The dynamic rotation of Langer's lines on facial expression

Faculty of Life Sciences, The University of Manchester, Manchester, England, United Kingdom
Journal of Plastic Reconstructive & Aesthetic Surgery (Impact Factor: 1.47). 04/2007; 60(4):393-9. DOI: 10.1016/j.bjps.2006.06.008
Source: PubMed

ABSTRACT Karl Langer investigated directional variations in the mechanical and physical properties of skin [Gibson T. Editorial. Karl Langer (1819-1887) and his lines. Br J Plast Surg 1978;31:1-2]. He produced a series of diagrams depicting lines of cleavage in the skin [Langer K. On the anatomy and physiology of the skin I. The cleavability of the cutis. Br J Plast Surg 1978;31:3-8] and showed that the orientation of these lines coincided with the dominant axis of mechanical tension in the skin [Langer K. On the anatomy and physiology of the skin II. Skin tension. Br J Plast Surg 1978;31:93-106]. Previously these lines have been considered as a static feature. We set out to determine whether Langer's lines have a dynamic element and to define any rotation of the orientation of Langer's lines on the face with facial movement. One hundred and seventy-five naevi were excised from the face and neck of 72 volunteers using circular dermal punch biopsies. Prior to surgery a vertical line was marked on the skin through the centre of each naevus. After excision distortions of the resulting wounds were observed. The orientation of the long axis of each wound, in relation to the previously marked vertical line, was measured with a goniometer with the volunteer at rest and holding their face in five standardised facial expressions: mouth open, smiling, eyes tightly shut, frowning and eyebrows raised. The aim was to measure the orientation of the long axis of the wound with the face at rest and subsequent rotation of the wound with facial movement. After excision elliptical distortion was seen in 171 of the 175 wounds at rest. Twenty-nine wounds maintained the same orientation of distortion in all of the facial expressions. In the remaining wounds the long axis of the wound rotated by up to 90 degrees . The amount of rotation varied between sites (p>0.0001). We conclude that Langer's lines are not a static feature but are dynamic with rotation of up to 90 degrees . It is possible that this rotation in the axis of mechanical tension will affect the appearance of the resulting scar.

1 Follower
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Computer models of the human face have the potential to be used as powerful tools in surgery simulation and animation development applications. While existing models accurately represent various anatomical features of the face, the representation of the skin and soft tissues is very simplified. A computer model of the face is proposed in which the skin is represented by an orthotropic hyperelastic constitutive model. The in vivo tension inherent in skin is also represented in the model. The model was tested by simulating several facial expressions by activating appropriate orofacial and jaw muscles. Previous experiments calculated the change in orientation of the long axis of elliptical wounds on patients' faces for wide opening of the mouth and an open-mouth smile (both 30(o)). These results were compared with the average change of maximum principal stress direction in the skin calculated in the face model for wide opening of the mouth (18(o)) and an open-mouth smile (25(o)). The displacements of landmarks on the face for four facial expressions were compared with experimental measurements in the literature. The corner of the mouth in the model experienced the largest displacement for each facial expression (∼11-14 mm). The simulated landmark displacements were within a standard deviation of the measured displacements. Increasing the skin stiffness and skin tension generally resulted in a reduction in landmark displacements upon facial expression.
    Computer Methods in Biomechanics and Biomedical Engineering 08/2013; DOI:10.1080/10255842.2013.820720 · 1.79 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In order to determine the signal attenuation that might be expected when using a portable telephone inside an automobile, the signal attenuation for a variety of incidence angles and antenna locations inside a car with one or two passengers was measured at 1920 MHz. In addition to the measurements, finite difference time domain (FDTD) calculations of the signal attenuation were also made. The FDTD calculations and measured signal attenuation were compared, and agreed well with one another. The FDTD predictions were then analyzed to provide statistical summaries of the signal attenuation characteristics for different incidence angles, number of passengers, windows up/down, and receiving antenna locations and orientations
    Antennas and Propagation Society International Symposium, 1996. AP-S. Digest; 08/1996
  • [Show abstract] [Hide abstract]
    ABSTRACT: The final appearance of a scar may be influenced by tension or mechanical factors [Borges AF. Scar prognosis of wounds. Br J Plast Surg 1960; 13:47-54; Arem AJ, Madden JW. Effects of stress on heating wounds. J Surg Res 1976;20:93-102; Burgess LP, Morin GV, Rand M, et at. Wound heating. Relationship of wound closing tension to scar width in rats. Arch Otolaryngol Head Neck Surg 1990; 116:798-802; Meyer M, McGrouther DA. A study relating wound tension to scar morphology in the pre-sternal scar using Langer's technique. Br J Plast Surg 1991;44:291-4] Karl Langer suggested that information could be gained about the tension inherent in skin, in all directions, by observing the wound edge retraction that occurred after making circular skin incisions [Langer K. On the anatomy and physiology of the skin II. Skin tension. Br J Plast Surg 1978;31:93-106]. Circular wounds may be used to demonstrate the orientation of the dominant axis of 'tension' in the skin but is this always a tensile stress as opposed to a compressive stress? This is the second article in a series documenting the mechanical properties of circular punch biopsy wounds. The aim of this study was to make detailed observations of the dimensional distortions of circular wounds on the face and neck, from which deductions could be made with regard to mechanical stress. One hundred and seventy-five benign head and neck lesions were excised from 72 volunteers using circular dermal punch biopsies. The distortions of the resulting wounds were observed to be elliptical in most cases. Measurements were taken of the maximum and minimum diameters of the wound and expressed as ratios of the size of the punch biopsy used for excision. The change in area from the area of the punch biopsy to that of the wound was also calculated.
    Journal of Plastic Reconstructive & Aesthetic Surgery 05/2008; 61(5):529-34. DOI:10.1016/j.bjps.2007.06.004 · 1.47 Impact Factor