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Comment & Response
Jul/Aug 2016

Clarifying Scar Revision Techniques and Their Proper Use—Reply

Author Affiliations
  • 1Department of Dermatology, University of California, Davis, Sacramento
  • 2Sutter-Pacific Medical Foundation, California
  • 3Department of Dermatology, University of California, Davis, Sacramento
JAMA Facial Plast Surg. 2016;18(4):317. doi:10.1001/jamafacial.2016.0769

In Reply We thank Thomas and colleagues for their impassioned commentary regarding our article,1 and we would like to address some of the issues that have been raised regarding our study.

First, Thomas and colleagues state, “Because linear primary closure and secondary scar revision techniques using Z-plasty or W-plasty have such different indications and uses, comparing them as done in this study is, at the least, incongruous and inappropriate.” When considering revision techniques to address a suboptimal scar, where functional or free margin distortion is not a concern, one option is simply to excise it and close it primarily. Or alternatively one could use a Z-plasty or an excision with W-plasty. Both Z-plasty and W-plasty rely, in part, on the notion that an irregular zigzag scar is less noticeable than a linear one. Given these are some available revision options, and little was known on the public's perception of linear vs zigzag scars, this seemed like a good basis for our study. Public perception is an important aspect when considering any scar revision method and our study provides valuable data in that regard.

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