By Jeffrey Weinzweig
Cosmetic surgery Secrets-the first secrets and techniques Series® name within the PLUS format-offers an easy-to-read, information-at-your-fingertips method of plastic and reconstructive surgical procedure and hand surgical procedure. Jeffrey Weinzweig has joined forces with world-renowned plastic surgeons Joseph McCarthy, Julia Terzis, Joseph Upton, Fernando Ortiz-Monasterio, and Luis Vasconez, and others to carry you the specialist viewpoint you want to clutch the nuances of this distinctiveness. This re-creation beneficial properties an extra colour that highlights tables, legends, keyword phrases, part and bankruptcy titles, and net references. All this, besides the preferred question-and solution process and record of the "Top a hundred cosmetic surgery Secrets," make it an ideal concise board assessment device and a convenient scientific reference.
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Additional info for Plastic Surgery Secrets Plus (2nd Edition)
How is a Z-plasty designed? A Z-plasty consists of a central limb, usually placed along the scar or line of contracture, and two limbs positioned to resemble a Z or reverse Z. The limbs must be equal in length to permit the skin flaps to fit together after transposition. The angles of the Z vary from 30° to 90°. The central limb, oriented along the line of contracture, usually is under considerable tension. After release or division of this contracture, the shape of the parallelogram immediately changes with spontaneous flap transposition and lengthening along the line of the central limb.
Five-flap Y-V advancement and Z-plasty. The central flap (C) is advanced in a Y-V fashion. The flaps of the two Z-plasties on each side of the central flap are transposed. (From Jankauskas S, Cohen IK, Grabb WC: Basic techniques in plastic surgery. In Smith JW, Aston SJ [eds]: Grabb and Smith’s Plastic Surgery, 4th ed. ) C E D 75 D E Fundamental principles of plastic surgery A B Figure 2-5. V-Y advancement technique. The central V is advanced forward and the defect is closed in a Y configuration.
Multiple Z-plasties, however, produce less transverse shortening. Lateral tension is reduced and more equally distributed over the entire length of the central limbs. Multiple Z-plasties are useful when insufficient tissue is available for a large single Z-plasty. In addition, multiple Z-plasties of facial scars often produce cosmetically superior results. 26. What is a four-flap Z-plasty? A four-flap Z-plasty is an effective technique to correct thumb–index web space and axillary contractures.