Taking another look at a few more surgical methods for reversing hair loss:
In linear or line grafts a 3-4mm linear strip of donor hair is removed from the side or back of the head and instead of dividing the strip into follicular unit grafts, the entire strip or large parts of it are transplanted. Since this large graft can’t be placed in tiny recipient sites, a trench must be surgically cut into the bald area and the large graft is placed into the trench. As hair grows, it looks unnatural and is not cosmetically acceptable. Round or square grafts are the original, standard, out of date pluggy-looking grafts. Each 3-5mm graft is made with a hole punch devise, resulting in a plug of hair about the size of a pencil eraser. Whether these large grafts are round or square, they are too large and do not even remotely resemble the way hair grows naturally from the head. When transplanted, because the grafts are so large and blood flow is compromised, hair in the middle of the graft often does not grow, leaving the patient with a doughnut effect.
Scalp reduction, also known as alopecia reduction (AR), galeoplasty (GP), or male pattern reduction (MPR), are barbaric and disfiguring. Performed in the doctor’s office under local anesthesia, the bald part of the scalp at the top or crown of the head is literally cut away, and the edges of the nearby hair bearing skin are sewn together, bringing the hair-bearing scalp from either side to meet in the middle. In some cases a hideous scar results. Scalp reduction problems also include: accelerated hair loss, thinning of the scalp, an unnatural appearance because the direction of hair growth is altered, and infection. Scalp reductions do not preserve hair for use in future transplants. The same wreath of permanent hair is stretched to cover the wider area in the crown, thereby thinning the permanent hair that would normally be used as donor hair for transplantation.
Hair lift is a more radical form of scalp reduction, in which dissection or loosening of the scalp skin is done at a level below the major arteries of the scalp. To avoid damaging these blood vessels, the nerves are cut and tied. This leaves your head permanently numb. Unlike other scalp reductions, this is major surgery, which requires hospitalization and general anesthesia. It leaves visible scars around the ears, and additional hair loss is often a consequence of this ill-advised procedure.
Scalp expanders are silicone balloons that are inserted into pockets that are created between the inside of the scalp and skull in order to stretch the skin on the scalp for future scalp reductions, flaps or hair lift surgery. After incisions heal, the balloons are gradually inflated with a series of saline solution injections. This radical procedure is only recommended in trauma cases when the patient has received deep burns to the scalp.
