Scalp incisions of an elective nature are commonly used as an approach in upper cranial maxillofacial surgery. Similarly, isolated linear parietal incisions are occasionally used to harvest outer table calvarial bone grafts. Although morbidity from these incisions is generally minimal, there is a tendency, particularly when a scar is widened, for it to be more visible if it is of a linear nature. In this review we will present our results with 16 consecutive patients in which a geometric pattern incision was used instead of a straight incision in hopes of improving the ultimate appearance of this scar. We have found that, in general, incisions made in a geometric fashion are less noticeable than traditional linear elective scalp incisions. This is particularly true when there was widening of the scar.
A 12-YEAR-OLD WHITE GIRL presented with a midline cervical lesion present since birth. A fibrous cord that limited extension of her neck was associated with the lesion. The patient noted occasional mucoid discharge from the inferior aspect of the lesion (Figure 1 and Figure 2). Her medical history was unremarkable, and she had never received any prior medical or surgical intervention for the lesion. On physical examination, a small skin tag was noted at the superior aspect at the level of the hyoid bone. An excoriated, dry tract extended inferiorly and terminated in a small fistulous tract with scant mucoid drainage. The lesion was not affected by swallowing or tongue protrusion.
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