How Can A Skin Grafted Scalp Site Be Removed?

Q: Dr. Eppley, I am looking for a plastic surgeon that can remove a skin graft that took place due to a car accident where I had a scalp flap rotated forwarded to replace forehead tissue and a skin graft put in place behind the rotated flap. This took place when I was very young. The graft is thin as no tissue underneath so tends to get injured easily if bumped and doesn’t heal well as well as disfiguring now with hair loss. The graft is approximately 6 inches long by 2 inches wide with the 6 inches going left to right on my head and the two inches front to back of head. Do you perhaps a procedure such as the Extended Scalp Reduction or other techniques in place now that were not available when the accident happened? Thanks for the response.

A: The question you are asking is whether a scalp skin graft site can be excised and primarily closed….without a flap and creating a tissue deficient somewhere which requires skin graft coverage. (which is what you have already had done many years ago) If you had not had prior surgery a scalp tissue defect of 6 x 2 inches might be able to be excised and primarily closed. But with prior surgery and loss of 1/2 of the scalp’s ability to stretch due to the previous flap, that is much more in question. Using tissue expansion of half of the scalp that has not previously operated on, it is undoubtably possible. That raises the next question of whether it is possible without tissue expansion. To provide a more qualified answer I would need to see pictures of your scalp and the skin graft site.

Dr. Barry Eppley

Indianapolis, Indiana