Islanded Superficial Temporal Artery Fasciocutaneous Flap in Temporal Hairline Reconstruction Following Skin Cancer: A Novel Approach

Summary:. Skin cancer defects spanning the temporal hairline present unique challenges. The junction between hair-bearing and non–hair-bearing skin is not a straight line, making it difficult to recruit hair-bearing scalp tissue to precisely fit its geometry. An aesthetically pleasing reconstruction...

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Main Authors: Beatrice L. Lucchesi, BS, John M. Felder, MD
Format: Article
Language:English
Published: Wolters Kluwer 2025-07-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006977
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author Beatrice L. Lucchesi, BS
John M. Felder, MD
author_facet Beatrice L. Lucchesi, BS
John M. Felder, MD
author_sort Beatrice L. Lucchesi, BS
collection DOAJ
description Summary:. Skin cancer defects spanning the temporal hairline present unique challenges. The junction between hair-bearing and non–hair-bearing skin is not a straight line, making it difficult to recruit hair-bearing scalp tissue to precisely fit its geometry. An aesthetically pleasing reconstruction should place scars in natural positions along the hairline, minimize tension during closure, preserve the direction and location of hair growth, and replace like tissue with like. The islanded superficial temporal artery fasciocutaneous flap (ISTAFF) mobilized in a V-Y fashion includes the galea and superficial temporal fascia and is supplied by the superficial temporal artery and vein pedicle. It represents a valid but seldom-described alternative to commonly used random pattern flaps, large rotational flaps, and skin grafting with tissue expansion, which may fail to address the different qualities of skin and scalp subunits intersecting at the hairline. In this small 3-case series, we demonstrate that the ISTAFF mobilized in a V-Y fashion is a simple yet effective method for reconstructing smaller defects of the temporal hairline. We also present a novel combination of the ISTAFF with other local flaps, namely a rectangular advancement flap and a rhomboid flap, to achieve tension-free and aesthetically pleasing reconstruction of large defects in this area, while respecting hair growth patterns and the natural course of the hairline.
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spelling doaj-art-cfb205622a7f4139a627b501723ba2be2025-08-20T03:32:28ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-07-01137e697710.1097/GOX.0000000000006977202507000-00040Islanded Superficial Temporal Artery Fasciocutaneous Flap in Temporal Hairline Reconstruction Following Skin Cancer: A Novel ApproachBeatrice L. Lucchesi, BS0John M. Felder, MD1From the * Michigan State University College of Human Medicine, Grand Rapids, MI† Division of Plastic and Reconstructive Surgery, Corewell Health East William Beaumont University Hospital, Oakland University William Beaumont School of Medicine, Royal Oak, MI.Summary:. Skin cancer defects spanning the temporal hairline present unique challenges. The junction between hair-bearing and non–hair-bearing skin is not a straight line, making it difficult to recruit hair-bearing scalp tissue to precisely fit its geometry. An aesthetically pleasing reconstruction should place scars in natural positions along the hairline, minimize tension during closure, preserve the direction and location of hair growth, and replace like tissue with like. The islanded superficial temporal artery fasciocutaneous flap (ISTAFF) mobilized in a V-Y fashion includes the galea and superficial temporal fascia and is supplied by the superficial temporal artery and vein pedicle. It represents a valid but seldom-described alternative to commonly used random pattern flaps, large rotational flaps, and skin grafting with tissue expansion, which may fail to address the different qualities of skin and scalp subunits intersecting at the hairline. In this small 3-case series, we demonstrate that the ISTAFF mobilized in a V-Y fashion is a simple yet effective method for reconstructing smaller defects of the temporal hairline. We also present a novel combination of the ISTAFF with other local flaps, namely a rectangular advancement flap and a rhomboid flap, to achieve tension-free and aesthetically pleasing reconstruction of large defects in this area, while respecting hair growth patterns and the natural course of the hairline.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006977
spellingShingle Beatrice L. Lucchesi, BS
John M. Felder, MD
Islanded Superficial Temporal Artery Fasciocutaneous Flap in Temporal Hairline Reconstruction Following Skin Cancer: A Novel Approach
Plastic and Reconstructive Surgery, Global Open
title Islanded Superficial Temporal Artery Fasciocutaneous Flap in Temporal Hairline Reconstruction Following Skin Cancer: A Novel Approach
title_full Islanded Superficial Temporal Artery Fasciocutaneous Flap in Temporal Hairline Reconstruction Following Skin Cancer: A Novel Approach
title_fullStr Islanded Superficial Temporal Artery Fasciocutaneous Flap in Temporal Hairline Reconstruction Following Skin Cancer: A Novel Approach
title_full_unstemmed Islanded Superficial Temporal Artery Fasciocutaneous Flap in Temporal Hairline Reconstruction Following Skin Cancer: A Novel Approach
title_short Islanded Superficial Temporal Artery Fasciocutaneous Flap in Temporal Hairline Reconstruction Following Skin Cancer: A Novel Approach
title_sort islanded superficial temporal artery fasciocutaneous flap in temporal hairline reconstruction following skin cancer a novel approach
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006977
work_keys_str_mv AT beatricellucchesibs islandedsuperficialtemporalarteryfasciocutaneousflapintemporalhairlinereconstructionfollowingskincanceranovelapproach
AT johnmfeldermd islandedsuperficialtemporalarteryfasciocutaneousflapintemporalhairlinereconstructionfollowingskincanceranovelapproach