ABSTRACT
Fusiform excisions are now relatively rarely discussed among the options of surgical scar revisions; however, in daily practice they are quite often used. Serial excisions, once com monplace procedures, virtually disappeared from the literature-but not in practice-after skin expansion became a more fashionable approach. However, the complication rate of skin expansion is still high, it may cause considerable morbidity during the period of infla tion, and expanders are quite costly. Thus, fusiform excisions, whether performed as a onestep or multistep procedure, still occupy a very important place in dermatologic surgical scar revision. Fusiform excisions obey the rule that the simplest closure is the best and therefore scars left from fusiform excisions often have the characteristics of an “ideal” scar: they are flat and level with the surrounding skin; they are a good color match with the ad jacent skin; they run parallel to the relaxed skin tension lines (RSTLs); they remain narrow; and short excisions are without straight, unbroken lines that can be easily followed with the eye (1). However, even the seemingly simplest method of surgical scar revision such as fusiform excision is not a “quick fix” for a complicated problem such as an unsighdy scar (2). Scars amenable to revision by fusiform and serial excisions are widened, hypertro phied, webbed, pincushioned, and pitted. Often, a sequence of different procedures is nec essary to achieve an optimal result.
