Tissue Expansion

[baldymcgee]

There's a kinda consensus on these forums that NW5 and higher patients should be *very* careful before starting down the hair transplantation route.

But then I saw this video:
https://www.youtube.com/watch?v=Z1U3gSSWoe8

And given the things that scalp expansion can do in the case of burn victims is this a viable option for high norwood patients?

[35YrsAfter]

There's a kinda consensus on these forums that NW5 and higher patients should be *very* careful before starting down the hair transplantation route.

But then I saw this video:
https://www.youtube.com/watch?v=Z1U3gSSWoe8

And given the things that scalp expansion can do in the case of burn victims is this a viable option for high norwood patients?

That's an interesting question. They used to do scalp reductions, in fact I had one in the late 70's. Back then they would cut an elliptical shaped strip from the top of a patient's head about 7" long and in my case 3/4' wide. Working at Dr. Cole's office, seeing mega strip scars, I suppose that scar widening is the main reason hair restoration physicians stopped doing scalp reductions. I suppose if you stretch the scalp, that could help prevent scars from widening. A bulging balloon under your scalp presents some major cosmetic challenges in public. That's most likely why they reserve this type of treatment for extreme cases such as burn patients.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
Please feel free to call or email me with any questions.

[gillenator]

Like the Frechet Extender which is one of the methods to address the scar expansion and stretching although you never hear of anyone doing it. Possibly its more available in Europe where it was developed.

Many of the scalp reductions were done with the Mercedes method which involves three distinct incisions in the midscalp. They then pull the scalp in three directions, remove the excess tissue, and then close the three sides. The result is a permanent scar that resembles the Mercedes Emblem.

The fundamental problem with this as with open donor surgery is that the patient continues to lose native surrounding hair and the scar becomes much more visible with time. The main objective with scalp reductions in general was to potentially reduce the surface area of balding surface and ultimately reduce the recipient area where new grafts would be placed.

Back then many men and women were not informed that genetic hairloss is in fact progressive and any visual remedy would not last. Effective hairloss meds were not available back then either.

Three triangular scars at 30 degree angles can be very difficult to reduce or alter. Obviously FUE and other corrective measures have arisen since then. Yet I cannot think of even one individual who had scalp reduction surgery and was happy with the end result. I know a number of these men who are wearing top end hair systems now.

Rarely does the subject come up any more but whenever it does, I have the same advice. Don't do it.

[topcat]

No because the numbers are the numbers regardless of how you get the hair there. You can stretch it there, cut a strip and place it there or have fue. Can you achieve more grafts with a strip, sure I suppose that is very possible is it worth it in the long run……………that’s a personal decision.

What you can expect with balloon expansion is having to endure a great deal of pain during the expansion phase along with a much higher chance of complications. You can then expect your neck hairline along with the hairline around your ears to be raised significantly. Remember the big white walls on the cars back in the 70’s that is what you will have around your ears. It looked good on the cars back in the day but not so much on a man’s head.

You see the way it works is I can point this all out and nobody will give me a hard time because nobody is really performing this procedure any more so I’m not stepping on any toes. But if I were to do the same with large fue punches, robots, or head tattooing well then some would say I have an agenda. When in actuality I would be posting information well ahead of it’s time. Your question is easy don’t do it.

[baldymcgee]

You can then expect your neck hairline along with the hairline around your ears to be raised significantly.

Objections like this are what confuse me: comparing scalp expansion with "plain" scalp reduction. If you stretch the skin then why would you expect the hairline around your neck/ears to raise up? Shouldn't you just get a general "thinning" of hair throughout your permanent zone (and, obviously, some scarring at the top of your head where the bald scalp was removed)?

It can't possibly end up looking worse than a NW6 with a couple of FUT megasessions under their belt (since those "stretch" the scalp quite a bit as well).

[35YrsAfter]

Objections like this are what confuse me: comparing scalp expansion with "plain" scalp reduction. If you stretch the skin then why would you expect the hairline around your neck/ears to raise up? Shouldn't you just get a general "thinning" of hair throughout your permanent zone (and, obviously, some scarring at the top of your head where the bald scalp was removed)?

It can't possibly end up looking worse than a NW6 with a couple of FUT megasessions under their belt (since those "stretch" the scalp quite a bit as well).

We had a patient a few years ago who used to post in the forums as "Juiceman". I met him at Dr. Cole's office around 2007. I believe, if memory serves me, he had 4 scalp reductions! He believed that he was headed for a Norwood 7. He was one of the fortunate patients who got a decent result from body hair grafts. Juiceman had been to many doctors including Dr. Wong and Dr. Woods. His result looked very good. Very natural. I should give him a call and ask him his personal opinion of scalp reduction surgery. I don't think doctors are doing that surgery much with the exception of extreme cases, like burn victims.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
Please feel free to call or email me with any questions.