"Beak"-plasty: A new effective modification of Z-plasty

BACKGROUND: Because the "lateral limbs" resulting from conventional Z-plasty form a steep angle against the relaxation skin tension line (RSTL), they often develop hypertrophic change, whereas the "central limbs" become inconspicuous after being realigned parallel to the RSTL. OBJECTIVE: To alleviate the above-mentioned hypertrophic change of the lateral limbs, we modified the conventional Z-plasty and invented a new technique. Because the shape of the flap resembles a bird's beak, we call the technique "beak-plasty." The purpose of this study is to present the new technique. METHODS: The technique is described and effectiveness of the technique is reviewed on 21 patients. In particular, three representative cases are presented with photographs. RESULTS: In all patients, the lateral limbs of the flaps did not become hypertrophic after a minimum follow-up period of 9 months. CONCLUSIONS: Our technique can effectively reduce Z-plasty's risk of postoperative hypertrophy in the lateral limb. Therefore, it can make the scar less conspicuous than in conventional Z-plasty. For this advantage, we recommend our technique as an effective armament for scar revision.