Correction of a post-traumatic scar fold in the lateral canthus using modified Z-plasty

Abstract

Post-traumatic scar deformations are common in many skin injury cases. These are usually aesthetic problems, but if these deformations impair mobility and the patient feels uncomfortable, we must resolve them. In a patient with a lateral post-traumatic scar fold in the lateral canthus that shortened the horizontal orbital fissure and created traction on eye opening, we performed modified classic Z-plasty, resulting in aesthetic and functional improvements without recurrence.

Keywords: Cicatrix; Esthetics; Eyelids.

Fig. 1.

At 1 year after the injury, shortening of the right lateral canthus by scar formation and reduction of the width of the right horizontal orbital fissure are observed.

Fig. 2.

There is a previous traumatic scar line from the lateral canthus to the temple, and the lateral canthus (white arrowheads) shows a fold formed by the scar (white arrow). The lower eyelid has baggy skin formed by the scar (black arrow).

Fig. 3.

(A) Design diagram of deformity. (B) After drawing the Z-plasty, the BC line is extended to create the CE line. At this time, the fan-shaped CDE includes the baggy skin to be excised.

Fig. 4.

(A) Postoperative photograph. (B) After excising the fan-shaped CDE area, the two flaps are transposed.

Fig. 5.

Eight months after surgery. The width of the right horizontal orbital fissure is improved, and no baggy skin of the lower eyelid is seen.