Since modern follicular unit transplantation surgeries leave such little scarring in the donor area, why aren’t hair restoration physicians performing more scalp reductions in the crown? It seems like there is greater laxity in the crown compared to the donor area, meaning a lot of bald scalp could be reduced with minimal scarring?
First, scars can be a real problem and can potentially disfigure someone, even in the best of hands. Additionally, tissue expansion really let us remove a lot of bald scalp, but very few men want to walk around with a balloon expander in for a month, when they can have a modern transplant.
Second, the surrounding hair can get pulled into an unnatural position.
Third, modern follicular unit grafting has greatly improved overall results with minimal potential complications.
Finally, using my landscape analogies that I use with patients: Imagine you have a farm that has a hill with no trees. It is easier to plant trees on the hill, than it is to grade the hill down to level so that surrounding tree’d land camouflages it.
William H. Lindsey, MD, FACS
Blake – aka Future_HT_Doc
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