Giant Vascular Malformation of the Face and Scalp: Resection and Innovative Reconstruction

Vascular malformations are very difficult to treat and usually require a multidisciplinary approach. We report a case of a giant facial and scalp vascular malformation resection and large defect reconstruction with the use of artificial dermis and hair follicle transplantation. In total, 3 surgeries were performed with in-between periods of 6 weeks. Firstly, the giant malformation was resected, and the defect was reconstructed using a dermal matrix and expander implantation. During the second surgery, expander was reintroduced, skin flaps were readvanced and hair follicle transplantation to the dermal matrix zone was performed for enhancing reepithelization and wound contraction by second-intention healing. During the third surgery the tissue expander was removed and skin grafts were placed in small non-transplanted areas. This strategy resulted in complete defect reepithelization without the need of skin grafting and a good aesthetic (with hair growth) and functional results were obtained, however, further studies are necessary.