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Updated: May 23, 2026
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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Total scalp reconstruction with bilateral anterolateral thigh flaps
Melissa M Kwee1, Warren M Rozen, Jeannette W C Ting
1Department of Plastic and Reconstructive Surgery, Dandenong Hospital, Southern Health, Dandenong, Victoria, Australia.
Microsurgery
|March 23, 2012
Summary
Reconstructing large scalp defects often requires complex free flap surgery. This study details a successful single-stage total scalp reconstruction using two anterolateral thigh (ALT) flaps for a massive defect.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Oncology
Background:
- Large scalp defects present significant reconstructive challenges.
- Free flaps are often necessary but may not always suffice.
- Previous attempts at reconstruction, including grafts and local flaps, had failed.
Observation:
- A unique case of total scalp reconstruction for a 743 cm(2) defect is presented.
- The defect resulted from desmoplastic melanoma resection and radiotherapy, complicated by osteoradionecrosis.
- Two large anterolateral thigh (ALT) flaps were employed in a single-stage procedure.
Findings:
- The reconstruction involved extensive resection of the cranium and soft tissues.
- The defect was resurfaced using a calcium phosphate bone graft substitute, titanium mesh, and two ALT flaps.
- Successful reconstruction was achieved with minor complications, including flap tip necrosis and donor site breakdown.
Implications:
- This case represents the first reported use of bilateral ALT flaps for extensive scalp resurfacing.
- The successful reconstruction of this large scalp defect highlights the viability of bilateral ALT flaps.
- Bilateral ALT flaps offer a promising option for complex and extensive scalp defect reconstruction.