OTAT plasty


The T-plasty consists of bilateral random-pattern sliding skin advancements transforming an O-shaped defect (O-T plasty) or an A-shaped defect (A-T plasty) into a final T-shaped scar. A circular defect is converted to an A shape by excising a superior wedge of tissue creating a partial ellipse with a blunt base. The base is closed

Figure 6 Sequence of a typical nasolabial V-Y advancement flap.

through bilateral tissue advancement with lateral tissue wedges (Burow's triangles) to avoid tissue bunching and dog-ears. An O-T plasty is similar except instead of excising the superior wedge, a tissue-sparing M-plasty is created at the superior margin.


The A-T plasty is indicated when the final scar base can be placed along a topographical unit border: around the lip or forehead adjacent to the eyebrow where the

cross can be placed at the vermilion border or superior eyebrow margin. Another common indication is for defects in the temporal area, where the cross on the T can be placed along the hairline and the forehead and cheek areas can be widely undermined to allow tissue movement. The arc is 180 degrees and the diameter 2D.


Using a T-plasty instead of converting the defect into an ellipse saves tissue and can avoid crossing a topographical unit border.


As in all advancement flaps, incision placement should be with the RSTLs, respecting the topographical unit border. Since this flap results in scars at right angles, it is limited to areas in which the scars can be camouflaged, usually bordering a topographic subunit that can accommodate the cross of the T.

How To Reduce Acne Scarring

How To Reduce Acne Scarring

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