Surgical principles for achieving a functional and cosmetically acceptable scar

Dermatologic surgery can sometimes result in scars that are less than satisfactory. Such results, and hence the need for scar revision, can be avoided with careful planning and the use of appropriate surgical techniques. In this practical review, we describe several techniques that will improve functional and cosmetic outcomes. While Z-plasty and its variants are simple yet essential surgical procedures, they can represent a challenge for less experienced surgeons. By gaining a clear understanding of the principles of Z-plasty, the dermatologic surgeon will be able to employ this technique, either alone or with other surgical techniques, in a range of clinical situations.