Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, 127 Changle West Road, Xi'an 710032, People's Republic of China.
Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, 127 Changle West Road, Xi'an 710032, People's Republic of China.
J Plast Reconstr Aesthet Surg. 2022 Sep;75(9):3365-3372. doi: 10.1016/j.bjps.2022.04.063. Epub 2022 Apr 29.
Congenital and acquired facial lesions around the hairline can bring huge physical and psychological trauma to patients. At present, reconstruction of this area remains a challenge. In this study, we present an alternative technique to reconstruct the aesthetic units using an expanded scalp flap combined with laser hair removal.
We retrospectively reviewed 25 cases of facial lesions around the hairline reconstructed with this surgical technique between May 2014 and May 2020. Expander was implanted under the scalp as designed before the operation. After the expander was fully expanded, the lesion was removed and the scalp flap was transferred. Laser hair removal was performed on the transplanted skin flap 2 weeks after flap transfer.
There were ten cases of postburn scar, nine cases of congenital nevus, four cases of traumatic scar, one case of haemangioma, and one case of nevus sebaceous. The median times of laser treatment was 3 (range, 1-8). The median follow-up time was 11 months, ranging from 1 to 27 months. The colour and texture of expanded flaps were similar to adjacent tissue in all cases. The direction of reserved hair in transferred flaps was consistent with the direction of hair in the recipient area or contralateral hair. There were no complications, such as infection, blistering, discolouration, and ulceration. All patients were satisfied with the appearance of the reconstructed hairline and the surgical outcomes.
The expanded scalp flap combined with laser hair removal is a feasible and effective technique to reconstruct both sides of the hairline simultaneously from a single donor site with a good colour match and a similar texture and thickness.
发际线周围的先天性和获得性面部病变会给患者带来巨大的身心创伤。目前，该区域的重建仍然是一个挑战。在本研究中，我们提出了一种替代技术，即使用扩张头皮皮瓣结合激光脱毛来重建美学单位。
我们回顾性分析了 2014 年 5 月至 2020 年 5 月期间采用该手术技术重建发际线周围面部病变的 25 例患者。手术前根据设计在头皮下植入扩张器。扩张器完全扩张后，切除病变组织并转移头皮瓣。皮瓣转移后 2 周，对移植皮瓣进行激光脱毛。
患者中，10 例为烧伤后瘢痕，9 例为先天性色素痣，4 例为外伤性瘢痕，1 例为血管瘤，1 例为皮脂腺痣。激光治疗次数中位数为 3 次（范围，1-8 次）。中位随访时间为 11 个月（范围，1-27 个月）。所有病例扩张皮瓣的颜色和质地均与邻近组织相似。转移皮瓣中保留的毛发方向与受区或对侧毛发的方向一致。无感染、水疱、变色和溃疡等并发症。所有患者对重建后的发际线外观和手术效果均满意。
扩张头皮皮瓣联合激光脱毛是一种可行且有效的技术，可从单个供体部位同时重建双侧发际线，色泽匹配良好，质地和厚度相似。
