Category: scalp reconstruction

Scalp Roll Excision: Preoperative Marking Guidelines and Surgical Technique

Scalp roll excision is designed to remove a redundant fold (“roll”) of skin along the posterior scalp or upper neck, most commonly in the occipital region. These folds may present as single, double, or—less commonly—triple rolls. Successful elimination of the rolls and restoration of a smooth posterior head contour depends primarily on accurate preoperative markings. Read More…

Double Occipital Scalp Roll Excision Case Study

Introduction Scalp roll excision is a minor surgical procedure used to remove a redundant fold or “roll” of skin at the back of the scalp or upper neck—most commonly in the occipital/posterior neck area. What it treats Prominent horizontal scalp or neck rolls Skin redundancy after weight loss Excess tissue following prior neck or scalp Read More…

Plastic Surgery Case Study – Reduction of the Male Single Occipital Scalp Roll

Background: The scalp is pierced as a homogenous layer of soft tissue covering the skull whose most dominant feature is the hair it may or may not contain. While the scalp does have five distinct layers throughout its large surface area of coverage the thicknesses of it varies. The thickest part of the scalp is Read More…

Plastic Surgery Case Study – Excision of Double Scalp Rolls after Massive Weight Loss

Background: Significant or what has been called massive weight loss is any amount over 75lbs. Such amounts of weight loss are known to result in the creation of loose skin due to expansion which almost never contracts back to its original amount and tightness. These post weight loss skin effects vary across the body with Read More…

Plastic Surgery Case Study – Custom Back of the Head Skull Implant with Scalp Roll Excision

Background: The back of the head is unique in many ways but is the only skull surface that can have bone and scalp aesthetic deformities. The back of the head can have bony protrusions such as occipital knobs and buns as well as a wide variety of bony flattening and asymmetry shapes. Excess scalp can Read More…

Plastic Surgery Case Study – Secondary Occipital Scalp Roll Excision with Central Bony Ridge Reduction

Background: At the interface of the bottom end of the skull on the back of the head (inferior edge of occipital bone) is the upper neck. This is where the thick neck muscles and fascia attach to the bone. Because of this location the skull bone and neck soft tissues are thickest at this interface. Read More…

Plastic Surgery Case Study – The Trearment of Scalp Cutis Verticis Gyrata (CVG) with Subnormal Release and Fat Grafting

Background: While there are a variety of pathologic conditions that can affect the scalp none is more unusual that cutis verticis gyrata. (C VG) While most people have seen someone so affected few realize that it is an actual pathologic problem. Appearing as wrinkles on the head is why is called gyrata being similar to Read More…

Plastic Surgery Case Study – Excision of Redundant Scalp Rolls Through An Ear Tuck Technique

Background: The scalp is essentially soft tissues stretch over a ‘beachball’. (skull) Because of its stretched out shape it is typically fairly tight. While everyone has some scalp laxity it is not particularly flexible or can be pushed around much. There are certain scalp circumstances, however, where greater scalp looseness occurs. One such circumstance is Read More…

Plastic Surgery Case Study – Excision of Scalp Mass With Vertical Scalp Tuck

Background: The thick hair bearing scalp can develop a variety of benign soft tissue masses/tumors. Lipomas, dermoid cysts and pilomatrixomas are the most common and develop from natural structures that exists in the scalp. (fat, sweat/oil glands and hair follicles) Most such masses are readily identifiable when they are seen by exposing and removing them Read More…

Plastic Surgery Case Study – Scalp Reconstruction in Parry-Romberg’s Disease

Background: Parry-Romberg syndrome is a rare but well known type of facial atrophy. It presents well after birth in children, teens or young adults with the onset of progressive atrophy of facial tissues. While it theoretically can affect any part of the face, I have seen a disproportion of cases that involve the upper third Read More…