A surgeon plans a Z-plasty for a contracted scar crossing the flexor crease of the axilla. What is the principal effect of a standard 60-degree Z-plasty?
- A It lengthens the scar axis by approximately 75% and redirects it into the transverse direction ✓
- B It shortens the scar while widening it along the original axis
- C It removes the scar entirely by excision and layered closure
- D It converts a linear scar into a wider elliptical scar without changing its orientation
Correct answer: A. It lengthens the scar axis by approximately 75% and redirects it into the transverse direction
Explanation
In a Z-plasty, two triangular flaps are transposed so the central limb changes direction and gains length. A 60-degree design lengthens the central limb by roughly 75%; 30 degrees gives about 25% and 45 degrees about 50%. The gain in length comes at the cost of increased width, and the scar is redirected toward relaxed skin tension lines, which is exactly what releases a contracture crossing a joint crease.
Reference: Grabb and Smith's Plastic Surgery, 8th ed.
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Written and medically reviewed by the StethoPrep medical team.