A New Alopecia Reduction Design: No Visible Scars, No Slots, No Frechet Flaps

There has been much discussion over a number of years about the efficacy of alopecia reductions in the treatment of male pattern baldness. The majority opinion has been negative, citing too much surgery, too many complications, and too much scarring involved in the procedure. As a result, the alopecia reduction procedure has become less popular with both doctors and patients, and is no longer performed at all in many practices. A new design of alopecia reduction is offered in this paper. It fulfills all of the criteria required of a modern procedure. There is no scarring in the temples and in the crown, there is no slot formation, and there is no need for Frechet Flaps. It is easy to design, easy to perform, and can be used with any intra- and interoperative device.

What's new in hair replacement surgery

The "isolated frontal forelock," "bridge over troubled waters," and lighter density coverage of larger areas are new options for hair transplant patients. Alopecia reductions are playing an increasingly important role in overall planning after a period in which they had at least appeared to be losing popularity. Tumescent anesthesia in the donor or recipient area results in safer, more comfortable, and effective anesthesia. Total excision techniques in the donor area as well as improvements in minigrafting represent important advances that are being utilized by an increasing number of practitioners. Carbon dioxide lasers are likely to play an important role in hair replacement surgery.

Planning for maximum coverage in surgical hair restoration

BACKGROUND

Previous articles in this publication have suggested that an isolated frontal forelock is probably the best objective for a majority of patients undergoing hair transplantation.

OBJECTIVE

This communication disputes the advisability of an isolated frontal forelock for a majority of hair transplant patients.

METHODS

Previous studies and publications indicate a relatively low incidence of extensive male pattern baldness. Newer harvesting techniques require relatively small donor a areas to yield large numbers of grafts. Alopecia reduction can significantly improve the donor/recipient area ratio, and minigrafting can produce very natural looking results with less donor graft utilization. All of the preceding are presented to support the position of the author.

RESULTS

Limiting oneself to an isolated frontal forelock is an overly conservative objective for a sizable majority of patients.

CONCLUSION

The isolated frontal forelock is a wise goal for a minority of patients who should be chosen on the basis of their limited objectives as well as their family history and a careful physical examination at the time of presentation. For most patients, more extensive coverage remains a reasonable option.