Our Summary

When skin cancer is removed from the head or neck area, it often leaves a small bulge of skin, or “dog-ear,” which can be undesirable for cosmetic reasons. The researchers in this paper describe a surgical technique they used to fix these “dog-ears” called Z-plasty. This method doesn’t involve cutting off the extra skin but instead rearranges it to make the area look more natural.

FAQs

  1. What is the Z-plasty technique used for in head and neck reconstruction?
  2. How does Z-plasty correct a dog-ear deformity in surgical wounds?
  3. What is the significance of recruiting tissue from the axis of the standing cone in Z-plasty?

Doctor’s Tip

A doctor might advise a patient undergoing Z-plasty to follow post-operative care instructions carefully, including keeping the incision site clean and dry, avoiding excessive stretching or pulling on the area, and attending follow-up appointments to monitor healing progress. It is also important for patients to communicate any concerns or changes in symptoms to their doctor.

Suitable For

Patients with dog-ear deformities following Mohs micrographic surgery on the head and neck are typically recommended for Z-plasty. This technique can effectively correct the dog-ear deformity without the need for additional skin excision. Z-plasty is especially beneficial for patients who want to minimize scarring and achieve a more aesthetically pleasing outcome following surgery.

Timeline

Before Z-plasty:

  1. The patient undergoes Mohs micrographic surgery to remove skin cancer from the head or neck.
  2. Following surgery, the patient may experience a dog-ear deformity, which is a protrusion of excess tissue at the wound closure site.
  3. The surgeon determines that a Z-plasty is the appropriate technique to correct the dog-ear deformity.

After Z-plasty:

  1. The surgeon performs the Z-plasty procedure by creating triangular incisions to redistribute tissue and eliminate the dog-ear deformity.
  2. The patient may experience some discomfort and swelling following the procedure.
  3. Over time, the incisions heal and the tissue redistributes, resulting in a more aesthetically pleasing and functional outcome.
  4. Follow-up appointments with the surgeon may be scheduled to monitor healing and ensure optimal results.

What to Ask Your Doctor

  1. Can you explain the Z-plasty technique and how it will be used in my specific case?
  2. What are the potential risks and complications associated with Z-plasty?
  3. How long will the recovery process be after Z-plasty?
  4. Will I need any follow-up appointments or additional procedures after the Z-plasty?
  5. Are there any alternative options to Z-plasty for correcting a dog-ear deformity?
  6. How successful is Z-plasty in achieving a satisfactory cosmetic result?
  7. Will I experience any pain or discomfort during or after the Z-plasty procedure?
  8. Are there any restrictions or limitations on my activities during the recovery period?
  9. How long will the results of Z-plasty last?
  10. Are there any specific post-operative care instructions I should follow to ensure optimal healing and results?

Reference

Authors: Tanis R, Croley JA, Hammel J, Wagner RF Jr. Journal: Cutis. 2020 Aug;106(2):80-81. doi: 10.12788/cutis.0031. PMID: 32941552