BackgroundDefects of the scalp are surgically challenging for several reasons: anatomical convexity limits tissue displacement, resistance to advancement is different at different points on the scalp, and there is also interindividual variation. For many patients, the idea of undergoing an advanced surgery such as a free flap is not preferred. Hence, a simple technique with a favorable outcome is needed. We hereby introduce our new technique: the 1-2-3 scalp advancement rule. ObjectivesThe objective of this study is to discover a novel way to reconstruct scalp defects secondary to trauma or cancer, without having the patient undergo a big procedure. Material and MethodsA total of nine cadaveric heads were used to test the idea of achieving greater advancement and increased scalp mobility to cover a 4×8 cm-sized defect using our proposed 1-2-3 scalp rule. Three steps performed were advancement flap, galeal scoring, and removal of the outer table of the skull. The measurement of advancement was recorded after each step, and the results were analyzed. ResultsThe mobility of the scalp was calculated from the sagittal midline with identical arcs of rotation. With zero tension, we found that the total distance of advancement with a flap had a mean of 9.78 mm, while the advancement for the same flap after galeal scoring had a mean of 20.5 mm, and after removing the outer table, the mean advancement was 30.2 mm. ConclusionTo create a tension-free closure necessary for optimal outcome for scalp defects, our study showed that increased distances were possible using galeal scoring and outer table removal, increasing the distance of advancement by 10.63 mm and 20.42 mm, respectively.

Background: The misconception of plastic surgery as a purely aesthetic specialty is common among medical students, interns, and the general population. Therefore, this questionnaire-based cross-sectional study was aimed at assessing the perception of plastic surgery among medical students and interns in Saudi Arabia and Canada. This study aims to elicit a thorough grasp of the numerous pathologies addressed by plastic surgeons from medical students and interns. Methods: A cross-sectional study was conducted in February 2020, targeting medical students and interns in Saudi Arabia: Imam Abdulrahman Bin Faisal University (IAU), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz University (KAU), and Canada (McGill). Paper and online-based questionnaires were distributed among participants, featuring sixteen medical scenarios requiring participants to select the specialty that best fit each case. Nine of these scenarios were handled mainly by plastic surgeons. Results: All-inclusive, 729 students and interns answered the questionnaire. The fact that just three of the nine plastic surgery scenarios were accurately selected by the participants suggests that most medical students and interns need to understand the range of services that plastic surgeons can provide. Conclusion: This study concluded that there is an overlap between different surgical specialties in the field. Thus training initiatives and increased exposure to plastic surgery subspecialties throughout medical school and educational programs are needed to establish boundaries and dispel misconceptions about this specialty.