Scalp reconstruction restores the appearance of the scalp after traumatic injuries, removal of skin cancers, or hair loss. Unknown to many, scalp skin is very different from the skin of the rest of the face. The skin is hair bearing, thicker and significantly less elastic.
During a consultation visit for scalp reconstruction, the size and location of the defect in addition to the quality and elasticity of your scalp skin will be assessed.
Treatment is variable depending on the previously mentioned characteristics that will be identified during the exam. In addition, other general information such as age and general health will be discussed in determining a safe and effective treatment.
Small and medium sized defects of the scalp may be repaired with mobilized adjacent scalp skin.
Large defects of scalp skin cannot be repaired with transfer of adjacent scalp due to inflexibility of skin. In these situations, the use of tissue expanders may be an option.
Following a surgical procedure to place the tissue expander, patients come to the office 1-2 times weekly to undergo expander injections where saline is injected into the expander so that it may increase in sizez. How many weeks these visits take place will be determined by the size of the defect and the size of the expander although 4 to 8 weeks of expansion is quite common.
When max infiltration has been achieved, an additional 4-6 weeks is required to allow the soft tissue time to adapt to the tension being placed on it and relax into it's new, larger size.
The final step is an additional surgery to remove the expanders and spread the newly enlarged scalp over the defect.
If there is bone exposed and a large defect is present, a microvascular free flap may be required to protect the bone.
The primary goal of any scalp procedure is simply wound closure and bone coverage, although aesthetic appearance is certainly taken into consideration.
Frequently, secondary surgeries may be required to revise and contour flaps to a more natural appearance.
Wigs may also be required if there is a large area of hair loss related to the initial wound.
Bony Reconstruction of the Skull
Although less common, occasionally the bone itself is removed as a result of a trauma, brain injury, or bone cancer.