Beveled Incisions: What is the Evidence?

BACKGROUND: Although many aesthetic surgeons believe that beveling the angle of an incision improves the aesthetic outcome with regard to scaring, the literature remains scarce largely because few studies have been conducted.

OBJECTIVE: This systematic review therefore aims to identify whether using a beveled incision adds an aesthetic benefit, to determine whether there is a specific angle that yields a superior outcome, and for the first time, to present a complete discussion of this subject for practicing surgeons.

METHODS: A comprehensive literature search was performed using the PubMed database to search for primary articles. The main inclusion criteria were primary journal articles investigating the use of a beveled angle via a controlled study.

RESULTS: A total of fifty-four publications were reviewed, with only four publications including 124 patients suitable for use in this systematic review. All the studies concluded that the use of a beveled angle incision improved aesthetic outcomes, with the ideal angle ranging from 10° to 45°.

CONCLUSIONS: The use of a beveled angle incision can improve scar aesthetics and encourages the regrowth of hair follicles and shafts through the scars via multiple mechanisms. Nevertheless, the paucity of literature available to the practitioner compels further research assessing this important topic.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .