Portland, Ore.; From the Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland.
In repairing cutaneous defects, the facial plastic and reconstructive surgeon is faced with many specialized areas of tissue. Reconstruction of thin eyelid skin and thick, sebaceous nasal skin requires different methods. The unique characteristics of the scalp make it one of the greatest repair challenges in the head and neck region, sometimes requiring multiple different reconstructive techniques for the same defect.
For all areas of the head and neck, great care must be taken to replace tissue defects with like tissue, to match color as well as possible, and to cause minimal donor site morbidity or distortion. Reconstruction of scalp lesions can be significantly more challenging owing to the poor distensibility and limited appropriate donor tissue. With the Mohs technique, only the involved scalp is removed, but malignancies may often extend much further than the margins of the visible lesion, resulting in larger defects. Benign lesions of the scalp are often excised for cosmetic reasons, but may also result in sizable defects.
Cox AJ, Wang TD, Cook TA. Closure of a Scalp Defect. Arch Facial Plast Surg. 1999;1(3):212-215. doi: