Z-plasty is a common technique used for scar revision and resections of lesions, particularly in the head and neck. The basic tenet is the the Z-shape is “reversed” in the final suture position.
Some key points to remember:
1. the optimal flap angle is 60 degrees.
2. the smaller the angle, the smaller the possible lengthening.
3. the smaller the angle the greater the risk of tissue necrosis.
4. he larger the angle, the greater the risk of placing undue tension on surrounding tissues.
5. the resultant rotated scar should be in or line with a natural skin crease
6. the base incisions should be the same length as the central scar or lesion to be removed
7. care should be taken to avoid dog ears near the base of the transposed flaps and if they occur they must be excised away from the base of the flap
Schematic for Z-plasty. Note that the position of the final central segment lies in the skin crease
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