The Subunit Principle in Scar Face Revision.

Area of Science:

• Plastic Surgery
• Dermatology
• Cosmetic Procedures

Background:

• Facial scarring presents significant challenges in plastic surgery, especially when scars are not aligned with relaxed skin tension lines.
• Traditional scar revision techniques include geometric designs (Z-plasty, W-plasty) and newer modalities like botulinum toxin, fractional CO2 lasers, microfat grafts, and platelet-rich plasma.

Purpose of the Study:

• To investigate the application of the facial subunit principle in surgical scar revision to enhance cosmetic outcomes.
• To evaluate the efficacy of tissue expansion in repositioning scars to optimal facial aesthetic boundaries.

Main Methods:

• A two-stage surgical approach involving tissue expansion of intact facial subunits.
• Advancement of flaps to reposition scars to the junction between facial subunits.
• Evaluation of the success of tissue expander placement and flap advancement.

Main Results:

• Tissue expansion successfully facilitated scar relocation to the junction between facial subunits in all four patients.
• The surgical procedure, including tissue expander delivery and flap advancement, was successful in all cases.
• The technique allows for the camouflage of previously conspicuous facial scars.

Conclusions:

• The facial subunit principle, combined with tissue expansion, offers a viable strategy for improving challenging facial scar revisions.
• This technique is particularly beneficial for patients with significant scarring seeking substantial aesthetic improvement.
• The two-stage nature and sacrifice of intact skin make it suitable for select cases with ambitious aesthetic goals.