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Scalp Reduction Surgery (Scalp Lifting)
Many patients present with a type of balding that involves the crown area or back portion of the head. In many instances, these areas of balding can be reduced by removing segments of the balding scalp and subsequently advancing hair bearing scalp into this area. Most often, this can serve to reduce the number of hair grafts required to fill in the balding area.
Scalp reduction procedures reduce the balding areas by removing segments of the bald scalp and stretching the hair bearing scalp to a higher position. Scalp reductions do not, by themselves, produce the cosmetic result of grafts or flaps, but aid in coverage and styling situations.
When used with hair grafts, scalp reductions decrease the area for hair grafting. This stretching of the scalp can be repeated as soon as the scalp loosens up enough to allow such reduction, usually after three months. A process call scalp extension can also accelerate the reduction. Scalp extension was designed by Dr. Patrick Frechet from Paris, France. Scalp extension allows scalp reduction to be performed with much greater effect and allows previously determined non-candidates to have successful scalp reductions. This typically involves the use of an elastic surgical device, which is placed on the undersurface of the scalp during the first scalp reduction. This is not visible on the outside of the scalps. Over a one month period, the elastic recoil causes a constant gentle upward pull on the hair bearing tissues, thereby further loosening and stretching the scalp. This allows for typically a larger reduction to be performed than if an extender was not utilized.
A significant reduction can be performed if the scalp is loose enough. Usually, a portion of the scalp 2-5 centimeters wide can be removed in one session. Because the scalp is being stretched, this procedure diffusely separates the hair in the fringe areas creating a good cosmetic effect. Scalp reductions leave scars within the involved areas of the scout, which can be camouflaged by hairstyles or by hair grafts in the future. Scalp reductions can be done before hair grafting is started. Alternatively, scalp reductions can be after the hair grafting is completed. In this latter situation, the grafts are inserted in such a pattern that leaves an area of bald scalp to be removed at a later date. In some cases, the limited number of hair grafts can be done simultaneously with scalp reductions.
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