LAM FACIAL PLASTICS

Hi Dr Lam,
I am really impresssed with your website and the information which you provide to the public. You have a really nice portfolio of work, but sadly I am based in th UK and it may not be possible for me to seek a consultation with you.
I have this depressed facial scar on my cheek, which is now 2 years old. I have recently been to see a plastic surgeon who has reccommended that a multiple Z-plasty would be the best option for repositioning the scar along the RTSL and help to camouflage the scar. Do you feel this procedure would benefit this scar vs a geometric closure? Would there be any other treatments that may work for this type of scar? I am a bit apprehensive to say the least about swapping this scar for what will potentially be an even longer scar.

Thank you for your time and any opinions you may be able to provide.

Hi Dr Lam,
I am really impresssed with your website and the information which you provide to the public. You have a really nice portfolio of work, but sadly I am based in th UK and it may not be possible for me to seek a consultation with you.
I have this depressed facial scar on my cheek, which is now 2 years old. I have recently been to see a plastic surgeon who has reccommended that a multiple Z-plasty would be the best option for repositioning the scar along the RTSL and help to camouflage the scar. Do you feel this procedure would benefit this scar vs a geometric closure? Would there be any other treatments that may work for this type of scar? I am a bit apprehensive to say the least about swapping this scar for what will potentially be an even longer scar.

Thank you for your time and any opinions you may be able to provide.

personally, i would not do a z-plasty. yes, it does reorient the scar along a RSTL. that would be important if there were tension in the line or contraction, neither which i see. by choosing a z-plasty you may improve the orientation but you get two other negative tradeoffs: a longer scar (no reason to have that) and an inferior type of camouflage. as you know in my opinion a regularly repeating z-plasty really does not look as good as an irregularly irregular GLBR. i think this is more than a matter of pure opinion. hope you find the right doctor for you over there.

s.

Hi Dr Lam,
Thank you for your response and advice. Could I ask for how long the GLBR has been a common procedure for scar revision and whether this technique is more widely used in the USA as opposed to the UK? The plastic surgeon (Professor S-- ) whom I was consulting with about this scar comes highly recommended and has over 30 years experience but seemed unaware of the geometric broken line closure technique when I spoke to him about it. Is this cause for concern? Does this mean he may not be as specialised in scar revision as perhaps I would need for this type of surgery.

Thank you.

sorry, i had to remove your doctor's name since i do not want to denigrate unintentionally or intentionally another surgeon. the GBLR has been a standard technique for decades. i learned it in the 90s. it does not mean he is a bad surgeon. i just truly believe it is far beyond the best way to manage a scar for the previously enumerated reasons.
s.