Background: The goal of complication-free scalp surgery remains elusive. Wide unsightly scars, stretch-atrophied hypesthetic, poorly vascularized tissues and distorted hair patterns are still commonly seen and appear to be largely refractory to remedial surgery.
Objective: To establish technical guidelines for scalp surgery most compatible with maximum functional/cosmetic benefit and complication-free results.
Methods: More than 3000 scalp operations, done personally, were reviewed. These covered the entire spectrum of plastic and reconstructive surgery and hair restoration procedures including more than 700 clinical surgical investigative procedures with pericranial flaps, subgaleal and subperiosteal scalp reductions, and deep plane fixation procedures.
Results: Notably improved scalp surgery outcomes resulted from the application of data derived from study of the surgical anatomy of the scalp. Unsightly scars, distorted hair patterns, hypesthetic poorly vascularized tissues, and distorted hair patterns were largely avoided.
Conclusion: An understanding of the surgical anatomy of the scalp is a cornerstone on which complication-free scalp surgery is based.