A New Surgical Approach for the Treatment of Extensive Baldness

Abstract

Utilizing the bilateral occipitoparietal flap, the Brandy bitemporal flap, and non-part-side frontoparietal advancement flaps, a patient with extensive male pattern baldness can now be treated aesthetically in just three or four steps.

Scalp Lifting

“…The final procedure developed, using Marzola's basic concepts, was the frontoparietal advancement flap 12,13 . This flap was innovated as a means to create a hairline without using punch‐grafts.…”

Scalp Lifting

“…Posteriorly, however, both parietal incisions meet at a point that veers approximately 45 degrees in the direction of the whorl on the crown, eliminating any possibility of a “slot” or “dog ear.” Thus, with two procedures, the right and left parietal scalp and occipital scalp all meet at the central crown, covering this region with the patient's natural hair. The anterior crown is subsequently covered, in three to four sessions, with minigrafts and micro‐grafts 22,23 …”

Patient Selection, Hair Transplant Design, and Hairstyle

“…Scalp reductions are one possible solution but can be a problem because of the scar, and the way they disturb the natural orientation of the hair. The Marzola/Brandy 4,5 scalp lift provides probably the best and most natural coverage. However, it requires more surgical skill and a surgical suite technically more highly equipped than most hair transplant surgeons use.…”