Sideburn Reconstruction Using a Pre-Expanded Island Scalp Flap Based on the Parietal Branch of Superficial Temporal Vessels

Abstract

Sideburns are crucial for head and face esthetics. Absence of sideburns is associated with physical and psychological consequences. Many methods have been described for sideburn reconstruction; however, characteristics of the ideal method include optimal vascularization, ideal hair density, natural hair growth, and facial symmetry with minimum donor-site morbidity. In this study, the authors describe a novel method of sideburn reconstruction using a pre-expanded island scalp flap based on the parietal branch of the superficial temporal artery. Between February 2012 and December 2020, 9 patients underwent sideburn reconstruction surgery that involved 2 stages. During the first stage, an appropriately sized tissue expander was inserted underneath the scalp. After sufficient inflation of the expander, at the second stage, an island scalp flap based on the parietal branch of the superficial temporal vessels was elevated to reconstruct the sideburns. The mean size of the defects was 8 × 4.4 cm (range, 6 × 3–12 × 5 cm), whereas the average flap dimension was 10.22 × 5.67 cm (range, 8 × 4–13 × 8 cm). All flaps survived completely without any perfusion-related complications. Patients were followed up after surgery, ranging from 4 to 34 months (mean, 15.67 months). All patients and/or their parents were satisfied with the final appearance in terms of hair density, hair growth direction, and facial symmetry. Although a 2-stage procedure, this novel technique allows the reconstruction of a new sideburn with natural growth and orientation of the hair and minimal morbidity for patients.