(a) Complication of eclabium secondary to herpetic infection of an advancement flap of the upper lip. (b) A 45-degree Z-plasty is planned and drawn. (c) The flaps are widely undermined and transposed. Note the use of skin hooks to minimize trauma to the tenuous tips. (d) Flaps sutured in place. Transposition of the triangular flaps brings about the following changes: the central limb is rotated (from a vertical to a horizontal direction), the distance between the original vertical scar (or limb) is increased, and the final scar is “broken” from a straight line to a nonlinear Z configuration. (e) Patient at suture removal. Note the immediate correction of the eclabium. (f) Results at several months. The scar lines have become more subtle.
