Scalp reduction procedures are rarely performed anymore for hair restoration purposes. What has developed in this area is the use of restoration procedures for repairing the damage caused by scalp reduction surgery leaving the individual with a more normal looking head of hair and scalp. One of the biggest disadvantages to using scalp reduction surgery as a hair restoration procedure was that it resulted in undesirable effects and caused many cosmetic problems.
It also involved depleting the donor hair follicle supply in order to correct the balding condition. In so many words, scalp reduction surgery altered the balance between the demand for the follicles and the supply of them. The increase in demand result from the scars that were produced from the procedure in the crown of the scalp. These scars needed to be covered in order to camouflage the scarring. The donor supply was then diminished in order to accomplish this.
If a scalp lifting or reduction procedure is performed by an inexperienced hair restoration surgeon, the scarring in the crown of the scalp can be even more severe and unsightly. Although the scarring can eventually be camouflaged, it requires a large quantity of hair follicles to do so. Scar tissue creates another problem in that it significantly limits the amount of follicles that can be transplanted into one scalp area in each session. This means that multiple transplant sessions are always necessary.
Another consideration is that the transplanting of hair follicles directly into the scar tissue can significantly alter the hair pattern during the re-growth stage. The correction of scalp reduction surgery and the defects associated with it is oftentimes approached in similar fashion to correcting donor supplies and/or hair plugs. Additionally, it is extremely important that the deformities and other problems resulting from any hair restoration procedures using the scalp reduction method should be addressed first before the camouflaging procedure is performed.
Another undesirable result is known as “ridging” which is caused by an increased quantity of scalp tissue that is considerably larger than the follicular units. This is referred to as hyperfibrotic healing. The growth of hair in the ridging area tends to be very poor in most instances. This can be improved by in cosmetic fashion by punching out specific follicle plugs where this ridging is the most severe. This decreases the amount of excess tissue as well as the “plugginess” look that typically occurs.
