The Burow's triangle scalp reduction. A new and improved technique for paramedian scalp reduction.

Abstract

The paramedian incision for scalp reduction has many advantages over the median (midline-sagittal) incision. This report describes a method by which the paramedian incision may be modified to provide even more advantages. In 20 patients with male pattern alopecia, an anterior and posterior paramedian incision was performed along contralateral borders of the bald scalp. The two incisions were joined in the central scalp by a trans-coronal incision. The tissue movement that followed was similar to that of a Burow's triangle advancement flap. The new configuration provided maximal visual access with improved tissue mobilization and ease of handling. Because the tension-bearing vector was directed parallel to the transcoronal incision, there was little tendency for the scar to widen. Because posterior "slots" or "troughs" were not created, additional corrective procedures were not necessary. The Burow's triangle scalp reduction design is cosmetically and mechanically more advantageous than traditional median and unilateral paramedian designs of equivalent length.