Synchronous tumors on the scalp are a common condition, and reconstruction methods of their defects should be considered together. The authors believe that the rotation flap combined with the Burow triangle, whose final scar looks like a question mark, can provide excellent results for suitable multiple tumor defects. From September 2022 to June 2023, the question mark reconstruction method was performed on 8 patients. The mean age of the patients was 74.1 years (range, 69-80y). All tumors were removed with sufficient negative margins. Hair-bearing skin was preserved in all patients, with only a narrow and acceptable scarred alopecic area. The question mark reconstruction method can provide excellent results for synchronous scalp defects by minimizing dog-ear deformity and unnecessary tissue excision and providing a "like-with-like" reconstruction.