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For those patients who are not suitable for hair transplantation because they have already lost too much hair there is Scalp Reduction Surgery. Scalp Reduction Surgery involves the surgical removal of parts of the already bald scalp, followed by the stretching of the parts of the scalp, which still has new hair growing on it. After stretching, the scalp is then moved to a higher position on the head. Good candidates for this procedure are patients with excellent hair on the sides and back of the scalp that can be stretched upward to cover the bald scalp that is to be cut. Scalp reductions leave scars on the bald areas of the scalp, which can be camouflaged by hair styling or by hair grafts. Private prices for Scalp Reduction Surgery vary depending on the individual case, although you would normally be looking at paying well over £2,000 for a straightforward procedure.
The most common and successful treatment for male baldness is hair grafting or transplantation. However not all patients are suitable for this procedure because they have already lost too much hair. In such cases, scalp reduction surgery may be the answer. Quite simply, if you can’t graft hair into new areas of the scalp, surgeons can reduce the size of the scalp to make you look less bald!
What Is It
Scalp reduction surgery involves the surgical removal of parts of the already bald scalp, followed by the stretching of the parts of the scalp, which still has new hair growing on it. After stretching, the scalp is then moved to a higher position on the head. This procedure may be recommended at the same time as hair grafting in order to leave a smaller bald area, which then needs fewer hair grafts afterwards to cover it. Good candidates for this procedure are patients with excellent hair on the sides and back of the scalp that can be stretched upward to cover the bald scalp that is to be cut. In addition, the patient must have thick hair to be grafted as this hair will be stretched and so it needs to be strong too.
This procedure is normally performed using a local anaesthetic in the scalp, along with a sedative to help to relax you and reduce anxiety. Usually, a portion of the scalp, two to five centimetres wide, can be removed in one session, and the remaining skin is then stitched back together. Newer methods of scalp reduction may also be used: these include scalp expansion and scalp extension and are explained below.
With a scalp expansion, balloon-like devices called tissue expanders are implanted under the sides and back of the scalp where the hair is still growing. These are gradually inflated over a four to twelve week period, resulting in an increase in the amount of loose hair bearing tissue as the skin stretches. The following scalp reduction surgery creates a greater amount of loose bald skin than would be possible if it hadn’t been stretched before surgery.
Scalp extension involves the use of a surgical device, made of two rows of hooks connected by elastic bands. This device is placed on the under surface of the scalp during the first scalp reduction procedure. Over a one-month period, the tension in the bands gets tighter which constantly and gently pulls upwards on the hair-bearing tissues. This loosens and stretches the scalp. This allows for another, and usually greater, scalp reduction to be done.
With scalp extension, a faster series of scalp reductions can be done within a 30- to 90 - day period. In the past, some scalps could not be reduced at all and those that could be reduced often took a year or longer for the procedures to be completed. The treatment is much quicker now!
Scalp extension has some of the benefits of scalp expansion, but causes less discomfort and deformity. However, the amount of tissue stretch is generally less than can be achieved with scalp expansion devices.
Side Effects and Risks
Side effects include some pain, swelling and numbness occur after the surgery.
Scalp reductions leave scars on the bald areas of the scalp, which can be camouflaged by hair styling or by hair grafts.
The stretching back of the skin can occur, and occasionally this treatment creates an unnatural appearance called a slot deformity.
Who Can Do It
Only suitably qualified and experienced surgeons should perform this procedure.
For more information about practitioner training, qualifications and relevant medical organisations please view the information contained within the Legislation section of the Consulting Room.
It is highly unlikely that anyone considering scalp reduction surgery would be able to access this free of charge on the National Health Service.
However certain regions do make special cases, and we would always recommend that you visit your General Practitioner before embarking upon a cosmetic procedure involving surgery.
As well as their advice and guidance they may also be able to refer you to a local NHS Hospital who can treat you.
The NHS has set out the following guidelines on how to get cosmetic surgery through the NHS:
"To qualify for surgery on the NHS you must meet specific criteria as set out by your local health authority. The NHS will not pay for surgery for cosmetic reasons alone. Reconstructive and cosmetic surgery to correct, or improve, congenital abnormalities and injuries will usually be carried out free of charge.
NHS reconstructive surgery is performed by plastic surgeons who have had extensive training and belong to the British Association of Plastic Reconstructive and Aesthetic Surgeons. Surgeons who carry out cosmetic surgery through the NHS also belong to the British Association of Aesthetic Plastic Surgeons.
To receive cosmetic surgery from the NHS, you will normally need a referral from your GP. You will have a consultation with a plastic surgeon and an assessment by a psychiatrist, or psychologist. It will then be decided whether there is enough social, psychological, or physical benefit to be gained to justify surgery."
Private prices for Scalp Reduction Surgery vary depending on the individual case, although you would normally be looking at paying well over £2,000 for a straightforward procedure.
Before and After Pictures
Results vary enormously depending upon both the patient and the skill of the individual surgeon, so outcomes for cosmetic surgery procedures will always be more variable than those for less invasive non-surgical treatments.
We currently do not have any before and after images for Scalp Reduction Surgery.