Z-plasty: a concise review

One of the most commonly used techniques in facial plastic surgery is the Z-plasty. Main reasons to perform these transposition flaps are to lengthen a pre-existing scar, to camouflage a scar, or to realign a scar. The classic 60 degrees Z-plasty allows a 75% increase in scar length and is the cornerstone against which all variations are compared. Understanding the classic Z-plasty permits the surgeon to expand his or her repertoire to include the numerous variations thereof. The double-opposing Z-plasty, unequal triangle Z-plasty, four-flap Z-plasty, compound Z-plasty, and planimetric Z-plasty are the most frequent variants of the basic Z-plasty. Each are presented with illustrations and clinical indications.