Scalp reduction procedures reduce the balding areas by removing segments of the bald scalp and stretching the hair-bearing scalp to a higher position. Scalp reductions do not, by themselves, produce the cosmetic result of grafts or flaps, but aid in coverage and styling situations. Scalp reductions for the routine treatment of male pattern baldness have fallen out of favor in recent years.
When used with hair grafts, scalp reductions decrease the area for hair grafting. This stretching of the scalp can be repeated as soon as the scalp loosens up enough to allow such reduction, usually after three months. A process called scalp extension can accelerate the reduction.
A significant reduction can be performed if the scalp is loose enough. Usually, a portion of the scalp two to five centimeters (3/4″ to 2″) wide can be removed in one session. Because the scalp is being stretched, this procedure diffusely separates the hair in fringe areas, creating a good cosmetic effect.
Scalp reductions leave scars within the bald areas of the scalp, which are camouflaged by hair styling or by hair grafts. Scalp reductions can be done before hair grafting is started. Alternatively, scalp reductions can be done after the hair grafting is completed. In this latter situation, the grafts are inserted in such a pattern that leaves an area of bald scalp to be removed at a later date. In some cases, a limited number of hair grafts can be done simultaneously with scalp reductions.
Also, scalp reduction can be done after Juri flaps are performed and healed in place.
The most frequent use of scalp reduction principles over the past 10 tears has been for scar revision or lesion removal of the scalp.
Skin is removed from within the dotted lines and the scalp edges are pulled upward and stitched in place.
Potential results after one or two scalp reductions. Further reduction procedures may be done.
The bald area has been reduced by scalp reductions. Hair grafts are shown filling in the remaining bald areas.
An example of styling, with the completed result after multiple scalp reductions and hair grafts.