Design

Authors: Liv Schöllhammer, MD, Frederik Gulmark Hansen, med.stud. and Magnus Balslev Avnstorp, MD

On this page you will find the design of a Z-plasty facial flap.

Background

• Double transposition of triangular flaps. See fig 1
• Used in scar revision the z-plasty can; change the direction of a scar, interrupt scar linearity, lengthen scar and release contractures
• Can be designed as a single or multiple. See fig 2

Flap design 

• A central limb and two peripheral limbs in the shape of a Z.
• All three limbs are identical in length.
• The scar or area with contractures makes up the central limb of the Z.
• Can be designed with angles between 30°-90° but 60° is the most common. 
• The greater the angles = greater gain in length = larger standing cutaneous defect.
• When the flaps are raised and transposed, the direction of the central limb will change. In a 60°angled z-plasty it will change approximately 90°. 

Acknowledgement

Illustrations: Christian Kaare Paaskesen, med.stud.