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Coronal approach

Closure

Closure

Closure of the calvarial bone graft donor site precedes the facial soft-tissue resuspension and galea and scalp closure at the end of the skeletal reconstruction.
The donor site is covered with a hemostatic material if required.
If available, the pericranium is sutured over the donor site.

Resuspension of the facial envelope
To prevent ptotic soft-tissue deformities resulting from degloving, several resuspension measures are recommended to restore the facial ligaments and septae prior to skin closure. The resuspension resembles a subperiosteal face lift procedure and is done in the following order (according to what is individually applicable):

  • Lateral canthopexy (A)
  • Refixation of the temporal muscle (B)
  • Refixation of the superficial layer of the temporalis fascia (C)