Plastic surgery; its principles and practice . low and parallel to it. A triangle of skin of the desired size is removed.The skin and muscle along the margin is raised and the muscle is removed. The dottedtriangle indicates the outline of the incision for the removal of the tarsus, if necessary. Theskin flaps are undermined and the wound is sutured. flaps is planned, it is advisable to use a general anesthetic, as the in-filtration would distort the tissues and make the proper flap outlinesdifiicult to calculate. Suture Material.—In operating on the lids I prefer horsehair forall the skin sutu
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Plastic surgery; its principles and practice . low and parallel to it. A triangle of skin of the desired size is removed.The skin and muscle along the margin is raised and the muscle is removed. The dottedtriangle indicates the outline of the incision for the removal of the tarsus, if necessary. Theskin flaps are undermined and the wound is sutured. flaps is planned, it is advisable to use a general anesthetic, as the in-filtration would distort the tissues and make the proper flap outlinesdifiicult to calculate. Suture Material.—In operating on the lids I prefer horsehair forall the skin sutures and very fine silk (oiled or vaselined) for the lidmargins or the conjunctiva. Dressings.^—A drop of sterile castor oil instilled into the eye beforeand after operating, is very efficacious in diminishing the amount ofthe resulting irritation. SURGERY OF THE EYELIDS 363 Before the dressing is placed care should be taken that no stitchend is left between the lids; the neglect of this precaution has oftencaused much needless discomfort.. Fig. 330.—Bilateral contracture following a burn, with partial ectropion of both lids, preventing closure. Duration seven years.—i. The lids cannot be closed more than isshown in the photograph. When asleep the eyeballs are rolled upward. 2. Twentymonths after the relief of the contracture and transplantation of whole-thickness graftsinto the upper and lower lids of both eyes. Note the perfect closure. The alae have alsobeen repaired.