A 57-year-old man with a 7-cm defect of the left temple underwent reco
nstruction with a large scalp rotation flap that shifted the donor def
ect to the back of the neck so that it could be closed primarily. This
approach, also used successfully in 7 other patients with similar def
ects, avoided the need for an unsightly skin graft in the donor site w
hile providing tissue with a color and texture that blended well with
the surrounding forehead and facial skin. Primary closure of the donor
site reduces scalp flap morbidity and improves the overall aesthetic
outcome.