The enigma of Serre's "Z-plasty" technique.

In 1835, Serre performed an operation to correct a cicatricial displacement of the right mouth commissure, which he described in his 1842 book. The drawings shown in a plate in the book (Fig. 2) and the description of the technique in the legend depicted the technique he had planned to perform (excision of tissue within lines ABCDE) but was not the technique he actually did. The description of the technique in the text of the book (Fig. 4) is very poor and incomplete. Apparently, he raised a triangular flap, which contained the right commissure, and sutured it into the skin defect on the check that he had created. The Z-plasty technique attributed to him (Fig. 1) in many textbooks is not the technique he had planned nor the technique he performed. He did not describe a Z-plasty but only the transposition of a single flap.