Alternative Incisions

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The coronal incision has been modified repeatedly by surgeons. The principal difference in these surgical techniques involves the position of the skin incision. A major modification has been placement of the incision behind the ear (Fig. 6-25) (5,6). The advantage of this positioning is further camouflage of the scar. Any inferior extension of the coronal incision can be hidden within the postauricular fold or along the hairline.

Figure 6-25 Postauricular placement of the coronal incision. The incision can be extended into the postauricular sulcus or within the hairline.

Even with well-placed incisions, the scar that forms may produce a separation of the hair that can become visible when the hair is wet, such as during swimming. A modification of the incision has been the use of a zig-zag incision instead of a straight incision within the hairline (Fig. 6-26) (7). The zig-zag incision helps break up the scar and make it less noticeable, even when the hair is worn short. The major disadvantage of this incision is the increased time needed for closure.

Incision Zig Zag
Figure 6-26 Zig-zag incision to make the scar less obvious.

I. Sli¿|iliL'jd DE, W'jrJ-Bcvíth, ÜP, Mofe KF: The morbidity of bicafogu iljtps m manillofacldl surçery. fir J Oral M.i.vitlofui: Surji 23?I, 1£>K5

FurtisDW I LindmarVs for jj^tnil&andlk! lemporofacjiffliviii™ of ihe facial nerve UrJ Surt;

.1 AI-Kb vit A. Bramlcv ]': A modified jlns-auricular approach n> [lie idmfwrttmiflilibuljir ¿luih nuhf arch. Br J Oiol /7:9fl 1979.

4. Ronffi E. Rûtiul M, Gffljï'wd FI': SniYï anraomy of the wuB Ann Otol tîîiino] Laryngol

5. Policy IW, Cnfoe| M TIhí rtirmuritij]jr coronal Incisión, Scaiml J Plast fttcottitr H and Surç 26:li 1V92

6. Ptismck JC, Gnld^-in J^ Goktc C: A^ynntugcs orthe p¡w tu u ne u [ur coroiiiil inti kîiS Ann Phisl sur^ mi.

7 Munn* IRfFcjron JA ïliei:o,miijl i ne m nu revisited Plû&t Rticüp&tr fflrç 185. I^LÍ4.

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