A 30 month-old boy with a large congenital nevus on the scalp underwent tissue expansion followed by excision of a 12 cm × 16 cm area. The procedure resulted in an excellent cosmetic outcome and normal hair growth with no skull deformities on postoperative CT. This case highlights the effectiveness of tissue expansion in pediatric patients for large congenital nevi, while also addressing the nuanced decisions related to the use of full-thickness skin grafts (FTSG) in this context.
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