Sewing but not for the squeamish

Caveat first: This post may not be suitable for all visitors. Do not progress beyond the fold if you are queasy.

One of my favorite sewing books makes no mention of fabric at all. Called Facial Flaps, Biomechanics and Regional Applications, it describes procedures for facial skin reconstructive surgeries. This title is out of print; others aren’t but these don’t have the “search inside this book” feature enabled which I can’t tell if it is a boon or a downside. There’s also a website on the topic, reiterating the caveat.


The reason I find the text so riveting is the explanation of stressors and tension redistribution; there are similar attributes with regard to garment making. As with garments, there are certain limitations with respect to suppression (e.g. darting). For example, the comparative of the limitations of the scalp are analogous to the primary range of motion. There’s a limit to give in the region. Therefore, the load must be spread. Here’s an example (below, figure A):

The oval represents a missing flap requiring reconstruction. The structure of the scalp is such that one cannot simply stitch opposing sides together. Rather, a second cut further up in the scalp is made (below, figure B).

Then the first flap is stitched. Load spread, the second is then closed (below, figure D).

There’s all kinds of examples of dispersing tension. While not generally applicable for most of our purposes, I have used some concepts in bias. I’m also wondering if these couldn’t be applied in leather garments being flesh. Here is another interesting example (there are lots of tension dispersion diagrams in the book).

For the full effect, the text reads:

Should I leave well enough alone or would you like more? I find the concept of back cutting compelling (below, full size 700kb)…

I can handle looking at drawings. I doubt I’d be this interested looking over a surgeon’s shoulder.

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10 comments

  1. Georgina says:

    These drawings are fascinating. On a somewhat related note, I am always disturbed by bad plastic surgery (cosmetic surgery). I think that a good plastic surgean should be like a good tailor, doing impeccable work.

  2. Deanna says:

    This is very interesting stuff! I wondered how they stitch an opening closed without having puckering. And sadly, I would love the opportunity to watch over the surgeon’s shoulder. I have thought I could start a new trend – decorative suturing.

  3. Helen says:

    What a great (and sensible) resource. If we do not use everything available to us to learn, we cannot optimize our education.

    As far as tailoring vs. surgeoning goes, a good fit is arguably somewhat more important for the latter.

  4. Wow….fascinating, isn’t it?

    While I was apprenticing with a Tailor by nights and weekends, I was in the medical industry by day…and did have the opportunity to actually stand over surgeons’ shoulders and watch procedures….which is probably why I will never ever have a face-lift…

    But the theory really is totally applicable to how we decide to manipulate fabric into garments.

  5. J C Sprowls says:

    Absolutely fascinating. I had an ex who was a plastic surgeon. I asked all the time to watch him work – he never let me. I did occasionally get things out of him. Like, when they do a jowl lift. One procedure is to cut a Z under the jawline and then criss-cross the Z flaps.

    I incorporated this concept into the roll of a jacket front with great results. It worked great in the sample room. It doesn’t scale up to the rest of the factory, though. It’s a bear to cut a 1/8″ Z into the facing and fronts – no smooth cuts to abut in the marker.

    The stitchers didn’t have a problem sewing it. In fact, several remarked that they liked the finished result. The cutters were downright dangerous to be around for about 2 weeks, afterward.

    That’s when I learned: “Don’t mess with Lefty!” I guess, in retrospect, I could also say: “When Left has a good lay…” >:-)

  6. Jeanette says:

    As a physician I use my sewing skills often, however, for the first example above I would actually undermine the wound to allow me to draw the edges together, this is easy to do on the scalp as there are several very strong layers of fascia and muscle to pull the tissues where one would like them to go, However this technique does not translate to fabric ;-)
    the Z-plasty however does and is rather cool.

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