CC BY-NC-ND 4.0 · Indian J Plast Surg 2018; 51(01): 084-088
DOI: 10.4103/ijps.IJPS_209_17
Reflections
Association of Plastic Surgeons of India

Scalp expansion: Surgical considerations and possible future directions

Edoardo Raposio
1   Department of Medicine and Surgery, University of Parma, Parma, Italy
2   Department of Surgical Specialties Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
26 July 2019 (online)

ABSTRACT

Introduction: Repairing large scalp defects has always been a difficult task for plastic surgeons. This is because the requirements of such procedures are two-fold: sufficient soft-tissue coverage is required, and to obtain a satisfactory aesthetic outcome, a sufficient number of covering hairs should be ideally provided. Materials and Methods: Based on the author's experience in this repair technique over a 20-year period, this article presents some technical details of scalp expansion, surgical refinements and possible directions for further technical advancement. Results: Data and details on relevant scalp anatomy, expander choice, expander placement, subgaleal undermining, galeotomies and acute scalp expansion are provided. Conclusions: The author hopes that the above-mentioned details may be of some utility in the complex field of scalp expansion.

 
  • REFERENCES

  • 1 Merlino G, Carlucci S. Role of systematic scalp expansion before cranioplasty in patients with craniectomy defects. J Craniomaxillofac Surg 2015; 43: 1416-21
  • 2 Desai SC, Sand JP, Sharon JD, Branham G, Nussenbaum B. Scalp reconstruction: An algorithmic approach and systematic review. JAMA Facial Plast Surg 2015; 17: 56-66
  • 3 Maillet-Declerck M, Calibre C, Herbaux B, Duquennoy-Martinot V. Long-term results in scalp tissue expansion in children. Eur J Pediatr Surg 2012; 22: 269-73
  • 4 Guzey S, Alhan D, Şahin I, Aykan A, Eski M, Nişancı M. et al. Our experiences on the reconstruction of lateral scalp burn alopecia with tissue expanders. Burns 2015; 41: 631-7
  • 5 Raposio E, Caruana G. Scalp surgery: Quantitative analysis of follicular unit growth. Plast Reconstr Surg Glob Open 2015; 3: e539
  • 6 Nordström RE. editor. Scalp. In: Tissue Expansion. Boston (MA): Butterworth-Heinemann; 1996: p. 107-23
  • 7 Nordström RE, Raposio E, Fan J. Geometric planning. In: Nordstrom RE. editor. Tissue Expansion. Boston (MA): Butterworth-Heinemann; 1996: 13-7
  • 8 Raposio E, Nordström RE, Santi PL. Undermining of the scalp: Quantitative effects. Plast Reconstr Surg 1998; 101: 1218-22
  • 9 Raposio E, Nordström RE. Tension and flap advancement in the human scalp. Ann Plast Surg 1997; 39: 20-3
  • 10 Raposio E, Santi P, Nordström RE. Effects of galeotomies on scalp flaps. Ann Plast Surg 1998; 41: 17-21
  • 11 Nordström RE, Greco M, Raposio E. The ‘Nordstrom suture’ to enhance scalp reductions. Plast Reconstr Surg 2001; 107: 577-82
  • 12 Sasaki GH. Intraoperative expansion as an immediate reconstructive technique. Facial Plast Surg 1988; 5: 362-78
  • 13 Raposio E, Cella A, Panarese P, Nordström RE, Santi P. Anchoring galeal flaps for scalp reduction procedures. Plast Reconstr Surg 1998; 102: 2454-8
  • 14 Raposio E, Nordström RE, Santi P. Aesthetic reconstruction of the vertex area of the scalp. Case report. Scand J Plast Reconstr Surg Hand Surg 1998; 32: 339-41
  • 15 Raposio E, Santi PL, Nordström RE. Serial scalp reductions: A biomechanical approach. Dermatol Surg 1999; 25: 210-4
  • 16 Nordström RE, Raposio E. Scalp extension – A quantitative study. Dermatol Surg 1999; 25: 30-3
  • 17 Raposio E, Cella A, Barabino P, Santi P. Ineffectiveness of acute scalp expansion. Plast Reconstr Surg 1999; 103: 1645-9
  • 18 Raposio E, Adami M, Capello C, Ferrando G, Molinari R, Renzi M. et al. Intraoperative expansion of scalp flaps. Quantitative assessment. Minerva Chir 2000; 55: 629-34
  • 19 Raposio E, Cella A, Panarese P, Caregnato P, Gualdi A, Santi PL. et al. Quantitative benefits provided by acute tissue expansion: A biomechanical study in human cadavers. Br J Plast Surg 2000; 53: 220-4