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Z-plasty is a type of surgery used primarily in scar revision. The surgery involves incisions of the skin around a scar and a “repositioning” of the scar’s incision line. The scar then heals more in accordance with natural lines and wrinkles of the skin. This type of surgery is especially effective with facial scarring because of its camouflaging effect.
Z-plasty surgery has seen results in masking and minimizing scars because of its slight repositioning of the scar lines. Scars cannot be removed completely, but Z-plasty surgery aims to mask scars by having them heal along the skin’s natural lines. If the same scars were to heal outside of these lines, they would be more apparent and obvious.
The surgery relies on what is called a transposition flap that consists of additional incisions around the scar. The resulting skin “flaps” are lifted and repositioned around and over the scar. The successful outcome is a redistribution of tension on the skin and its wound.
There are many types of skin flaps in medicine, each named after how they are cut and which muscles they attach to or cover. The stitching is done with very fine fabric and is taken out a few days after surgery. Z-plasty is named for the resulting effect of a “Z” pattern where the scar used to be. The Z pattern may be effective in covering up one long scar by making it into smaller, less noticeable lines.
Before performing Z-plasty, your certified board plastic surgeon will go over all of the necessities and diagnoses with you to make sure that it will be the best surgery for your particular scar. The skin around the scar must be of a thickness that is consistent with Z-plasty necessity. Either too much or too little skin composing the skin flaps will result in a faulty or unattractive outcome.
Successful Z-plasty surgery relies on several factors that may include the patient’s social and medical history. Problems associated with diabetes, smoking, vascular disease, chemotherapy, or other medical problems relating to the skin may make Z-plasty not an option. If you or a family member has a history of keloid or hypertrophic scarring you may be at risk for further scarification problems as well.
Discuss the various options and treatments available and ask as many questions as you can before surgery with your board certified plastic surgeon. Make sure and know all of the risks and benefits of Z-plasty before undertaking this or any surgery.