Z-Plasty Scar Revision
A Z-plasty scar revision surgery reduces the appearance of a prominent scar be interrupting its linear appearance. By creating a more jagged scar, it is more difficult for the human eye to detect, making it less noticeable.
Z-Plasty Scar Revision
- avg. recovery
About the Procedure
Scars come in a variety of shapes, sizes, and colors. Depending on the healing conditions, scars can become raised, depressed, or discolored. When an incision or injury heals and appears too prominently or is in a conspicuous location, a revision surgery may be needed to better conceal the scar. A Z-plasty scar revision surgery can correct and diminish the appearance of a visible, linear scar by interrupting the straight line and creating a zig-zag shape instead. The Z shape to the scar not only allows for less tension on the incisions (which creates a lesser likelihood for keloid scarring), but makes it harder for the human eye to detect. The goal of a scar revision is to also reposition the new centerline of the scar at a natural skin fold, further softening the appearance of the scar. During a Z-plasty scar revision surgery, either general, local, or local anesthesia with sedation will be used depending on the size and location of the original scar. Once the patient is thoroughly anesthetized, an incision will be made on top of the original scar along the entire length, cutting it in half. At the ends of either side of the original scar, additional incisions will be made of the same length of the original scar, forming a Z-shape. If the scar is long, several Z-shaped cuts may be made along the length of the original scar, sometimes referred to as a W-plasty. Next, the triangular flaps of the Z-shaped incision will be undermined, allowing for free movement of the two flaps. Then, the two triangular flaps will be transposed, moving the original scar from the middle portion of the Z-shape to the top and bottom of the Z-shape. The incisions will then be closed with sutures. Initial wound healing typically takes 1-2 weeks while the scar will continue to refine over a 1 year period.
The goal of a Z-plasty scar revision is to reduce the appearance of a prominent scar.
What to Expect
A Z-plasty scar revision surgery reduces the appearance of a prominent scar be interrupting its linear appearance. Here is a quick guide for what to expect before, during, and after a Z-plasty procedure.
- Stop taking blood thinning medications for 2 weeks
- Stop smoking 4 weeks before and after the procedure
- General, local, or local anesthesia with sedation depending on size and location of original scar
- Original scar cut along entire length, dividing it in two
- Incisions made at each end of original scar, both in equal length to original scar
- Multiple Z-shaped cut may be needed if scar is long
- Triangular flaps within Z-shape are undermined and transposed
- Sutures to close
After a scar revision surgery, patients will be required to care for the wound. Over-the-counter pain medications may be taken to relieve any swelling or discomfort. Initial recovery will take 1-2 weeks while the scar will continue to heal over the course of several months to 1 year.
The ideal candidate for a Z-plasty is unhappy with the appearance of a scar and has realistic expectations for the outcome of the surgery.
Not Recommended For
A Z-plasty scar revision surgery is not recommended for patients who smoke and are unwilling to quit smoking or have an active skin infection or disease. Notify your provider if you are prone to keloid formation as extra care will need to be taken.
Side effects from a Z-plasty scar revision surgery may include bleeding, infection, swelling, redness and discoloration, and discomfort.