
WIDELY
IS
THERE
ONE WAY OR ANOTHER
IT
INCORPORATE
RIP
AIDED BY AN INCISION
THE BILATERAL
IN
SKIN
NEW POSITION
ITS
THE PRINCIPLE
AGAIN
NASAL
TO EACH OTHER
UNDERMINED AND
IS
THE UPPER
ALONG
OVERLYING MUCOSA
ITS
THE
CLOSED BY APPROXIMATION
IT
SKIN
RETRACTED UPWARDS AND THE ALAR CARRILAGES
IS
FLAP
HACK
TURNS
THEIR
IS
ALAR CARTILAGE
ESTIMATED
IS
REQUIRED
THE
CONTINUED
IS
MOBILIZED
FULLY
COLUMELLAR
THEN
SKIN
HIS
POTTER EXPLAINED
MARGIN TO THE NASAL RIP AND THEN FOLLOWS THE LOWER BORDER OF THE
COLUMELLAR
LAGE
ADVANCEMENT OF
OF COLUMELLA
COTRECT LENGTH
AND
VY
THE MEDIAL
DETAIL
ALAR
BY THE GENSOUL OPERATION
EXPOSURE
THEIR
NASAL
TO
CORRECTIONS
CONDEMNATION FROM BEHIND
THE
IN
IRON
PESKOVA AND
11
1960
CURTAIN
COMMENTED ON
PROLABIUM
THIS
TO
OPERATION
THE
WEDGESHAPED
USED HY
AND OTHERS LENGTHENING
SEVERE DEFORMITY
THE
LIP
IS
IS
OF THE COLUMELLA
AND IN
FOR
CENTER
YEARS
OF BILATERAL
LENGTHENING
490
THIRD
VERTICAL
CLEFT
SCAR
LIPS
IS
ONLY
SATISFACTORY
CHILDREN
MOST SURGEONS HAVE COME
MANY
FROM THE MIDDLE
BROWN RAGNELL BENAIM
NOR SUFFICIENT
DISFIGURING
FLAP
PRAGUE
OF THE
THE COLUMELLA
LENGTHEN
IS
FARA OF CHARLES UNIVERSITY
TO
KIRCHSTEIN
SMALL
RESULT
DOCKHORN
HOWEVER AND IN
THE
VERTICAL
SCAR
OF
CAN UNDERGO HYPERRROPHY
AGREE WITH
WAS BEING
WITH
ONLY
THIS
STAND BUT
ADDED ROUTINELY
INADEQUATE
FOR
TO THE
COLUMELLA