Cosmetic Surgery Flashcards
- The following demonstrates facial lacerations, which of the following most closely follows the resting skin tension lines?
A picture of R vertical lac on forehead
B picture of R vertical lac crossing inferior border of mandible
C picture of L vertical lac along upper lateral nasal cartilage
D picture of R vertical oblique lac on R cheek
OMSSAT 2004, pages 46-48
ANSWER: B
RATIONALE:
‘The concept of resting skin tension lines (RSTLs) was introduced by Borges and Alexander in 1962. They based their definition of these RSTLs on how a wound tends to behave following incision of the skin, i.e., whether the wound gapes widely or very little. It has been known for decades (Dupuytren, 1834, Langer 1861) that skin incisions placed right angles to skin tension lines produce widely gaping wound margins. If these lines are followed during the incisions or excision of scars and neoplasms generally a far better result will be achieved than if the incisions cross the tension lines. The course of the facial tension lines does not always coincide with normal wrinkle lines due to aging.’
The answer is B. All of the other lacerations are at right angles to the RSTLs
REFERENCE:
Kastenbauer ER, Reconstructive surgery of the external nose. In: Head and Neck Surgery, 2nd ed. Vol I. Tardy ME Jr, Kastenbauer ER. editor. Naumann HH, coordinating editor. Thieme Medical Publishers Inc, New York. 1995, pp 303-304.
