A surgeon plans a Z-plasty to lengthen a contracted scar across the axilla using equal limb angles. At which design angle is approximately 75 percent theoretical lengthening of the central limb achieved?

• A 30 degrees
• B 45 degrees
• C 60 degrees ✓
• D 90 degrees

Explanation

Theoretical gain in central limb length depends on the flap angle: 30 degrees gives about 25 percent gain, 45 degrees about 50 percent, 60 degrees about 75 percent, and 75 degrees about 100 percent. The classic 60 degree Z-plasty balances useful lengthening against acceptable flap tip vascularity, since angles beyond 60 degrees make transposition difficult and increase dog-ear deformity.

Reference: Grabb and Smith's Plastic Surgery, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.