Reconstruction of Large Anterior Scalp Defects Using Advancement Flaps

Reconstruction of the scalp may be challenging for reconstructive surgeons because of the special anatomic structure of the scalp and underlying skeleton. Anterior scalp defects especially deserve special care for pleasant hairline re-creation and redirection of hair follicles. Local transposition or rotation flaps are the most common reconstruction methods for moderate or large anterior scalp defects. However, currently available techniques usually require multiple stages for completion of the reconstruction without alopecia. In this study, we report our experience with unilateral or bilateral advancement flaps for moderate or large anterior scalp defect reconstructions. Eight patients who had anterior scalp defect of varying etiology were presented. The defect size ranged between 3 x 5 and 8 x 12 cm. The average size of the defect was 53. 3 cm(2). The defects were located on the frontoparietal area of the scalp in 3 patients and frontal area in 5 patients. Unilateral advancement flap was used in four cases. All the flaps survived except in one patient who had partial flap loss. Based on our experience, we suggest that large scalp defects located especially on the frontal or frontoparietal area can be reconstructed with unilateral or bilateral scalp advancement flaps in one stage without the need for multiple surgeries.