SCAR-LENGTH REDUCTION BY RING-SHAPED EXPANSION

Conventional tissue expansion with rectangular or round expanders ofte n results in considerable dog-ear formation and, after resection, in l engthening of the final scar. The resulting scar is always much longer than the maximal diameter of the skin lesion. These disadvantages are partially avoided by the use of croissant-shaped expanders. Taking th e idea of the croissant-shaped expander and thinking further in terms of differential expansion, a new expander has been designed. It consis ts of a ring-shaped expander that is placed under the normal skin arou nd the lesion. When the appropriate expansion is reached, the skin les ion is excised and the defect is closed with a running subcuticular su ture, pulling as much skin as possible centripetally. The resulting sc ar is shorter than the maximal diameter of the skin lesion. The new ex pander has been tested in two patients in regions that are reputed for poor scar quality (the back and the upper arm). The results are encou raging.