An unavoidable and often unsightly complication of elective surgery is the inevitable scarring that follows.1 Placing elective surgical lines of incision in favorable locations minimizes the aesthetic and functional loss due to scar contracture. In 1861, anatomist Karl Langer applied the research of Dupuytren to develop a full-body map of elliptical lines arranged from similarities observed in tissue distortion of cadavers. Langer concluded that scars resulting from induced wounds were shaped by their regional collagen orientation.2 Swiss physician Emil Kocher, MD, later recommended the topographical “Langer lines” as a guideline for surgical incisions.2 It was soon realized, however, that Langer lines deviated from wound deformation in live patients.

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