Darth Jello
Cheese Spelunker
Scalp Flap SurgeryScalp flap surgery relocates an entire strip of bald resistant scalp intact from the side of the head to the frontal hairline area. This is a five step procedure.
First an incision is made along the upper margin of the intended flap. Then an expansion balloon is placed under the scalp tissue and the wound is sutured closed. For the next three or four weeks saline solution is injected into the balloon to stretch the tissue.
Second, when the tissue expansion is accomplished the patient returns for a delay procedure. An incision is made which becomes the upper two thirds of the flaps and then is sutured back in place to induce collateral circulation.
Third, about a week later a similar procedure is performed on the lower third of the flap and it is elevated and then sutured back in place.
The fourth step of this relocation process is for a strip of hair-bearing scalp near the bald area to be surgically excised from the side of the head. However, 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. This results in a bulge of tissue or a “dog ear” at the base of the flap due to the twisting of the tissue to its new location at the front of the hairline.
Fifth about one week later, the dog ear is removed.
This procedure produces dramatic and dense results in the hairline area. However, there are numerous drawbacks to this procedure.
The “down side” of Scalp Flap Surgeries
One of the more obvious problems with scalp flaps is that the angle of the hair at the hairline is reversed. Normally a person’s hair will angle forward. But after a flap procedure a patient’s hair will angle backwards. This produces an unnatural appearance.
In addition, the patient will have an abrupt wall of hair for a hairline. If his hair continues to thin behind this thick wall of hair the patient will have an even more unnatural appearance.
Typically micrografts are placed in front of this thick strip of hair to soften its abrupt appearance and to hide the scar. However, this often does not remedy the odd direction of the hair and often does not sufficiently mask the scar.
An even worse scenario can result if the flap tissues dies, thus producing a very unsightly scar There have also been occasions when the donor scar has stretched leaving a wide 1.5 to 2 inch scar along the side of the head where the flap was removed.
Based on what that said, you could end up looking like a cabbage patch doll if it doesn't take.