Free expanded scalp flap for reconstruction of the temporal hair line

A 20-year-old male who sustained a severe avulsion injury of his left scalp and face together with a cranial bone fracture on his right temple six years previously, presented with extensive alopecia over the left temporal scalp. There was also a depression in the right temple with complex scarring caused by previous operations. A simultaneous complete reconstruction of the scalp defect and the depression was obtained by expansion of the left temporoparietal scalp, followed by free-flap transfer of the expanded tissue and augmentation with a free scapular flap. The end result was very satisfactory.