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Double-Opposing Unilobar Rotation Flaps in the Reconstruction of Moderate-to-Large Defects of the Scalp

Moulton-Barrett, Rex FACS*; Vanderschelden, Benjamin BSc*

doi: 10.1097/SCS.0000000000002029
Brief Clinical Studies

Closure of medium-to-large-size defects of the scalp are often associated with unacceptable aesthetic results, wound break down, alopecia, and excessive scarring. The authors present 2 cases of double-opposing unilobar rotation flaps for the reconstruction of large, that is, at least 7 cm diameter, full thickness defects of the scalp. Unlike previously described double flap closures of scalp defects, the double-opposing unilobar rotation flap design are true rotation flaps, which require a Burow triangle excisions and which have a versatility in both width and length of design to accommodate closure of large defects of the scalp. Some of the advantages of this technique are the retention of hair-bearing skin without distortion of the follicle position, an aesthetically pleasing scar, minimal tension at the wound closure site, and the versatility as well as simplicity of the technique.

*University of California, Berkeley, CA.

Address correspondence and reprint requests to Rex Moulton-Barrett. E-mail:

Received 7 January, 2015

Accepted 28 June, 2015

The authors report no conflicts of interest.

© 2015 by Mutaz B. Habal, MD.