title: The paramedian scalp reduction with posterior Z-plasty. A technique to minimize the "slot" defect.
abstract: BACKGROUND
  One consistent and undesired sequela resulting from scalp reductions has been the "slot" or "trough" defect, referring to the scar following the final reduction. Attempts to correct this have not been entirely satisfactory.
  
  
  OBJECTIVE
  To present an approach to minimize the "slot" defect that consists of staged modified paramedian scalp reductions combined with a large posterior Z-plasty during the final reduction.
  
  
  METHODS
  A paramedian crescent-shaped ellipse was marked onto the patient's scalp parallel and adjacent to the existing fringe hair. Subsequent reductions were performed in a similar manner approximately 2 months apart. The final reduction consisted of mobilization and transposition of the large flaps used in the posterior Z-plasty.
  
  
  RESULTS
  Patients who underwent the staged modified paramedian reductions combined with a posterior Z-plasty had significant minimization and adequate camouflage of the undesirable "slot."
  
  
  CONCLUSIONS
  Combining a large posterior Z-plasty with a paramedian reduction minimizes the slot defect.
authors.affiliation: Department of Dermatology, Otorhinolaryngology, and Surgery (Division of Plastic Surgery), University of Michigan Medical Center, Ann Arbor 48109.
authors.forename: B R
authors.initials: BR
authors.lastname: Nelson
authors.forename: D B
authors.initials: DB
authors.lastname: Stough
authors.forename: M
authors.initials: M
authors.lastname: Gillard
authors.forename: D B
authors.initials: DB
authors.lastname: Stough
authors.forename: T M
authors.initials: TM
authors.lastname: Johnson
mesh_terms: D000505:Alopecia / Q000601:surgery*; D006197:Hair / Q000637:transplantation*; D006801:Humans; D008722:Methods; D012535:Scalp / Q000601:surgery*