From the Research
A Z-plasty at 45 degrees increases scar length by approximately 50%. This means that if you have a 2 cm scar, after a 45-degree Z-plasty, the scar will be about 3 cm long. The Z-plasty technique involves creating two triangular flaps at equal angles (in this case 45 degrees) on opposite sides of the original scar, then transposing these flaps to form a Z-shaped scar. This technique works by redistributing tension along the scar line, which can help prevent contracture and improve the appearance of the scar by breaking up the straight line.
The mathematical relationship between the angle of the Z-plasty and the increase in length follows a formula where a 30-degree angle gives about a 25% increase, 45 degrees gives a 50% increase, and 60 degrees provides approximately a 75% increase in length, as supported by the study 1. However, the most recent and relevant study on Z-plasty, 2, also confirms the effectiveness of the technique in scar revisions and correction of free margin distortion, but does not provide specific data on the percentage increase in scar length at 45 degrees.
Surgeons choose the appropriate angle based on how much lengthening is needed and the specific characteristics of the tissue involved. It's worth noting that other studies, such as 3 and 4, discuss the use of Z-plasty in various contexts, including scar revision and burn scars, but do not provide specific information on the percentage increase in scar length at 45 degrees.
Some key points to consider when performing a Z-plasty include:
- The angle of the Z-plasty determines the amount of lengthening achieved
- The technique involves creating two triangular flaps at equal angles on opposite sides of the original scar
- The Z-plasty can help prevent contracture and improve the appearance of the scar by breaking up the straight line
- Surgeons should choose the appropriate angle based on the specific characteristics of the tissue involved and the amount of lengthening needed, as discussed in 2.