Scalp Flap Surgery
I remember seeing a hair flap procedure on The Learning
Channel which seemed to turn out pretty well. I'm
curious to hear your opinion of Hair Flap Surgery.
Do you perform the surgery? If so, how do the results
compare to transplants? If not, what exactly don't
you like about the procedure. Isn't the density
of the moved hair far superior to what you could
get in a traditional transplant? Thanks for your
Although I perform only hair grafting I have seen
some very good & very bad flap results. The problem
is you have to have someone experienced do the procedure.
Just because someone can perform grafting or reductions
well does not mean they can do flap procedures &
vice versa. If performed improperly part of the
flap (skin & hair or just hair may be permanently
lost). Also, just as hairgraft donor site scars
on the back of the head can spread leaving a line
lacking hair so can the flap donor site on the side
of the head/temple area. However, this is more likely
with flaps as the closure tension is greater than
that for a hairgraft donor site. Areas of alopecia
in the temple areas are more noticeable than those
on the back of the head as natural hair recession
proceeds. The corner transition between temple &
frontal hairlines is difficult to impossible to
recreate with flaps. What bothers me most about
flap procedures is long term results even those
that look good in the short term. What happens with
long term loss of remaining hair that is not on
the flap? Does one end up with a very abnormal pattern?
I have not seen these people many years after flap
surgery to know the answer.
The advantage of grafts is that if they are small
& placed close together (within reason) it does
not matter if a few are lost. Also if native recipient
site hair is lost in later years one should look
thinner rather than freakish if the procedure was
performed properly. My philosophy is that each hair
restoration surgery should be a stand alone procedure
& be performed with possible future hair patterns
in mind not the present hair pattern. Lastly, any
surgeon can have a complication no matter how reputable.
The only surgeons who don't have complications are
those that don't operate. I would rather have a
complication from a hairgrafting procedure than
a hair flap procedure.