Unger, Robin et al.: 2023 Hair Transplantation DOI: 10.1055/b-0042-191783
Section VI Repair and Special Considerations

87 Scalp Extension and Triple-Flap Techniques to Treat Extensive Baldness

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Editors: Unger, Robin; Shapiro, Ronald

Authors: Gupta, Aditya K.; McDonald, Adriane; Noreldin, Ahmed Adel; Bauman, Alan J.; Juliano, Alessandra; Abbasi, Ali; Dua, Aman; Christiano, Angela M.; O’Mara, Angela; Yong, Angeline Anning; Tosti, Antonella; Ruston, Antonio; Nusbaum, Aron G.; Poswal, Arvind; Shahmalak, Asim; Alp, Bayramoğlu; Nusbaum, Bernard P.; Farjo, Bessam; Feriduni, Bijan; Wolf, Bradley R.; Puig, Carlos J.; Varona, Christopher M.; Albertini, Conradin von; Ziering, Craig; Pathomvanich, Damkerng; Josephitis, David; Perez-Meza, David; Mangubat, E. Antonio; Ball, Edward A. M.; Poblet, Enrique; Eisenberg, Eric L.; Wang, Etienne C. E.; Rinaldi, Fabio; Jimenez, Francisco; Krenitsky, Gabriel H.; Williams, Greg; Abaci, Hasan Erbil; Radwanski, Henrique N.; Park, Jae Hyun; Hernandez, Irene; Harris, James A.; Vogel, James E.; Devroye, Jean; Irvine, Jeff; Epstein, Jeffrey; Cooley, Jerry E.; Shapiro, Jerry; Wong, Jerry; Kim, Jino; Jackow, Joanna; Cole, John; Dua, Kapil; Washenik, Ken; Williams, Ken; Erdogan, Koray; Sicco, Kristen Lo; Yagyu, Kuniyoshi; Bloch, Leila David; Santos, Leopoldo Duailibe; Avila, Lorena; Pontes, Luciana Takata; Khanna, Manoj; Avram, Marc R.; Pitchon, Marcelo; Crisóstomo, Márcio; Barusco, Marco N.; Sanseverino, Maria Angélica Muricy; Schambach, Marie A.; Unger, Mark; Speranzini, Mauro; Cole, Megan; Mayer, Melvin L.; Beehner, Michael L.; Neff, Mike; Mohmand, Mohammad H.; Ahmad, Muhammad; Rogers, Nicole E.; Large, Nicole; Farjo, Nilofer; Otberg, Nina; Desai, Nirav V.; Mohebi, Parsa; Frechet, Patrick; Mwamba, Patrick; Shapiro, Paul; Rose, Paul T.; Tesauro, Piero; Kinler, Rae Lynne P.; Rabbani, Ramin; Konior, Raymond J.; Kothottil, Renu; Lemos, Ricardo Gomes de; Mejia, Ricardo; Shiell, Richard C.; Finney, Robert; True, Robert H; Dorin, Robert J.; Haber, Robert S.; Unger, Robin; Shapiro, Ronald; Adajar, Ruel A.; Knudsen, Russell G.; Nadimi, Sahar; Lam, Samuel M.; Vasa, Sanjeev; Tovar, Sara Lea Salas; MD, Sara Wasserbauer; Boden, Scott A.; Keene, Sharon A.; Abbasi, Sheida; Kabaker, Sheldon S.; Kobren, Spencer David; Gabel, Steven; Hwang, Sungjoo “Tommy”; Nakatsui, Thomas C.; Carman, Timothy; Lardner, Tina; Elliott, Vance W.; Mysore, Venkataram; Unger, Walter P.; Rassman, William; Doucet, Yanne S.; MD, Young-Ran Lee; Guo, Zongyou

Title: Hair Transplantation

Print ISBN: 9781626236936; Online ISBN: 9781684202737; Book DOI: 10.1055/b000000335

Subjects: Plastic, Reconstructive and Cosmetic Surgery;Dermatology

Thieme Clinical Collections (English Language)



 
Patrick Frechet

Summary

Extensive baldness, Norwood stages VI and VII, affects a great number of patients. The use of grafts alone to treat these patients is inadequate for a full and satisfactory hair coverage. For the past 30 years, the author has experienced satisfaction and safety managing these patients using the scalp extension and triple-flap techniques to treat the two posterior thirds of the bald area and grafts for the frontal zone. This is an efficient approach that requires four procedures and 4 months to provide full coverage for extensive baldness. A scalp extender is key to the success of this approach. The extender works by stretching the hair-bearing tissue at the sides of the scalp so as to facilitate a larger and more predictable midline alopecia reduction. It is well known that complete elimination of alopecia in the posterior aspect of the scalp using midline reductions results in the formation of a “slot.” The triple-flap component of this comprehensive approach has been designed to complete the vertex restoration by eliminating any residual slot deformity with naturally directed hair.

 
  • 2 Frechet P. How to avoid the principal complication of scalp reduction in the management of extensive alopecia.. J Dermatol Surg Oncol 1985; 11 (6) 637-640 PubMed (PMID: 4008735)
  • 3 Unger MG, Unger WP. Management of alopecia of the scalp by a combination of excisions and transplantations.. J Dermatol Surg Oncol 1978; 4 (9) 670-672 PubMed (PMID: 701586)
  • 4 Norwood OT, Shiell R, Morison I. Complications of alopecia reductions.. J Dermatol Surg Oncol 1983; 9: 831-834 (PMID: NOT_FOUND)