Retroauricular hairline flap transfer to the face.

For facial skin defects including the hair-bearing area of preauricle-sideburn, lateral forehead-temporal hairline, and upper eyelid-eyebrow region, the transfer of a hairline flap that incorporates a skin flap is one option available for creating a natural hairline. An island or free retroauricular hairline flap (retroauricular skin flap including retroauricular hairline) based on the superficial temporal vessels or posterior auricular vessels was used to reconstruct facial skin defects including hair-bearing areas in seven patients. All flaps "took" perfectly, and aesthetically satisfactory results were achieved with minimal donor-site morbidity. However, flap vessels must be selected with great care during the surgical procedure because of the anatomic variation found among patients in the positions of the superficial temporal and posterior auricular vessels.