Scalp reduction-is a surgical hair restoration procedure that (1) surgically removes bald scalp, and (2) stretches hair-bearing scalp upward to replace bald scalp that has been removed. In selected patients scalp reduction is a very effective method of hair restoration when performed. Depending on individual patient characteristics, Dr. English may be perform (1) as the only hair restoration procedure desired by the patient, (2) in combination with hair transplantation to achieve a desired aesthetic effect, or (3) occasionally in combination with the aesthetic surgical procedure called brow lifting to remove frown lines from the forehead and crow's feet from around the eyes.

Good candidates for scalp reduction are patients with excellent donor hair on the sides and back of the scalp that can be stretched upward to cover areas of excised bald scalp. A good supply of donor hair is also needed to provide donor grafts for any supplementary hair transplantation. Scalp reduction may, in selected patients, be carried out by using a scalp extension or scalp expansion device - a technique that stretches hair-bearing scalp skin to provide greater coverage in bald areas.

Is Scalp Reduction Right for You?

Scalp reduction can be a very successful approach to hair restoration. Is it right for you? A number of factors can bear upon that decision:

• Physical condition-the patient should be in good general health and have no medical conditions that would rule out a surgical procedure.
• Degree and pattern of hair loss-the patient and the physician hair restoration specialist should together make the final decision as to whether scalp reduction is a good choice for hair restoration. In general, scalp reduction is likely to be most useful in a patient who has a large area of scalp baldness and an adequate supply of good-quality donor hair on the sides and back of the scalp. Another consideration is the rapidity of scalp progression and the likelihood that scalp will significantly progress in the future. These factors will influence the need to consider future hair transplantation to keep pace with an ever-expanding zone of baldness. The patient who undergoes scalp reduction should be willing and able to have future scalp reduction and/or hair transplantation and/or correction of surgical complications as the need arises.
• Tightness or laxity of scalp skin-scalp skin that has very little laxity (the ability to stretch) may not be a good foundation for scalp reduction. The rationale for scalp reduction is that bald scalp can be surgically removed and hair-bearing scalp skin stretched up to cover the excised area. A substantial degree of scalp skin laxity is required to make the procedure work well.
• The patient's objectives-what do you, the patient, want hair restoration to accomplish? Your objectives, discussed thoroughly with the physician hair restoration specialist, will be a major factor in determining if scalp reduction is a good option for you. For example, scalp reduction may be a good option for a patient who wants to "pull up" all available donor hair to provide dense coverage of the scalp-given that other factors such as scalp laxity are favorable to that decision.

If you are considering some type of hair restoration we encourage you to contact our office and meet with Dr. English. He can assist you in determining if Scalp reduction is the right method for you.

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