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To review our experience of facial reconstruction with split-thickness skin grafts (STSGs) harvested from the scalp.We included all patients undergoing STSG harvested from the scalp for the reconstruction of extensive forehead or temple defects after cancer resection. We recorded the size of resection before surgery and after healing, and we calculated the resulting contraction rate. Time of healing and occurrence of complication were also recorded.Forty patients were included. Their mean age was 87 years, and the mean size of resection was 26 cm2. The duration of healing at the donor site was shorter than 12 days, and pain levels were low. The rate of contraction at the recipient site was 11% after healing. Good morphologic outcomes were reported by both patients and surgeon.Extensive forehead and temple defects can be covered in this way with a low morbidity; rapid, painless healing; and a high success rate, making this procedure particularly suitable for elderly patients.