• Daohong Kan, Xuefeng He, Bing Liu, Chaokun Yang, and Yong Zou.
• Department of Burn and Plastic Surgery, The Second People's Hospital of Yibin (The Yibin Hospital of West China Hospital, Sichuan University), Sichuan, China.
• Medicine (Baltimore). 2023 Aug 18; 102 (33): e34821e34821.

RationaleTitanium mesh is one of the most widely used implant materials applied in cranioplasty; however, it has been reported to encounter the risk of progressive scalp thinning and implant exposure over time. Here we present 2 cases of exposed titanium mesh (TM) and unusual phenomena of full-thickness skin regeneration beneath the mesh.Patient ConcernsTwo patients, 1 with an 8-year and 1 with a 2-year history of implant exposure after cranial TM implantation.DiagnosesThe patients were diagnosed with scalp ulcers and cranial TM exposure.InterventionThe exposed part of the implant was removed, and the full-thickness skin beneath the mesh was directly used as functional soft tissue coverage to repair the scalp defect.OutcomesFull recovery for both patients with cosmetic satisfaction.LessonsThough the exact mechanism of this epithelisation phenomenon beneath the TM remains to be elucidated, it provided a feasible choice for clinicians to reconstruct the scalp's integrity without exerting complicated procedures when dealing with similar cases.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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