Forehead Flap Ballooning for Scar Revision

Abstract

Nowadays, cutaneous expansion is used progressively in reconstructive surgery for treating the variety of problems such as burns alopecia scar revision in children and adults. With the use of tissue expansion technique, the reconstruction of many acquired and congenital defects has been made possible. Tissue expanders are principally based on the mechanical and the biological creep in which mechanical creep is the morphological changes occurring in cellular level in response to applied stress and biological creep is the resultant expansion of skin surface. There is an excellent closure of extensive soft tissue defects without additional scars in donor area with tissue expanders as compared with other methods of plastic surgery the case report highlights the excellent results of tissue expander in an esthetically compromised patient due to hypotrophic scar on the forehead. This is a novel technique as it was performed under local anesthesia without the use of any sedation in a regular clinical setup.

Keywords: Hypotrophic scar revision; reconstruction; tissue expander.

Figure 1

Preoperative hypotrophic scar on forehead

Figure 2

Preoperative computed tomography scan showing normal findings

Figure 3

Tissue expander in situ

Figure 4

Fifth week postexpansion showing ballooning of forehead flap

Figure 5

Second stage surgery, removal of tissue expander

Figure 6

Excision of the hypotrophic scar

Figure 7

Primary closure using 3-0 vicryl, 6-0 prolene and staples, respectively. Negative suction drain placed for 48 h and removed postoperatively

Figure 8

Follow-up post 1 week

Figure 9

Follow-up after 6 months