 I am Stephen Carmichael. I am here to introduce you to an article called The Tangled Web of Langer's Lines that was published in 2014 in Clinical Anatomy. I have always thought that Langer's Lines had something to do with surgical incisions. When I asked other clinical anatomists what Langer's Lines were, they said something about determining the orientation of elective surgical incisions, but nobody could be specific, so I decided to investigate. It turns out that Langer's Lines are more closely related to where not to make an incision in the skin. They are skin tension lines, but relaxation lines of the skin are more useful for planning incisions that will have a better cosmetic result. A key observation that led to Langer's Lines is that punctures of the skin made with a round instrument, such as an ice pick, result in elliptical wounds. Langer credits Dupatron with first making this observation. Dupatron is better known for describing a contracture of the palmar apneurosis, but he also noted that a patient who attempted suicide by stabbing himself in the chest with a round tool, yet the wounds were elliptical. It was reported in the literature by some that the patient survived this attempt. Others reported that the attempt was successful. We were able to resolve that inconsistency. Karl Langer lived in or near Vienna from 1819 to 1887. He published four scholarly articles on skin tension lines that were not appreciated during his lifetime and often misrepresented for decades afterwards. English-speaking anatomists and surgeons only became aware of Langer's original work in 1978 when Thomas Gibson and his colleagues at the Library of the Royal College of Physicians and Surgeons of Glasgow obtained and translated these articles. Langer's use of classical convoluted scientific German along with a local dialect made them difficult to translate. Also some of the articles were not translated in their entirety because, according to Gibson, it was descriptive anatomy at its most boring. Gibson also states that some descriptions of Langer's lines by others were nonsense. This is a classic case of misinformation including incorrect citations being passed down again and again through the years. What Langer did do was made multiple stab wounds into cadavers with a round tool, cadavers with various ages and various body habitances, and mapped out the patterns made by the resulting ellipses. The maps that he made are what we now call Langer's lines. Langer and others appreciate the relationship between these lines and surgical incisions. Some made correct correlations, some were incorrect. There are other lines of the skin that are associated with Langer's lines and surgical incisions and other lines that are unrelated. I listed 46 of these lines but there are certainly more. Interestingly, there were no published images of Carl Langer. With help from colleagues at the University of Vienna, I was able to obtain this undated photograph of Carl Langer. He has to be given credit for carrying out the most extensive studies of the skin for his day, but Langer's lines or skin tension lines are not directly related to planning surgical incisions. Relaxation lines of the skin are more closely related to planning surgical incisions. The tale of what has been known about Langer's lines has been a tangled web indeed. With this in mind, I paraphrased a well-known couplet by Sir Walter Scott. Oh, what a tangled web we weave when first we plan the skin to cleave.