Flap surgery on the scalp has been performed successfully for more than 20 years. This procedure is capable of quickly covering large areas of baldness and is customized for each individual patient. The size of the flap and its placement are largely dependent upon the patient’s goals and needs. One flap can do the work of 350 or more punch grafts.
A section of bald scalp is cut out and a flap of hair-bearing skin is lifted off the surface while still attached at one end. The hair-bearing flap is brought into its new position and sewn into place, while remaining “tethered” to its original blood supply. As you heal, you’ll notice that the scar is camouflaged—or at least obscured—by relocated hair, which grows to the very edge of the incision.
In recent years, plastic surgeons have made significant advances in flap techniques, combining flap surgery and scalp reduction for better coverage of the crown; or with tissue expansion, to provide better frontal coverage and a more natural hairline.
This technique is sometimes referred to as advancement flap surgery because sections of hair-bearing scalp are pulled forward or “advanced” to fill in a bald crown.
Scalp reduction is for coverage of bald areas at the top and back of the head. It’s not beneficial for coverage of the frontal hairline. After the scalp is injected with a local anesthetic, a segment of bald scalp is removed. The pattern of the section of removed scalp varies widely, depending on the patient’s goals. If a large amount of coverage is needed, doctors commonly remove a segment of scalp in an inverted Y-shape. Excisions may also be shaped like a U, a pointed oval or some other figure.
The skin surrounding the cut-out area is loosened and pulled, so that the sections of hair-bearing scalp can be brought together and closed with stitches. It’s likely that you’ll feel a strong tugging at this point, and occasional pain.
Before: Hair transplant candidates should have some noticeable hair loss with healthy hair growth at the back and sides of the head to serve as donor areas.
Step 1: A tube-like instrument punches round grafts from the donor site to be placed in the area where hair replacement is desired.
Step 2: A tube-like instrument punches round grafts from the donor site to be placed in the area where hair replacement is desired.
Step 3: When the skin beneath the hair has stretched enough, it is surgically placed over the bald area.
Step 4: During flap surgery, a section of bald scalp is cut out and a flap of hair-bearing skin is sewn into its place.
Step 5: The patterns used in scalp reduction vary widely, yet all meet the goal of bringing hair and scalp together to cover bald areas.
After: The results of hair transplant surgery can enhance your appearance and self-confidence.