The inevitable consequence of wound healing is scar formation, which can have a significant impact on patients’ physical and psychological wellbeing.

The ideal scar is thin, flat, oriented along the relaxed skin tension lines (RSTLs) and has good color match with the surrounding skin.

In clinical practice, a large proportion of scars are symptomatic, unsightly, and not ideally oriented within the skin.

Scar revision has the potential to improve patients’ quality of life by creating a scar with better tissue quality that is cosmetically and functionally more acceptable;

central to this is an ideal orientation parallel to RSTLs.

W-plasty is a popular excisional scar revision technique, using short serial triangular incisions on either side of the scar, which are advanced without any rotational element.

The aim of this work is to review the evolution of W-plasty techniques over time with particular reference to the choice of component triangles and propose a site-specific selection of W-plasty techniques in scar management practice.