There are various techniques currently employed for surgical hair loss restoration and it is not uncommon for more than one to be used at a particular time. The main procedures used today are scalp reduction, tissue expansion, flap surgery and hair transplantation.
Scalp reduction is a procedure in which the surgeon will remove segments of the bald scalp of a patient and then loosen the hair bearing scalp surrounding that area, pulling it over the scalp and joining the skin with sutures. This will therefore reduce the size of the bald ‘patch’. This procedure is obviously more suited for people who have bald areas at the top or back of the head rather than on their forehead or at the front of their hairline. Scalp reduction is sometimes performed to reduce the size of the area which is about to undergo hair transplantation.
Tissue expansion surgery has been of great benefit to patients who needed reconstructive surgery – perhaps because of burns, for example. The idea here is to insert a somewhat balloon-like appliance under an area of the head which still has active hair follicles and is adjacent to an area without hair. As this implement gradually inflates over a period of weeks, the skin will expand, producing new cells and resulting in a ‘bulge’ of new hair-covered skin. This skin can then be stretched to cover the nearby bald area.
Scalp flap surgery entails literally moving a segment of the scalp which is hair-bearing and placing it in a different location where hair is needed. So, a bald section of scalp is removed and replaced by a ‘flap’ of scalp with hair. When the flap is transported to the new, recipient part of the scalp, it will be left attached to its nerve and blood supplies until it has properly grafted in its new position. Flap surgery is often performed in conjunction with scalp reduction and tissue expansion, to give a more natural looking hair line.
The best known and most frequent method of surgical hair loss restoration, however, is hair transplantation, a procedure which uses the patient’s own hair to fill in the balding areas. Initially, plugs of skin, each containing about 20 separate hair follicles, would be taken from areas at the sides or back of the head and then transplanted to bald areas. In recent years, though, strip grafts and micro or minigrafts of just a few hair follicles became more common and now it is possible for surgeons to transplant single hair follicles. Because this can be a very precise operation, it is possible to create a very natural looking hairline. It is also popular because, after the transplant process, the donor follicles still maintain their genetic characteristics and will, therefore, continue to grow.
The surgical transplantation of hair is a relatively straightforward and almost painfree outpatient process.
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