Incisions

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All skin incisions result in scar formation. Scars are less obvious if the incision is made in or parallel to skin creases, for example an upper eye lid incision in the upper lid crease for ptosis surgery

If this is not possible one should try to keep the incision parallel to the lines of minimum skin tension (Figure 1.6). One exception to this is the vertical incision for lower lid lesions to avoid cicatricial ectropion. The incision should be as vertical as possible for the smallest scar and rapid healing. It is always helpful to mark an incision before distortion by local anaesthetic or stretching and it should be made in a single steady motion. It is helpful to cut "down-hill to uphill" to avoid blood obscuring the surgical field.

Figure 1.6 Lines of minimum skin tension.

Further reading

Collin JRO. A Manual of Systematic Eyelid Surgery (2nd ed).

London: Churchill Livingstone, 1989. Jones LT, Wobig JL. Surgery of the Eyelids and Lacrimal

System. Aesculapius, 1976. McCord CD, Tanenbaum M, Nunery WR. Oculoplastic

Surgery (3rd ed). New York: Raven Press, 1995. McNab AA. Manual of Orbital and Lacrimal Surgery.

Edinburgh: Churchill Livingstone, 1994. Zide BM, Jelks EW. Surgery Anatomy of The Orbit. New York: Raven Press, 1985.

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