The Paramedian Scalp Reduction With Posterior Z-Plasty

November 1992 in “ The Journal of Dermatologic Surgery and Oncology ”

Bruce R. Nelson, Dowling B. Stough, Montgomery Gillard, Dowling B. Stough, Timothy M. Johnson

scalp reduction posterior Z-plasty paramedian scalp reduction slot defect scalp flaps

TLDR The method effectively reduces and hides scalp defects after surgery.

The study presented a technique to minimize the "slot" defect, a common issue following scalp reductions, by using staged modified paramedian scalp reductions combined with a large posterior Z-plasty. The method involved marking a paramedian crescent-shaped ellipse on the patient's scalp and performing reductions approximately 2 months apart. The final reduction included mobilization and transposition of large flaps in the posterior Z-plasty. Results showed that this approach significantly minimized and adequately camouflaged the undesirable "slot" defect, offering a more satisfactory outcome for patients.

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