The O-to-Z plasty.

Closure of circular defects in the eyelids and canthal areas, as well as the face and neck regions, can present a challenging problem for the ophthalmic plastic surgeon. The O-to-Z plasty devised by Dr. Marvin Quickert is an excellent procedure for dealing with medium-sized circular defects in these regions. It is most commonly used after removal of benign or malignant tumors. In this procedure, skin is undermined from subcutaneous tissue and muscle around the entire circular defect. Two parallel incisions are made along normal lines of cleavage tangential to the circular defect. This allows the skin edges to be advanced and closed along a diagnol converting the defect to a Z closure. The advantage of this procedure is that it allows a smooth firm closure without a "dog-ear" defect. In addition, skin grafts can be avoided in closing many small- and moderate-sided circular defects.