Scalp Kinetics in Multiple Excisions for Correction of Male Pattern Baldness

Abstract

The author placed tattoo marks in the scalp in a certain pattern in seven patients with male pattern baldness to ascertain the complex movement of the scalp due to serial longitudinal midline excision of the bald area.

One Variety of a Long, Nondelayed, Temporo‐Parieto‐Occipital Flap

“…Usually 3.0–4.0 cm of flap can be overlapped at the widest point. This agrees with the values obtained when performing sagittal midline excisions, which utilize exactly the same degree of laxity of the scalp bilaterally to the level of the helix of the ears 6–8 …”

“…6). 8 This second flap is shorter because it only goes across the scalp and not all the way to the frontal hairline. In cases where a long flap of about the same size and design as the first one is necessary, two delays with intervals of 7 days are necessary.…”

Dual transposition flaps for the reconstruction of large scalp defects

“…Further compounding the difficulty with scalp surgery is a property known as stretch-back. 1,2 Following expansion and during healing, the scalp has a tendency to contract back toward its original state because of the inherent inelasticity of the galea. This leads to prolonged and greater tension across the wound and scar spreading.…”

The use of galeotomies to aid the closure of surgical defects on the forehead and scalp

“…The benefits of a galeotomy are augmented if it is performed in a loose scalp region which is inherently more distensible 1 . Galeotomies may lessen the risk of a widened, splayed scar due to the stretchback phenomenon of scalp skin, which has been encountered in scalp reduction surgery 6 …”