This procedure is now rarely if ever indicated for male pattern baldness in our practice. It is included here for historical or reconstructive reference.
A procedure designed by Dr. Patrick Frechet of Paris, France, has become known as “scalp extension”. Scalp extension allows scalp reduction to be performed with much greater effect and allows previously determined non-candidates to have successful scalp reductions. Basically, it involves the use of a surgical device, made of two rows of hooks connected by broad-based elastic bands, that is placed on the undersurface of the scalp during the first scalp reduction. Over a one-month period, elastic recoil causes a constant, gentle upward pull of the hair-bearing tissues, thereby loosening and stretching the scalp. This allows for another, and usually greater, scalp reduction to be done. The scalp extension process can be repeated. With scalp extension, the complete 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 as long as 1 1/2 years for the procedures to be completed. Scalp extension has some of the benefits of scalp expansion, although the amount of tissue stretch is less. Its great advantages are that it causes little or no discomfort and deformity. It is a relatively simple procedure, thereby adding little time and difficulty to the scalp reduction operation.
Scalp reduction- extender is to be inserted
Scalp reduction completed- extender in place.
After four weeks- sides of scalp stretched.
Extender removed. Results after second reduction.