Scalp and Forehead Reconstruction

Abstract

Reconstructing the scalp and forehead is a challenging endeavor frequently undertaken by facial plastic and reconstructive surgeons. There are many anatomical factors to be considered in this area, including multiple neurovascular structure present that should be identified and preserved. Hair morphology and physiology should be considered, and trichophytic techniques should be incorporated into incision planning and closure. The reconstructive ladder must be used when considering options in reconstructing scalps and forehead defects. This article reviews reconstructive options including secondary intention, primary closure, skin grafting, allografts, tissue expanders, and local, regional, and free tissue transfers, among others in the surgical management of forehead and scalp defects. The reconstructive surgeon should be familiar with these techniques and be able to use them when indicated, based on the size, shape, and location of defects.

Soft tissue grafts for dural reconstruction after meningioma surgery

“…These sites mean additional, albeit limited resections for the donor tissue. [33,34]. Viable tissue near the incision site represents another source of autografts, as demonstrated in our study.…”

Management of Large Facial Defects

“…Free tissue transfer is often successfully used for patients with scalp defects and forehead defects. [21][22][23] For the curved surface of the scalp, a latissimus dorsi free flap is commonly performed as muscle only, and then covered with a skin graft, with favorable cosmetic result. A wide variety of free flaps are utilized for soft-tissue reconstruction elsewhere on the face; the anterolateral thigh (ALT) and radial forearm free flaps are good options when there is both a cutaneous and volume defect 24 (►Fig.…”

Excision of Large Scalp Arteriovenous Malformations with Aesthetic Scalp Reconstruction

“…Arteriovenous Malformations (AVMs) are high flow vascular malformations found all over the body. 1 Scalp has the thickest layer of skin in the body (3-8 mm) 2 and scalp arteriovenous malformations (SAVMs) account for 8% of all AVMs. 1 SAVMs mostly originate in the subcutaneous layer of scalp which contain the vessels and nerves and rarely has intracranial extension.…”

“… 1 SAVMs mostly originate in the subcutaneous layer of scalp which contain the vessels and nerves and rarely has intracranial extension. 2 Skin involvement is fairly common especially in large AVMs as long standing cases and recurrent lesions due to inadequate excision. Most of cases are congenital and present in the 2 nd or 3 rd decade.…”