Prevention of hyper- and hypotrophic scars through surgical incisions in the direction of the "main folding lines" of the skin

Gottfried Lemperle
2020 Plastic and Aesthetic Research  
How to cite this article: Lemperle G. Prevention of hyper -and hypotrophic scars through surgical incisions in the direction of the "main folding lines" of the skin. Plast Aesthet Res 2020;7:40. http://dx. Abstract Langer's lines are still the recommendation and matrix for surgical incisions in most surgical textbooks, even if they were never meant to be by their first describer in 1861. To achieve minimal scarring, surgeons should attempt to make incisions parallel to skin tension lines, i.e.,
more » ... ension lines, i.e., in skin folds or skin creases. On the basis of visible stretch marks (striae distensae) in the skin, which always appear in the same direction against skin tension in men and women, the direction of skin tension lines can be manifested also in the skin of children and young patients. These invisible or virtual tension lines are the same as the main folding lines (MFL) in adults and run perpendicular to the stretch marks. While well-established on the face and abdomen, these folding lines may not be obvious on other parts of the body. On chest, back and extremities, optimal direction of surgical skin incisions should take into account the patterns of striae distensae, which develop perpendicular to skin tension lines. MFL should be used in elective incisions in children, adolescents, and young women as a guide for the prevention of later visible hyper-or hypotrophic scars.
doi:10.20517/2347-9264.2020.14 fatcat:wrlqzc6c3zbbzngkw4lovhpise