Scalp Flap Surgery for Hair Restoration

Skin flap surgery is a method of moving a "flap" of skin and underlying tissue from one area of the body to another. It is surgery performed to (1) repair a non-traumatic cosmetic defect such as male pattern hair loss, (2) repair a site of traumatic injury to restore its functionality and cosmetic appearance, or (3) repair a skin defect caused by a congenital malformation.

The flaps used in both cosmetic and reconstructive surgery are either "pedicle" flaps or "free" flaps:

* Pedicle flaps are flaps that are surgically removed from a donor site and transferred to a recipient site with an attached pedicle of tissue that contains the flap's artery-vein blood supply along with the flap tissue. Transfer of artery-vein blood supply along with the flap improves the survival and health of the transferred tissue. Pedicle flaps are the type most often used for cosmetic hair restoration.

* The free flap is called "free" because it is transferred from donor site to recipient site without any attached pedicle. However, it must contain arteries and veins that are reattached to blood vessels at the recipient site by microvascular surgery. Free flaps are often used in reconstructive surgery when local skin is not sufficient to raise a pedicle flap to cover a defect-for example, to cover a substantial area of scarred scalp tissue. In recent years, free flaps have been used for cosmetic hair restoration by skilled and highly trained physician hair restoration specialists.

Scalp flap surgery has an important but limited role in hair restoration. The surgeon who performs the procedure must be a skilled physician hair restoration specialist with specific training and experience in use of skin flaps for hair restoration. In the hands of an appropriately trained and experienced surgeon, scalp flap surgery can be a highly successful approach to hair restoration in carefully selected patients.

http://www.ishrs.org/surgical/surgical-scalp-flaps.htm