title: Optimizing Design and Execution of Linear Reconstructions on the Face.
abstract: BACKGROUND
  Linear closure (LC) is the most common reconstructive design for cutaneous defects. Successful performance of a LC is dependent on both appropriate surgical planning and technical execution.
  
  
  OBJECTIVE
  To review the design and execution of LCs on the face.
  
  
  METHODS
  A systematic evaluation of LCs is provided to guide a logical approach for the repair of cutaneous facial defects.
  
  
  RESULTS
  Reproducibly excellent aesthetic and functional results may be achieved with strategies that reduce incisional tension, preserve free margin position, and restore skin contour. Cosmetic unit borders and relaxed skin tension lines may be used to further camouflage facial scars. A comprehensive knowledge of facial anatomy, biomechanical properties of the skin, and incisional tension vectors facilitates correct preoperative planning and intraoperative technique.
  
  
  CONCLUSIONS
  Proper design and execution of LCs allow for enhanced cosmesis and permit the cutaneous surgeon to progress to more technically advanced surgical procedures such as cutaneous flaps.
authors.affiliation: Division of Dermatologic Surgery and Cutaneous Oncology, Department of Dermatology, Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Sobanko
mesh_terms: D002921:Cicatrix / Q000601:surgery; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D004954:Esthetics; D019317:Evidence-Based Medicine; D005153:Facial Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D013524:Surgical Flaps; D016896:Treatment Outcome