title: Modified dovetail-plasty in scar revision.
abstract: Scar revision is one of the fundamental techniques in the field of plastic and reconstructive surgery. Local flaps, such as a Z-plasty, W-plasty, or geometric broken-line closure, have been used for scar revision. Camouflaging a scar during scar revision for marginal scars from skin grafts and flaps, trapdoor scars, and linear scars is difficult. We describe our experience with the use of modified dovetail-plasty for scar revision in these difficult areas. Our study group consisted of 28 cases among 22 patients (9 males and 13 females) with a mean age of 33.6 years (range, 6-61 years). The conspicuous scars were located on the face (50%) and extremities (50%). The authors designed Y-shaped incision lines to relax the skin tension lines on one side of the excision line and trapezoid incision lines on the other side. There were 16 follow-up operations performed over 6 months after the initial operation among a total of 22 patients. There were scar depressions (2 patients) and a hypertrophic scar (1 patient) at the interval area between the dovetail flaps. A diffuse hypertrophic scar occurred in 1 patient with a dorsal foot scar. The overall success rates of the procedure as assessed by the surgeons were as follows: excellent (75%), good (12.4%), fair (6.3%), and poor (6.3%). This new local flap can achieve an inconspicuous scar using a blurred scar line and reducing tension. The authors recommend a modified dovetail-plasty for the revision of trapdoor scars and scars under excessive tension.
authors.affiliation: From the *Institute of Burn, Reconstructive and Plastic Surgery, Bestian Seoul Hospital, Seoul; and †Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital, Anyangsi, Republic of Korea.
authors.forename: Suk Joon
authors.initials: SJ
authors.lastname: Oh
authors.forename: Jihoon
authors.initials: J
authors.lastname: Yang
authors.forename: Seon Gyu
authors.initials: SG
authors.lastname: Kim
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Jung
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Koh
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002921:Cicatrix / Q000601:surgery*; D062109:Dermatologic Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D055815:Young Adult