There may be two distinct processes in the healing of open wounds, particularly of vestibuloplasty wounds. The first is the active process of contraction which is limited by grafting. The second is remodeling and includes the subgraft, graft, and changes in peripheral tissue (maturation). The perioral musculature may have an influence on the vestibuloplasty wound and this may explain loss in the vestibular depth. The biology of open wounds is discussed in terms of vestibuloplasty wounds.