The lines of minimal tension, also called relaxed skin tension lines, are result of the skin's adaptation to function and are also related to the elastic nature of the underlying dermis (Fig. 1-1). The intermittent and chronic contraction of the muscles of facial expression create depressed
creases in the skin of the face. These creases become more visible and depressed as one ages. For instance, the supraorbital wrinkle lines and the transverse lines of the forehead are caused by the contraction of the frontalis muscles, which insert into the skin of the lower forehead. In the upper eyelids, many fine perpendicular strands of fibers of the elevator aponeurosis terminate in the dermis of the skin an along the tarsus to form the supratarsal fold. Similar insertions in the lower lid create fine horizontal lines, which are accentuates by the circumferential contraction of the orbicularis oculi muscle.
Incision lines should be made within the lines of minimal tension. Incision made in or parallel to such a line or crease will become inconspicuous if careful closure is performed. Any incision or portion of an incision that crosses such a crease, however, is often very conspicuous.
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