Cosmetic surgery to overcome baldness

Procedure Summary

Hair restoration surgery dates back to 1822 in Germany, where documentary evidence exists of patients having one area of hair-filled skin from their scalp transferred to another area where hair loss had occurred. For more than a century after that, hair restoration procedures were only used to help victims of burns or other trauma. Hair restoration for purely aesthetic reasons was more typically sought from non-surgical means, primarily ‘miracle cure’ elixirs. The more familiar concept of cosmetic surgery to combat hair loss was developed in Japan in the 1930s. The next great breakthrough came in 1959 when an American, Doctor Norman Orentreich, presented a paper on cosmetic surgery for hair restoration. Many recognise the publication of this paper as heralding the modern era of cosmetic scalp surgery.

Are you a candidate for ‘scalp reduction’ or ‘scalp flap’ surgery?

Plastic surgery to eliminate your bald patch (to a large degree at least) offers an instant remedy for many men. The actual method of scalp surgery varies depending on the type of baldness you have. There are two basic approaches: scalp reduction surgery and scalp flap surgery. Scalp reduction surgery is suited to men with the classic bald patch on the crown of their head and healthy growing hair at the sides and back. During the procedure balding skin is removed and hair-filled skin pulled over the scalp to cover the gap. Scalp flap surgery is more suited to men with baldness or thinning hair at the front of their head. During this procedure a hair-filled piece of the scalp is removed and re-attached to a bald area of the scalp. Your particular suitability for scalp surgery will be discussed during your initial consultation with the plastic surgeon.

As one man explained his situation, “I had the typical baldness of a middle-aged man – the only problem was that I was 24! The bald circle on top of my head was a constant distraction whenever I met new people, especially women. I’m not a vain person, but I don’t like being the odd one out. After discussing it with my doctor and then a cosmetic surgeon, I decided to have scalp reduction surgery.”

Undergoing scalp surgery

Scalp reduction surgery
This form of hair loss cosmetic surgery is performed on the crown or vertex area of the head and usually takes between 1 - 2 hours.  Initially, the scalp is numbed with a local aesthetic. Exploiting the elastic properties of the skin, a portion of the bald scalp area is removed and the hair-filled scalp at the sides pulled together and sutured. The sutures are usually removed in 7 to 10 days. The most common section of bald skin removed to is in a ‘Y’ shape at the crown of the head. By doing this, an area of up to 5cm can be restored.

A simple procedure known as scalp extension can speed up the time between surgeries by accelerating the growth of skin on the scalp. This involves inserting tissue expanders into the scalp. Over a period of a few weeks these expanders are filled with a saline solution, which allows the skin to stretch. The expanders are then removed and the scalp reduction surgery is performed.

A scalp reduction surgery may involve several procedures performed over 3 to 4 month intervals to achieve the desired results. This allows the skin time to regain its elasticity. Factors such as the size of the balding scalp and looseness of the skin will determine how many procedures are needed. With each successive procedure further scalp is removed, along with the scar from the previous surgery.

Scalp flap surgery
In this procedure, a strip of hair-filled scalp is partially detached with a small section of about 5cm at one end left attached to allow continued blood flow into the skin and hair. A piece of bald scalp the same size as the flap is then removed, usually from the front of the head. The flap is rotated (to maintain the correct direction of hair growth) and sutured into place where the bald area was. Typically, this operation is carried out in three separate procedures at least a week apart (to ensure an adequate blood supply before moving the flap).

As with all cosmetic surgery, there is always some degree of risk associated with scalp surgery. You may experience some bleeding, pain and swelling, and there is a low risk of a condition called necrosis, where poor circulation means that new tissue fails to grow beneath the scalp. Scarring will normally be covered by hair, though many patients choose to undergo a small amount of a hair transplant to thoroughly cover the scars. In some cases, people develop a slot deformity (an odd-looking indentation along the scar), while others develop a slot defect, where hair grows in the wrong direction around the scar.

As one patient said following his scalp flap operation, “After my surgery I just played it safe and rested, keeping any pressure off my scalp and avoiding any bending, straining, shampooing etc. – and it worked. My head soon felt like normal and my ‘new’ hair grew perfectly.” Thousands of hair restoration surgical procedures are carried out each year. When performed by a qualified plastic surgeon, and when the patient complies with all pre and post operation advice, the results are typically successful.

Who should carry out scalp surgery?

Only suitably qualified surgeons with experience gained in an establishment registered with the Healthcare Commission (in the UK) should perform this procedure. The cost of the operation varies, though you can expect to pay at least £2,000 for a basic scalp reduction procedure. If scalp surgery is something that you are considering, you can discuss all of the issues mentioned here in greater depth during a consultation with a cosmetic surgeon.

Book your FREE consultation today with:

MYA

Optimax

Have your say!

If you've had experience with this procedure then why not leave a comment below and share your thoughts and advice with our readers.