Scalp Reconstruction

Scalp reconstruction is a surgical procedure aimed at restoring the form, function, and aesthetics of the scalp, typically following trauma, injury, surgery, or medical conditions affecting this area. These procedures are typically performed by plastic surgeons or dermatologic surgeons who specialize in the reconstruction of the scalp and hair-bearing areas.

• Evaluation and Consultation: The process begins with a comprehensive evaluation of the patient's medical history and a thorough examination of the affected scalp. The surgeon assesses the extent of the defect, the underlying anatomy, and the patient's functional needs, such as hair growth and sensation. During the consultation, the surgeon discusses treatment options, expected outcomes, and potential risks and complications.
• Preparation: Before the reconstruction surgery, the patient may undergo preoperative tests and assessments to ensure they are in good health for surgery. The surgeon provides instructions on preoperative preparation, including any medications to avoid and dietary restrictions.

Surgical Techniques:

• Primary Closure: Small defects in the scalp may be closed directly with sutures if there is enough remaining healthy tissue. This technique is often used for minor injuries or small excisions.
• Skin Grafts: Skin grafts may be used to cover larger defects in the scalp where there is not enough healthy tissue to close the wound directly. The surgeon harvests skin grafts from another part of the body, such as the thigh or abdomen, and transfers them to the scalp to cover the defect. Skin grafts may be split-thickness (containing only the epidermis and part of the dermis) or full-thickness (containing all layers of the skin), depending on the depth and size of the defect.
• Local Flaps: Local flaps involve moving adjacent skin and tissue to cover the defect in the scalp. The surgeon designs a flap of tissue with its own blood supply and rotates or advances it into the defect area. Local flaps may be used for larger defects or to reconstruct specific areas of the scalp, such as the hairline or crown.
• Tissue Expansion: Tissue expansion involves placing a silicone balloon-like device (tissue expander) under the healthy scalp tissue near the defect. Over several weeks or months, the expander is gradually filled with saline solution to stretch the overlying skin and create new tissue. Once enough tissue expansion has occurred, the expander is removed, and the expanded tissue is used to reconstruct the scalp defect.