“…Fair to excellent outcomes have been reported 349,350,362,364,365 and are arguably optimized with the use of cold-steel scalpel blades and, when possible, inclusion of the occipital hairline in the excision, which should be exacted down to muscle fascia. 350,362,364,365 With massive lesions, excellent outcomes have been reported with staged excision and primary closure 365 and may surpass that obtained with healing by secondary intention. 349 Excision with skin grafting offers no real cosmetic benefit.…”