Learning Objectives: After studying this article, the participant should be able to: 1. Understand the theoretical geometry behind the Z-plasty maneuver. 2. Recite the reasons why application of the Z-plasty differs in vivo from that calculated in theory. 3. Describe how the number of limbs, flap thickness, and flap location may alter Z-plasty outcome. 4. Discuss the indications for the use of Z-plasty.
For the neophyte, the Z-plasty maneuver can be a surgical procedure veiled in intrigue. The theoretical mechanics of Z-plasty geometry are described, establishing that the new length of the central limb in a 60-degree Z-plasty is ✓3 of its original length. Factors such as skin tension, flap thickness, and flap location can, in application, distort the desired outcome. An algorithm is established that describes the indications and simplifies the execution of this technique. (Plast. Reconstr. Surg. 103: 1513, 1999.)