Clinical and Histological Proof that Surgical Incisions along Skin Folding Lines Result in Optimal Scars

Abstract

To perform elective surgery resulting in inconspicuous scarring, incisions must be placed along or parallel to tension lines or collagen fibers. Since both are invisible, we were able to show that both, tension lines and collagen fibers, run perpendicular to the striae distensae, which in humans always are formed in the same direction. We present unambiguous clinical examples and histological pictures which prove the direction and parallelization of collagen fibers and their supportive elastic fiber network. As less collagen fibers are destructed during surgery and severe stretching of the wound edges -less fibroblasts are needed for repair, resulting in an optimal scar.

A non-invasive computational method to determine the directionality of skin tension lines

“…Thus, on the cosmetics front, the ability to identify skin tension lines can help evaluate the effectiveness of skin treatments. From a clinical point of view, skin tension lines are useful in surgeries to determine the direction of incisions [10,11], since incisions aligned with skin tension lines can result in optimal scar formation and minimize wound contraction [12].…”