14 cutaneous expansion package sets made by SEBBIN Laboratory (France) were used. Each set involved an expansion package that varying in size, shape and volume. Largest package is 400cc and smallest one is 100cc. These packages were applied to 8 patients. Among these, 2 patients applied 1 package and 6 patients applied 2 packages. The procedure was failed in two cases. 12% cases were covered by more than 90% of damaged surface, the quality of expanding flaps was ensured in both terms of hair density and direction. However, the scar quality of flaps is not good.
Therapeutics ; surgery ; hair ; Scalp

Trichilemmal carcinoma is a cutaneous adnexal tumor originating from the outer root sheath of hair follicle, and it was first described by Headington in 1976. Clinically, it usually occurs as an asymptomatic solitary papule, nodule or mass on the face or scalp. This neoplasm is a malignant counterpart of trichilemmoma, and it has been reported in the literature as trichilemmal carcinoma, tricholemmal carcinoma, malignant trichilemmoma, and tricholemmocarcinoma. Although histologically, trichilemmal carcinoma frequently has maliganant features, it has a relatively benign clinical behavior. We think Mohs micrographic surgery is a useful treatment modality in trichilemmal carcinoma because the final skin defect is smaller than a wide excision. We report a case of primary trichilemmal carcinoma which had developed on the face, treated with Mohs micrographic surgery.
Hair Follicle ; Mohs Surgery ; Scalp ; Skin

Equipment Design ; Scalp ; surgery ; Surgical Instruments

Sebaceoma, also known as sebaceous epithelioma, is a rare, benign, adnexal tumor with sebaceous differentiation. It usually appears as a yellowish papule, nodule, or plaque on the scalp and face, on which there are abundant sebaceous glands. Histologically, it is a well-circumscribed lesion composed of undifferentiated basaloid cells and mature sebaceous cells in relatively preserved lobulated architectures. A 31-year-old woman presented with a 1.3-cm ×1.1-cm nodule on the right earlobe. Mohs micrographic surgery was performed to completely remove it. Histopathological examination revealed that mature sebaceous cells with scalloped nuclei and focal cystic change were present in the lobule.
Adult ; Carcinoma ; Female ; Humans ; Mohs Surgery ; Pectinidae ; Scalp ; Sebaceous Glands

Adult ; Female ; Humans ; Replantation ; methods ; Scalp ; injuries ; surgery

Forehead deep wrinkles make man's face ugly. Especially, in case that a young people has short forehead, one or two forehead deep wrinkles is likely go give a aggressive impression to people. Traditional forehead lift basically not only perfrom the selective excision of frontalis muscle which cause forehead wrinkles, but extend the width of forehead by practical lift through scalp excision. Recently, various filling materials such as collagen have been developing, and laser resurfacing and endoscopic plastic surgery has gradually been generalized, so the frequency of the traditional forehead lift which needs the extensive operation through coronal incision is gradually diminished. But collagen injection is repeatedly taken every regular times and it has a weak point that the width of forehead cannot be regulated. Laser resurfacing can't solve the problem of deep wrinkles. The purpose of endoscopic brow lift which has been generalized currently is mainly brow lift, and so this method is not good for deep wrinkles because it can't modualte frontalis muscle which cause forehead transverse wrinkles. Recently it has been reported that Alloderm composed of dermal collagen from cadavar skin is universally used in covering as well as filling up soft tissue defect and its usability is also successful. Authors recently correct three young persons who have forehead deep wrinkles by combination of endoscopic forehead lift and subcutaneous Alloderm implantation under the wrinkles for 2 years. At first, we extended the width of forehead and smoothed the depth of wrinkles by endoscopic brow lift. After having endoscopic operation, we inserted Alloderm in subcutaneous pocket and performed suspension suture outside. The average increase of forehead width is 5 mm and all patients had corrected transverse wrinkles remarkably. During the 9 months, wrinkles didn't recur and implanted Alloderm also didn't absorbed. As a better method, authors reported that combining endoscopic brow lift with Alloderm implantation for the correction of short forehead and deep wrinkles could be used in place of traditional forehead lift.
Collagen ; Forehead* ; Humans ; Scalp ; Skin ; Surgery, Plastic ; Sutures

OBJECTIVETo improve the recognition and treatment of Chinese cutis verticis gyrata.

METHODSBased on the review of the etiopathology, clinical features, diagnosis, classification and treatment of the disease in the literatures, six patients with the cutis verticis gyrata were treated with the skin graft or the expanded scalp flap.

RESULTSThe operative effects were satisfactory during 6 months to 5 years of the follow-ups. No recurrence was found in all cases. Two patients treated with skin graft had lead to baldness, four patients treated with the expanded scalp flap had been good appearance.

CONCLUSIONSThe method of the expanded scalp flap is good and effective treatment for the cutis verticis gyrate.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Scalp ; abnormalities ; Scalp Dermatoses ; pathology ; surgery ; Tissue Expansion ; methods ; Young Adult

OBJECTIVETo evaluate a "silicone suture" technique for enhancing the effect of scalp reduction.

METHODSUnder the local anesthesia, when an incision was made in the midline of the lesion, the dissection was carried out underlying the sub-galea on both sides of the lesion, as far as the width of the lesion. A 3 mm silicone suture in diameter was placed in the galea beyond the lesion. After the first suture bite was anchored in the tissue at one end, the suture device was continued across the midline in such a way as a running, buried, horizontal mattress suture and it was brought out to the skin surface through the deep tissue at the another end of the lesion with a locker. The extra-tissue of the lesion was then excised and the wound was directly closed in layers. After one week of the operation, the silicone suture was gradually tightened in 2-3 times a week for about 3-5 weeks, until both sides of the lesion were approximately closed. The device was there after removed and the wound was directly closed in layers after the scar was excised.

RESULTSBetween October of 1999 and March of 2006, 12 scarring-scalp patients, 7 males and 5 females, were treated by using the silicone suture device without complications. The excised defects were 5-10.5 cm in width. The stretching period was 26.4 days in mean. With the following-ups over 3 months, no hypertrophic scar and widening scar cases appeared.

CONCLUSIONSThe silicone suture as an alternative device for tissue extension could be a safe, simple, effective and economical device. It could significantly enhance the efficiency of scalp reduction.

Adolescent ; Adult ; Alopecia ; etiology ; surgery ; Cicatrix ; complications ; surgery ; Female ; Humans ; Male ; Scalp ; surgery ; Silicones ; Sutures ; Young Adult

Eyelids ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Maxillofacial Injuries ; surgery ; Orbit ; surgery ; Scalp ; surgery ; Skull Fractures ; surgery ; Surgical Procedures, Operative ; methods

OBJECTIVETo investigate the therapeutic effect of scalp flaps pedicled with superficial temporal vessel and hair removal for reconstruction of facial skin defects.

METHODSFrom Jan. 2010 to Dec. 2011, 6 cases with large facial skin defects were treated with scalp flaps pedicled with superficial temporal vessel and hair removal. At the first stage, the skin expanders were implanted subcutaneously at the homolateral side according to the defect size. After the expansion was finished, the expanded flaps pedicled with superficial temporal vessel were used to reconstruct the facial skin defects at the second stage. 2 weeks after operation, hair removal was performed to remove the hair on flaps. 4-6 treatments were needed.

RESULTSSeven flaps in 6 cases were survived completely. The wounds at donor sites were closed directly. The effect of hair removal was reliable. The patients were followed up for 6 months to 1 year. The flap color, texture and thickness had a good match with surrounding skin tissue.

CONCLUSIONSIt is a good option to reconstruct facial skin defects with scalp flaps pedicled with superficial temporal vessel and hair removal.

Adolescent ; Face ; surgery ; Hair Removal ; Humans ; Reconstructive Surgical Procedures ; Scalp ; transplantation ; Surgical Flaps ; blood supply ; transplantation