The Z-Plasty is one of the most fundamental local flaps. It’s a variation of a transposition flap (meaning simply that it was rotated into a defect right next to it).

The trick is that all three limbs need to be equal and that the angles should be equal.

If the angle between the central limb and the lateral limb is 60°, then there should be an increase of the central limb by 75% (ex: 2cm -> 3.5cm)*

Since the Z-Plasty lengthens and changes the line of tension, it is great for releasing scar contractures.

* If you want you can measure the doodle, it’s pretty close to a 75% increase which I found really cool (in that I created it by rotating the flaps). MATHMAGIC!