Depilation Before, During, or After Scalp Flap Expansion for Facial Reconstruction Using a Long-pulse 800-nm Diode Laser

Following facial reconstruction with a scalp flap, unwanted hair is a common esthetic problem. Reports on the safety, effectiveness, and differences in laser hair removal before, during, and after tissue expansion are lacking. The authors aimed to assess the efficacy of 800-nm diode laser hair removal before, during, and after flap expansion. A total of 366 patients who underwent long-pulse 800-nm diode laser hair removal from the scalp flap were included in this study. The patients were divided into 3 groups based on the timing of laser hair removal: nonexpansion, expander, and expanded. Participants received 1 to 8 treatment sessions at intervals of 25 to 30 days. To assess the effectiveness and differences in the treatment of each group, 2 independent observers compared the photographs and measured the reduction in the terminal hair count after treatment. The hair reduction rate was significantly higher with fewer treatment sessions when laser hair removal was performed during tissue expansion compared with after surgery or before surgery. Two cases of blisters were reported in the expanded group, all of which healed after aspiration and dressing changes. No severe adverse events were reported. Hair removal during or after scalp flap expansion is safe and effective when using an 800-nm diode laser. The depilation process during tissue expansion should be extremely accurate and well-designed. Depilation of the scalp before surgery is not recommended because of its low efficiency and long treatment duration.