Why is a Zig-Zag Incision used in a Minimal Incision Arm-Lift?

Dear freedomh20,

I commend your thoughtful approach to your upcoming surgery. When considering any procedure, understanding the techniques and their rationale is crucial.

The choice of incision pattern in an arm lift, or brachioplasty, depends on several factors, including the patient's anatomy, the amount of excess skin, desired outcomes, and surgeon's preference and experience.

The zig-zag, or Z-plasty incision, offers several potential advantages in a minimal incision arm-lift:

Reduced Tension: The zig-zag pattern can distribute tension along the incision more evenly, potentially leading to a finer, less noticeable scar once healed.

Improved Scar Camouflage: The irregular pattern of a zig-zag may help break up the linearity of the scar, making it less noticeable as it doesn't follow a straight, continuous line.

Flexibility: Z-plasty can provide added flexibility in terms of skin redistribution, particularly useful in areas with multidirectional skin laxity.

Closure & Healing: In some cases, the zig-zag incision can facilitate better closure of the surgical site and possibly improve the healing process and final appearance.

While the zig-zag incision offers these potential benefits, a straight-line incision can still be an option for some patients, depending on their unique needs and the surgeon's assessment.

It's essential to discuss your concerns directly with your plastic surgeon. They can provide insights into why they believe the zig-zag pattern is the best choice for your particular situation and show you potential outcomes. If you're still uncertain, seeking a second opinion from another board-certified plastic surgeon can provide additional perspective.

Your comfort with the procedure and confidence in the anticipated results are paramount. Taking the time now to address your concerns will ensure you make the most informed decision moving forward.

Wishing you all the best in your upcoming procedure.

Sincerely,
Dr. Katzen

Be sure to discuss the type of incision/scar with your surgeon so you feel comfortable with his or her plan.  Yes, the zig zag incision is used frequently for brachioplasty procedures but not exclusively.  Remember the scars, zig zag or not, will take six months to a year to heal and fade after the procedure.  Best of Luck to You!

The other respondents have responded nicely as to why a “zigzag” car may be beneficial in some cases.  My concern in your case, after reviewing your photographs, is whether you will be pleased with the outcome of the many arm lifting procedures; remember that “mini” operations often have "mini” outcomes and patients end up being disappointing. Discuss your goals carefully which your plastic surgeon and make sure that you are both on the same page when it comes to ascertaining goals and understanding realistic expectations. Best wishes.

That is technically called a "Running W-Plasty" and has been a tool of plastic surgeons forever. It helps break up a scar into many short scars making it less noticeable to the eye and less likely to tighten up into a band. It does not have to be that shape, you are free to request a straight or curved line. Be sure you clearly understand you will see little to no change in the character of the skin below the upper 1/3 of the arm or you will be very disappointed in the minimal lift results.

Straight scars often contract and can limit the range of motion when they cross a joint.  A zig zag incision does not tend to contract the way a straight incision does.  I always discuss this with my patients before surgery.  Otherwise, they will think that "Zorro was here". Also, sometimes a zig zag scar is actually less obvious than a straight scar.  Weird, huh?