The obvious examples are inside the hairline or in the eyebrow. In these sites the incision, instead of being perpendicular to the skin surface, should be made parallel to the hair follicles. This avoids the creation of the hairless scar line which results from sectioning of the hair follicles. A practical point to note in making a scalp incision is the possibility of subsequent baldness reveal-ing a scar previously hidden.
In this, account should be taken of the patient’s sex, and any hereditary factors in the potential pattern of baldness. Use of the Z-plasty The Z-plasty has a potentially significant role as an adjunct to other methods designed to improve the appearance of scars. The general point to be made at this juncture is that the Z-plasty is unsuitable for use in the ini-tial management of a wound resulting from trauma.
It should be reserved for possible use in subsequent scar revision, and even then it calls for careful judgment, skill in design, and scrupu-lous technique.