Summary
Karl Langer investigated directional variations in the mechanical and physical properties
of skin [Gibson T. Editorial. Karl Langer (1819–1887) and his lines. Br J Plast Surg 1978;31:1–2]. He produced a series of diagrams depicting lines of cleavage in the skin [Langer
K. On the anatomy and physiology of the skin I. The cleavability of the cutis. Br J Plast Surg 1978;31:3–8] and showed that the orientation of these lines coincided with the dominant axis
of mechanical tension in the skin [Langer K. On the anatomy and physiology of the
skin II. Skin tension. Br J Plast Surg 1978;31:93–106]. Previously these lines have been considered as a static feature. We set
out to determine whether Langer's lines have a dynamic element and to define any rotation
of the orientation of Langer's lines on the face with facial movement.
One hundred and seventy-five naevi were excised from the face and neck of 72 volunteers
using circular dermal punch biopsies. Prior to surgery a vertical line was marked
on the skin through the centre of each naevus. After excision distortions of the resulting
wounds were observed. The orientation of the long axis of each wound, in relation
to the previously marked vertical line, was measured with a goniometer with the volunteer
at rest and holding their face in five standardised facial expressions: mouth open,
smiling, eyes tightly shut, frowning and eyebrows raised. The aim was to measure the
orientation of the long axis of the wound with the face at rest and subsequent rotation
of the wound with facial movement.
After excision elliptical distortion was seen in 171 of the 175 wounds at rest. Twenty-nine
wounds maintained the same orientation of distortion in all of the facial expressions.
In the remaining wounds the long axis of the wound rotated by up to 90°. The amount
of rotation varied between sites (p>0.0001).
We conclude that Langer's lines are not a static feature but are dynamic with rotation
of up to 90°. It is possible that this rotation in the axis of mechanical tension
will affect the appearance of the resulting scar.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Plastic, Reconstructive & Aesthetic SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Editorial. Karl Langer (1819–1887) and his lines.Br J Plast Surg. 1978; 31: 1-2
- On the anatomy and physiology of the skin I. The cleavability of the cutis.Br J Plast Surg. 1978; 31: 3-8
- On the anatomy and physiology of the skin II. Skin tension.Br J Plast Surg. 1978; 31: 93-106
- Lacerations against Langer's lines: to glue or suture?.J Emerg Med. 1998; 16: 185-189
- Langer's lines: to use or not to use.Plast Reconstr Surg. 1999; 104: 208-214
- An overview of facial aesthetic units.J Oral Maxillofac Surg. 2003; 61: 1207-1211
- Excision of small tumours of the skin of the face with special reference to the wrinkle lines.Surgery. 1949; 4: 592-600
- Relaxed skin tension lines, z-plasties on scars and fusiform excision of lesions.Br J Plast Surg. 1962; 15: 242-254
- Relaxed skin tension lines (RSTL) versus other skin lines.Plast Reconstr Surg. 1984; 73: 144-150
Article info
Publication history
Published online: September 01, 2006
Accepted:
June 11,
2006
Received:
April 9,
2006
Identification
Copyright
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
