A modification of the MacFee incisions for neck dissection

The dissection of cervical lymphatics for cancer after radiotherapy imposes a special need to ensure good healing of skin flaps with good access and acceptable aesthetic results. Adaptability of incisions for extended surgery is also desirable. Although it is felt that the adoption of the basic MacFee incision pattern fulfils these criteria, the author has for years employed curved modifications of the two horizontal incision lines. This develops a waisted skin bridge which is freely mobile and gives better access to the deep structures. The technique is contrasted with other approaches and described in detail. It complies with the safe principle of join-free linear incisions and is practical for regular use.