Background. There are fundamental concepts we use in managing surgical defects. Whether planning a primary closure or a local flap, we frequently modify the basic design to maximize aesthetic outcomes, taking into consideration a number of factors including the location of the defect and tissue availability.

Objective. We describe the stellate modified purse-string closure, a novel flap modification.

Method. Report of an illustrated case.

Result. A patient with vertex scalp defect was reconstructed using the stellate purse-string flap.

Conclusion. Certain modifications of commonly used reconstructive techniques can be utilized in specific situations to enhance cosmesis. Advantages of this modification are discussed.