Langer's lines, Langer lines of skin tension, or sometimes called cleavage lines, are

topological Topology (from the Greek words , and ) is the branch of mathematics concerned with the properties of a geometric object that are preserved under continuous deformations, such as stretching, twisting, crumpling, and bending; that is, wit ...

skin lines drawn on a map of the human body. They are parallel to the natural orientation of

collagen Collagen () is the main structural protein in the extracellular matrix of the connective tissues of many animals. It is the most abundant protein in mammals, making up 25% to 35% of protein content. Amino acids are bound together to form a trip ...

fibers in the

dermis The dermis or corium is a layer of skin between the epidermis (skin), epidermis (with which it makes up the cutis (anatomy), cutis) and subcutaneous tissues, that primarily consists of dense irregular connective tissue and cushions the body from s ...

, and generally parallel to the underlying muscle fibers. Langer's lines have relevance to forensic science and the development of surgical techniques.

History

The lines were first discovered in 1861 by

Austria Austria, formally the Republic of Austria, is a landlocked country in Central Europe, lying in the Eastern Alps. It is a federation of nine Federal states of Austria, states, of which the capital Vienna is the List of largest cities in Aust ...

anatomist Anatomy () is the branch of morphology concerned with the study of the internal structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old scien ...

Karl Langer (1819–1887), though he cited the surgeon Baron Dupuytren as being the first to recognise the phenomenon. Langer punctured numerous holes at short distances from each other into the skin of a

cadaver A cadaver, often known as a corpse, is a Death, dead human body. Cadavers are used by medical students, physicians and other scientists to study anatomy, identify disease sites, determine causes of death, and provide tissue (biology), tissue to ...

with a tool that had a circular-shaped tip, similar to an ice pick. He noticed that the resultant punctures in the skin had

ellipsoidal An ellipsoid is a surface that can be obtained from a sphere by deforming it by means of directional scalings, or more generally, of an affine transformation. An ellipsoid is a quadric surface; that is, a surface that may be defined as the ze ...

shapes. From this testing he observed patterns and was able to determine "line directions" by the longer axes of the ellipsoidal holes and lines.

Application

Knowing the direction of Langer's lines within a specific area of the skin is important for

surgical Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery ...

operations, particularly cosmetic surgery. If a surgeon has a choice about where and in what direction to place an incision, they may choose to cut in the direction of Langer's lines. Incisions made parallel to Langer's lines may heal better and produce less scarring than those that cut across. Conversely, incisions perpendicular to Langer's lines have a tendency to pucker and remain obvious, although sometimes this is unavoidable. The orientation of stab wounds relative to Langer's lines can have a considerable impact upon the presentation of the wound. Langer's lines include breast static tension lines, which mark a guide for

breast surgery Breast surgery is a form of surgery performed on the breast. Types Types include: * Breast augmentation * Breast reduction * Breast-conserving surgery, a less radical cancer surgery than mastectomy * Lumpectomy * Mastectomy * Mastopexy, or brea ...

incisions.

Keloid Keloid, also known as keloid disorder and keloidal scar, is the formation of a type of scar which, depending on its maturity, is composed mainly of either type III (early) or type I (late) collagen. It is a result of an overgrowth of granulation t ...

s are more common when incision is given across Langer's lines. Sometimes the exact direction of the collagen fibers are unknown, because in some regions of the body there are differences between different individuals. Also, the lines described by Kraissl differ in some ways from Langer's lines, particularly on the face.

Alternatives

Other authors have created topological skin maps. Kraissl's lines differ from Langer's lines in that while Langer's lines were defined in cadavers, Kraissl's lines have been defined in living individuals. Also, the method used to identify Kraissl's lines is not traumatic.

References

{{Authority control Dermatologic signs Skin lines

History

Application

Alternatives

See also

References