Hair Loss

Plastic Surgery Techniques For Hair Loss

Plastic surgery can help to lessen the visible effects of baldness. Techniques include:

• Hair transplantation
• Scalp flap transfer
• Skin expansion
• Serial excision

Hair Transplantation

This is the traditional method of resurfacing bald areas of scalp with hair. Plugs of bald scalp are removed and then filled with plugs of scalp containing several hair roots taken from hair-bearing areas. These grafts hear into their new locations, and the hair follicles eventually grow.

The number of grafts required and the length of a treatment session will vary, depending on the degree of baldness. Several operations may be required, and the procedure can be expensive. The technique does leave many small scars on the donor sites, but these are not usually apparent.

Scalp Flap Transfer

This technique is based on the fact that the sides of the scalp (above the ears) and the back of the scalp usually remain hair-bearing. A long thin “flap” of hair-bearing scalp is removed and replaced across a bald patch to create a dense band of normal hair growth. Parts of the bald scalp may be removed as part of the procedure. The donor site is closed by stretching the adjacent scalp.

This technique can replace hair across a large area of bald scalp. The thick hair growth looks normal. The very narrow scars are easily hidden among the hair.

Skin Expansion

In this technique, one or more inflatable bags are inserted in pockets under areas of hair-bearing scalp adjacent to the bald patch. These bags, or expanders, are connected to valves that are also implanted under the skin. After the scalp has healed following the surgery, saline is injected into the valves, causing the expanders to gradually enlarge and stretch the overlying hairy scalp.

After a number of injections, over a period of some weeks or months, the expanders are so large that they have stretched out the hairy scalp to a greatly increased area. At a second operation, the bald scalp can be removed and the expanded hair scalp can be stretched to take its place.

This technique can produce excellent results, but during the interim period, while the expanders are getting bigger, the appearance can be bizarre. In addition, any procedure involving implanted foreign material may be complicated by infection.

Serial Excision

In this technique, as much of the bald area as possible is surgically removed in the first operation. The adjacent hair-bearing areas of scalp are pulled in close to the bald area, accepting the fact that some bald scalp will remain. This process is then repeated one or more times at a later date, so that the bald area is eventually removed.