The directions of static skin tensions in the face: their roles in facial incisions.

The circular excisions of facial skin lesions were performed in 202 sites on 126 patients. The shapes of the resultant defects were observed to identify the directions of skin tensions in a static state. The round shapes remained in the forehead, temple, and nose. In the other areas of the face, the wounds were stretched in certain directions and became elliptical. The orientations of the facial static tensions were identical to the wrinkle lines in many facial areas. It is suggested that the wrinkle lines show the optimal directions of selective incisions in most facial areas except for the medial canthus and upper and lower lips.