 Loose connective tissue between the periosteum and the aponeurosis makes these two rigid structures easily slide over each other and contributes to skin movement.Thus, if vascular and nervous anatomy is respected, the skin, subcutaneous tissue and galea aponeurotica can be lifted off the skull with minimal bleeding, nerve damage, or chance of necrosis.This method was first described by Orticochea in 1967, but has been updated to minimize scarring.