Forehead Rotation

The Scar Solution Natural Scar Removal

Scar Solution Book By Sean Lowry

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A wedge-shaped lateral forehead defect can be closed by making a long incision behind the frontal hairline, widely mobilizing the forehead skin, and rotating the skin into the defect. A dog ear is excised at the pivot point in the central forehead, and the wound is closed (Fig. 4.6b).

Similarly, wedge-shaped defects in the lateral forehead can be covered by a modification of the Esser cheek rotation flap (Fig. 4.7). Burow's triangles are excised below the earlobe and on the neck to close the secondary defect. In the area of the zygomatic arch, the flap should be carefully dissected on the subcutaneous plane to avoid damaging the temporal branch of the facial nerve, which is very superficial in that area.

Other options for covering lateral forehead defects are described in the section on reconstructing cheek defects (see Figs. 8.10, 8.16, 8.19, 8.22, and 8.24).

Fig. 4.6 Lateral forehead defect closed with a rotation flap.

a The flap incision is placed approximately 3-4 cm behind the hairline. b The primary defect is closed. A Burow's triangle is excised at the pivot point (this may be postponed due to risk of flap necrosis).

Fig. 4.6 Lateral forehead defect closed with a rotation flap.

a The flap incision is placed approximately 3-4 cm behind the hairline. b The primary defect is closed. A Burow's triangle is excised at the pivot point (this may be postponed due to risk of flap necrosis).

Fig. 4.7 Lateral forehead defect closed with an Esser cheek rotation flap.

a Cheek rotation with Burow's triangles. b Closure of all defects. Z-plasty (red line) can be added to disperse the scar.

Fig. 4.7 Lateral forehead defect closed with an Esser cheek rotation flap.

a Cheek rotation with Burow's triangles. b Closure of all defects. Z-plasty (red line) can be added to disperse the scar.

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