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Hair Transplant Questions & Answers
 
Subject: Scalp Flap Surgery
 
Question: 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 time.
 
Answer: 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.
 
Answered by: Dr Aaron Stone
 
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