Relaxed skin tension lines, z-plasties on scars, and fusiform excision of lesions

Abstract

Summary The direction of the tension which exists on the skin while in the state of repose, known erroneously by many as Langer's lines, should be more accurately named “ relaxed skin tension lines ” (RSTL). The reason for this name, the actual direction they follow, and the great importance they bear in the ˦sthetic appearance of a scar are stated. The reasons, advantages, and disadvantages for the number, angles, size, and direction of Z-plasties to improve an un˦sthetic antitension line scar are discussed. The surgical techniques used in scars at the eyebrow area are shown in detail; these include W-plasty and Z-plasty techniques. The correct techniques which should be used in fusiform excision of a single lesion or two nearby lesions are graphically explained.