Removal Skin Tumors of 4 Cases by Using the Modified S-plasty / 대한피부과학회지

Conventional S-plasty is a modified method showing favorable results compared with the standard fusiform excision. The modified S-plasty can greatly reduce the tension of suture lines as well as the length of the suture by approximately two thirds. It therefore obtains excellent aesthetic outcomes. So far, skin grafts or flaps have been used as a general method when a simple primary closure is impossible, but these are complex and take much time. In this case, we can get better surgical and aesthetic results by using the modified S-plasty instead. The scar is more natural if a curved line is sutured along the skin crease of the forehead or nasal area on the face. We surgically removed skin tumors in 4 cases by using the modified S-plasty. All resulted in good aesthetic outcomes.

Half V-Y-S Plasty for the Reconstruction of Circular Defects Around the Nasolabial Fold Area

When soft tissue circular or elliptical pathologic lesions are located around the nasolabial fold, the most appropriate method is to make the excision parallel with the scar or along a natural wrinkle-crease. For this purpose, simple elliptical excision following primary closure is recommended. But when its long axis of elliptical defects is located vertically to the nasolabial fold, these will bring a bad aesthetic result after elliptical excision following primary closure due to long vertical straight scar to nasolabial fold. If soft tissue defect is larger, we should depend on the wide dissection for the closure of elliptical excised area. As a result, it is inevitable to make postoperative deformity due to tension around the eyelids, oral commissures, canthal fold, and alar nose. V-Y-S plasty was introduced by Algamaso in 1974 for closure of a round defect. It adopted some aspects of the double rotation flaps(or S-plasty) and some of the V-Y advancements. The authors applied from March 1998 to December 2000 to use single rotation flaps(or half-S plasty) and V-Y advancement for closure of a round defect, around nasolabial folds in 12 patients, named it half V-Y-S plasty, by modifying of Argamaso's V-Y-S plasty. We could obtain sufficient coverage of round defects and placement postoperative scar on the nasolabial fold and alar crease area using single V-Y-S plasty. Even in case of hypertrophic scars, we could obtain the same result and symmetric postoperative supralabium contour. The average soft tissue defect diameter was 1.9 cm (biggest one: 3.2 cm), and advanced gain of V-S advancement was 1.34 cm. As a result, we could obtain the final result more aesthetic and functional than that of straight line closure or other type of local flap. We described the experience of half V-Y-S plasty with a review of literature.