Changes in the length and area of congenital nevi involving the face and extremities after two serial excisions

Serial excision or staged excision is a well-established method in plastic surgery. It is widely used to remove congenital nevi, wide scars, and confined tattoos. The technique itself is very simple because it only involves excision and suturing. However, the operator must decide how many resections to perform, how much tissue to excise during the first resection, and which shape is appropriate. The most commonly used excision method is elliptical or fusiform excision. The length of this shape of resection should be 3–4.5 times its width to obtain good results without leaving a dog ear [14]. Reducing this ratio as much as possible is the goal of staged resection. However, it is difficult to predict the final length after staged resection. Accurate descriptions of this issue in textbooks are difficult to find, and most studies have only dealt with length. Changes in area have not been published yet. In addition, the results of geometric studies cannot be directly applied to patients in clinical practice [5]. Factors affecting the number of stages of resection and the final length include lesion size and shape, anatomical location, and the elasticity of surrounding tissues [6]. Jae Il Choi, Daegu Son