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A summary of Hans May's biography of Erich Lexer is reproduced, followed by a translation of Lexer's first publication, in Spain in 1921, on the correction of pendular breasts. Lexer's fundamental contributions to mammaplasty are analyzed. This author was the first in the history of mammaplasty to perform breast reduction with an "open" nipple-areola complex transposition, with preservation of the continuity of the skin to the remaining gland. This feature was far ahead of its time, as the techniques based on this concept did not become popular until after 1955. Lexer also was the first to propose subcutaneous mastectomy for treatment of fibrocystic disease, to perform breast augmentation in the ptotic hypoplastic breast with fat flaps, and to use free fat grafts taken from the abdomen or hips for augmentation mammaplasty.

The signs of aging of the upper lip, the pathogeny, and different treatments proposed up to now are discussed. A personal technique used since 1992 is presented. It is based on an earlier personal technique, described in 1970, which consisted of dissecting the skin from the orbicularis muscle and inserting a temporary (three weeks) silicone sheet. The present technique consists of a skin excision at the nasolabial junction, based on that described by Cardoso and Sperli in 1971. However, I dissect the skin of the vermilion border and insert a trapezoidal graft of the pretemporal areolar tissue, taken during rhytidectomy. The graft is fixed with Vicryl sutures at the level of the nasolabial folds. In a few patients this has been combined with a peel. The technique corrects both the superficial and the deep wrinkles caused by the retraction of the fibers that join dermis and orbicularis muscle. It achieves an eversion of the vermilion, enhancing its convexity and producing a fuller look, and shortens the lip, which adopts a concave, youthful appearance because of the improvement of the philtrum and of Cupid's arch. Our technique has been used in 15 patients who were satisfied with the results.