Why Is A Straight Line Excision Better Than A Geometric Broken Line Closure Method For My Scar?
Q: Dr. Eppley, I am interested in scar revision of my wide midline abdominal scar from a prior surgery. One surgeon I saw recommended a geometric broken line closure (GBLC) type of scar revision. You have recommended a more simpler vertical excision and straight line closure. My question is why would you choose that particular procedure over the GBLC if the broken line procedure yields better results?
A: There is no guarantee that a broken line closure will produce a better result on a midline abdominal scar and there is no medical evidence to support that it will. And if the scar should widen to any degree, you will have more scar length than what you started with. Whomever advised you that a GBLC for your midline abdominal scar (that has never had a revision before) was the right choice for scar revision is simply wrong. That is simply not done on many body scars. It is most commonly done on facial scars which are a completely different in how they heal than any scar below the neck. You should initially do the simplest and least risky scar revision technique first and then proceed to more complex forms should that not produce a substantial improvement.
Dr. Barry Eppley