Scalp Reduction

Scalp reduction (permanent solution)

Scalp reduction is normally performed using local anaesthetic on the scalp, along with a sedative to help to relax the patient and reduce anxiety. Usually, a portion of the scalp (two to five centimetres wide) can be removed in one session and the remaining skin is then stitched back together. Newer methods of scalp reduction may also be used. These include scalp expansion and scalp extension and are explained below.

Scalp expansion (permanent solution)

Scalp expansion involves balloon-like devices, called tissue expanders, being implanted under the sides and back of the scalp where the hair is still growing.

These are gradually inflated over a four to twelve week period, resulting in an increase in the amount of loose hair bearing tissue as the skin stretches.

The following scalp reduction surgery creates a greater amount of loose bald skin than would be possible if it hadn’t been stretched before surgery.

Scalp extension (permanent solution)

Scalp extension involves the use of a surgical device that is made of two rows of hooks, connected by elastic bands. This device is placed on the under surface of the scalp during the first scalp reduction procedure. Over a one-month period, the tension in the bands gets tighter, gently pulling upwards on the hair-bearing tissues. This loosens and stretches the scalp, allowing for another scalp reduction to be done.

With scalp extension, a faster series of scalp reductions can be done within a 30- to 90 – day period. In the past, some scalps could not be reduced at all and those that could be reduced often took a year or longer for the procedures to be completed. The treatment is much quicker now!

Scalp extension has some of the benefits of scalp expansion, but causes less discomfort and deformity. With this procedure, however, the amount of stretched tissue is generally less than can be achieved with scalp expansion devices.

Hair transplants (permanent results)

A hair transplant is the only treatment that produces permanent results. During a hair transplant, the patient’s existing hair follicles are moved from the back of the head to the bald area. The hair follicles at the back of the head are genetically conditioned to remain in place for a person’s whole life. They continue to produce new hair even after a transplant, therefore giving lifelong results. With today’s methods, we can achieve a natural result without signs of a transplant. Older methods, which resulted in a ‘doll’s hair look’, are not used at Australia Plastic surgery.

The hair follicles are moved one by one which changes their natural form.

Natural hair growth can also stop for other reasons, e.g. after operation on a tumour, following an accident, after certain skin conditions or a burn. This condition can usually be treated with a hair transplant.

Other treatments (temporary solutions, effect wears off once treatment stops)

Laser (temporary solution)

Laser stimulates the bottom of the hair, increasing the scalp’s blood circulation and providing more blood to the hair follicles. In some cases, laser can awaken dormant hair follicles and cause them to produce hair again. The hair may become thicker and stronger and occasionally new hair is produced. To achieve a positive effect using laser, the treatment must be repeated several times a week. The effect wears off once treatment stops. Treatment with laser can be combined with a hair transplant and medication for hair loss.

Medicines (temporary solution)

Medical treatments are often used to stop hair loss. In some cases, there have even been signs of new hair growth. However, the effect wears off if treatment is stopped, which means that we recommend a permanent treatment to maintain the effect. Medicines can be combined with a hair transplant and/or laser.

Regaine (temporary solution)

Regaine or minoxidil is a liquid liniment used locally on the area affected by hair loss. The lotion is best applied in the morning and at night, and is used to stimulate hair growth and minimise further hair loss. The treatment is suitable for both men and women.

Propecia(temporary solution)

Propecia or finasterid is a prescribed treatment for hair loss in the form of a tablet to be taken once a day. It is used to stop hair loss and stimulate new hair growth. If the treatment is stopped, any effect wears off with 6 months. After 9-12 months, the patient’s hair will have reverted to its original state. It has not been proven to have any effect on bald patches and advanced baldness. Propecia should not be used by women.