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A scalp flap is one way to quickly and
effectively move a large group of healthy, densely packed
hair to an area of thinning or baldness. Up to 10,000
hairs or more can be moved in one flap. In this procedure,
a strip of hair-bearing scalp adjacent to a bald area
is separated. A small area of about 2 inches at one
end is left attached to the scalp to allow continued
blood flow in to that piece of skin and hair.
The bald area of the same size as the
flap is removed, and then the flap is rotated into the
place where the bald area was (usually in the front
of the head). Typically, this operation is carried out
in three small stages each separated by a week to ensure
an adequate blood supply before moving the flap. The
final operation is when the flap is rotated and sutured
into it's new location.
Although you will instantly have hair,
this will likely be very noticeable to those that know
you because of the dramatic, quick change from thinning
or no hair to dense, full hair (unless you normally
wear a hairpiece). The scar may be visible along the
edge of the flap, and the sharp demarcation between
the flap and the hairless area may also contribute to
obvious hair replacement. Follicular
unit hair transplant (hair grafts) can then be used
to camouflage the flap and scar by placing grafts of
one or two hairs along the edge of the flap.
If necessary another flap can be rotated
from the other side of the head to cover additional
bald areas. A scalp reduction
may also be employed to remove smaller areas of baldess,
particularly on the crown of the head.
recovery - After scalp flap surgery,
you will have prescriptions for antibiotics to prevent
infection and pain pills to control discomfort. Many
patients do fine with acetaminophen (Tylenol) after
surgery and do not require stronger medication.
After the first two preliminary procedures,
you will wear a bandage overnight. After the flap is
moved in the third stage, you wil have a gauze compression
dressing on for a few days to protect the flap, minimize
swelling, and absorb drainage. It is normal to see a
few drops of blood on the gauze. If you notice more
than a few drops, or if the area of blood is increasing,
call your doctor right away. The dressing usually is
removed after 2 to 3 days, and sutures come out after
7 to 10 days.
After about a week, you will be allowed
to gently wash your hair. At this point, most people
return to work, if they haven't already. If desired,
follicular unit grafts (grafts of 1 to 4 hairs) can
be placed along the flap edge for a more natural appearance
6 weeks after your surgery.
risks - Scalp flap surgery can
result in infection, scarring, or rarely, insufficient
blood supply that leads to loss of part of the flap.
cost - Scalp flap surgery can cost
$10,000 to $15,000 or more.
results - Once the flap is rotated
and healed, it will continue to remain just as if it
were in its original site. Scalp flap surgery does not
stop hair loss, and you will continue to lose hair just
as you would have if the flap of hair was not rotated,
but usually the effects of scalp flap surgery will last
10 to 20 years or more.
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