Thursday, January 20, 2011

Perfect scar: how it's made?

Today I will talk about the best way to make an incision of the skin, so that the result will be the smallest cicatrice possible.
The most important component of the skin, that influences the way that a wound will heal is collagen, and in this case, type III collagen. Type I collagen is found in the skin, where it makes a network that draw invisible traction lines.[1]
According to Karl Langer, the first anatomist to search this subject in 1861, the human skin has a certain pattern. He observed this while doing research on cadavers with rigor mortis.

[2]
In 1999 Wilhelmi BJ and Co. published an article called "Langer's lines: to use or not to use" in which he claimed that the best incision lines are not Langer's, but ones made by Borges and Kraissl. The important detail observed in 1984 by Albert F. Borges was that in living humans traction lines differ a little bit. And so he formulated "Relaxed Skin Tension Lines", which are considered to be guideline for facial surgery.

 The best lines for body surgery is considered to be the one made by Cornelius J. Kraissl, because the healing process is faster and the scars post-incision are usually smaller.[3]
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1. http://www.ncbi.nlm.nih.gov/books/NBK21582/
2. http://www.med-ars.it/galleries/langer.htm
3. The Encyclopedia of Cosmetic and Plastic Surgery; Rinzler C.A.; Facts on File Inc; 2009

2 comments:

  1. Rigor mortis ... mi-a adus aminte de ceva funny

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  2. You mention in your last sentence: "the scars post incision are usually smaller". It should have been "scars post in incision are LESS VISIBLE or thinner, if/ when done within the Related Skin Tension Lines" Since the length of the cut will not change whatsoever after the incision is done.
    Furthermore, in your graphic where an incision would be done on the forehead, do note that both sides of the fusiform excision should be the same length (which in your diagram it's not) since at the time of suturing, you may run into trouble if not, having more skin on one side than the other.
    Silvia Borges (daughter of AFBorges, you referenced)

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