• The lid is placed on traction using a mattress stitch over tarsorrhaphy tubing.
• The scar is marked along its length.
• The upper and lower limbs of the Z are marked.
• A single Z can be converted to multiple Zs.
• The skin flaps are raised and reflected on skin hooks.
• Underlying cicatrix is excised and haemostasis obtained.
• The flaps are transposed and sutured in place "A-stitches" are useful at the apices of the flaps (Figure 2.3).
• The lid is placed on traction.
• Pressure dressings are applied for 48 hours.
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