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Facial Flaps

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.

Figure 1 | Z-plasty

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°. 
Figure 2 | Z-plasty W

Acknowledgement

Illustrations: Christian Kaare Paaskesen, med.stud.

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