© 2018

Biodynamic Excisional Skin Tension Lines for Cutaneous Surgery

  • Provides the original concept of excisional skin tension lines

  • An important work in the field of surgical foundations

  • First major new concept in skin tension lines since Langer’s cleavage lines in 1861


Table of contents

  1. Front Matter
    Pages i-xix
  2. Sharad P. Paul
    Pages 129-144
  3. Sharad P. Paul
    Pages 173-183
  4. Back Matter
    Pages 185-188

About this book


This book is a detailed review of the ‘state-of-the art’ of skin lines in cutaneous surgery. Surgical literature is inundated with references to Langer’s Lines, Cleavage Lines, Wrinkle Lines and Relaxed Skin Tension Lines, but this title discusses the difference between these and incisional and excisional lines biomechanically, introducing the concept of biodynamic excisional skin tension (BEST) Lines.

The problem with current concepts of skin tension lines is that they seem to differ in different textbooks, and lines for surgical egress, which work in conditions of low tension, are not necessarily suitable for skin cancer surgery. Biodynamic Excisional Skin Tension Lines for Cutaneous Surgery describes skin biomechanics, the properties of collagen and elastin, lower limb skin vascularity and also maps BEST lines across the body, making it a great reference guide for plastic or dermatologic surgery worldwide. As such, it will be beneficial for anyone performing cutaneous surgery and skin cancer excisions in clinical practice, or for those planning further research into skin biomechanics to read this volume.


Langer’s lines Cleavage lines Tension lines Plastic Surgery Dermatologic surgery

Authors and affiliations

  1. 1.School of MedicineUniversity of QueenslandQueenslandAustralia

About the authors

Dr Sharad P. Paul initially embarked on surgical training in general/plastic surgery before establishing an integrated skin cancer practice. He has worked as a surgical consultant in public/teaching hospitals and also in primary care. Since 1996, his Skin Surgery Clinic has performed over 45,000 skin cancer operations, making the center known for one of the largest series of skin cancer patients worldwide.

He is a Senior Lecturer (skin cancer) at the School of Medicine, University of Queensland, Australia and an Honorary Senior Lecturer, Department of Surgery at the University of Auckland. He is also an Adjunct Professor at the Auckland University of Technology. Given these academic and teaching attachments, he has a long list of conference keynote presentation and publications in peer-reviewed journals. He is a Fellow of the Skin Cancer College of Australasia and has also been conferred the Distinguished Fellowship of the Royal NZ College of General Practitioners. In 2015, he was awarded the Ko Awatea International Excellence Award for Leading (Health) Improvement on a Global Scale with the citation noting “Dr Sharad Paul role in improving skin cancer management, education and patient-centred care internationally, across several countries."

In 2016, Dr Sharad P. Paul co-authored Clinical Cases in Skin Cancer Surgery and Treatment (Springer). He is the author of several nonfiction books for popular audiences in the field of skin and medicine.

Bibliographic information

  • Book Title Biodynamic Excisional Skin Tension Lines for Cutaneous Surgery
  • Authors Sharad P. Paul
  • DOI
  • Copyright Information Springer International Publishing AG, part of Springer Nature 2018
  • Publisher Name Springer, Cham
  • eBook Packages Medicine Medicine (R0)
  • Softcover ISBN 978-3-319-71494-3
  • eBook ISBN 978-3-319-71495-0
  • Edition Number 1
  • Number of Pages XIX, 188
  • Number of Illustrations 7 b/w illustrations, 67 illustrations in colour
  • Topics Dermatology
    Plastic Surgery
  • Buy this book on publisher's site
Industry Sectors
Health & Hospitals
Internal Medicine & Dermatology
Consumer Packaged Goods


“Biodynamic excisional skin tension lines for cutaneous surgery presents a new paradigm in skin lines. … the illustrations, diagrams, and images that accompany this innovative approach make this book a worthy reference to have.” (Derek W. Nickerson, Journal of the American Academy of Dermatology, Vol. 80 (5), May, 2019)