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Suturing

Principles of good suturing Placing an incision within or parallel to a relaxed skin tension line (RSTL) will produce a better scar with less tendency to hypertrophic scarring than one that crosses these lines. RSTLs tend to lie perpendicular to the direction of pull of the underlying muscles. On the face, they are sometimes called wrinkle lines and can be made more obvious by asking the patient to contract their muscles. When incision lines running parallel to RSTLs cannot be made, then they should be curved/wavy or a series of z-plasties.