Forehead Reconstruction Essay

Introduction
The forehead is the superior most unit of the face and it forms the upper 1/3rd of the face by aesthetic measures. The forehead resemblances a trapezium and its boundaries include the anterior hairline superiorly, the glabella and frontonasal groove in the midline inferiorly & the eyebrows and supraorbital ridge form the lateral inferior borders and laterally it is bounded by the arc of the temporal line in the temporal region. The dimensions of the forehead vary from person to person and have variations depending on the gender, age, familial features and race.
Relevant Anatomy
The forehead and the scalp have anatomically the same layers except few changes. As mentioned earlier in the text, the scalp has five layers namely the

Depending upon the amount of tissue loss, one may need to reconstruct or replace the skin alone, or along with the subcutaneous and the underlying affected bone.
Contraindications for Forehead Reconstruction
There are no specific contraindications for forehead reconstruction, but if the patient is medically not fit to undergo surgery one should opt for simpler options like regular dressings and healing by secondary intention.
Pre-surgical assessment and planning
History of previous radiation is very important as radiation makes the tissues less elastic and less flexible compared to the normal non radiated skin.
Photographic records of all patients should be maintained as part of documentation of the defect before surgery in addition to planning for surgery. It also helps in auditing the results in the postoperative period.
The location of the defect should be assessed with regards to the local skin laxity, the natural skin creases and the subunits to plan for cover and provide better aesthetic results. The disfigurement of the hairline and eyebrows should be avoided as far as