Apart from a commonly known restoration surgery of hair follicles applied in the case of hairloss, other surgeries such as:

• Scar excission
• Scalp reduction surgery
• Implant extender
• Scalp flap surgery for hair restoration
• Hair restoration surgery with an expander are carried out.

These surgeries are often supplemented with hair transplant surgeries. However, it is the surgeon’s experience and knowledge that are decisive factors in terms of selection the most suitable treatment for the existing hairloss.

Scar excission

It is most often applied for those patients with only minor hairloss.

The surgery is carried out under local anaesthesia.

A sufficient laxity of the scalp is of huge importance here.

Planning the direction of an excission, the surgeon has to take into account the direction of hair growth and the area of head where the corrective surgeries will be carried out.

The patient most often returns home after the surgery. No stay in the clinic is requiered afterwards.

On the 7-10 day since the surgery took place, the stitches are removed.

Initially, the scar is pink and narrow. Within the next few months it turns pale. It may also become wider.

Scalp Reduction Surgery

It was Sparkhul in 1978 who as the first in the world introduced the term of scalp reduction surgery. The method alone became popular in the 70s of 20th c. Blanchard, Stough, Webster and Unger are considered to be its great propagators.

In Poland, however, it was Jerzy Kolasinski, M.D., who as the first carried out these surgeries in the 80s of 20th c.

The scalp reduction surgery is most often applied in the treatment of androgenic alopecia and consists in removing a bald scalp from the central region of the head. Depending on the shape and size of the scalp various forms of excission are used.

The surgery is most often carried out under local anaesthesia. It is often possible to reduce even extensive hairloss.

The result of the surgery is visible directly after the surgery is finished.

The only disadavantage of scalp reduction surgery is the fact that a visible scar is left and some pain troubles may last two or three days.

The surgery is repeated every second or third month provided that a patient tolerates the whole procedure well. Thanks to this surgery, it is possible to not only reduce central hairloss significantly, but also to limit the number of hair transplantation considerably. Scalp reduction surgery is an integral part of the hair restoration treatment and it is often associated with hair transplantation.

Applying hair transplantation surgery, after scalp reduction treatment has been finished, allows not only to restore hair in the forehead area, but also to cover the scar which is reduced after the grafts are placed on it, which makes the scar invisible.

Implant extender

The extender is a kind of a temporary implant placed under bald skin with the purpose of reducing hairloss. It was invented and popularized by Patrick Frechet. It consists of an elastic stretching tape and a row of metal hooks on its both sides. The extender is placed in the extended position under the skin. Then, within 4-6 weeks the implant shrinks which results in stretching the scalp on both sides of the bald region, which fills the defect.

The extender is removed during the next surgery, a part of a bald area is cut out and the hairy skin is lifted into the bald position. It is possible to repeat the operation as long as the moment of a total baldness reduction is obtained.

Similar results can be obtained by using a silicon thread called the Nordstrom suture. It was invented by a Finnish surgeon, Rolf Nordstrom, and is applied not only in scalp reduction surgeries, but also in corrective surgeries of scars in various parts of the body.

Scalp flap surgery for hair restoration

Scalp flap surgery for hair restoration is performed in the case of more extensive hairloss located especially on the top of head. The surgery is done in a series of one or two procedures and allows to adjust the scar’s location and hair direction so that the traces of surgical intervention are almost invisible.

This type of the surgery is also applied in case of excissions of neoplastic changes of the scalp.

The treatment often requires covering scars with hair grafts.

Hair restoration surgery with an expander

Because of the restricted application of classic plastic surgeries using scalp flaps for hair restoration, more often the surgeries of stretching the scalp with an expander are performed.

The expander is a kind of an implant placed under the scalp in the area near a scar or a plane hairloss. The expander is filled with physiological salt within the next few weeks by percutaneous injections. Something of a kind of an artificial bump is created. Its capacity makes the stretched skin cover it.

The next stage of treatment consists in excising the loss (scar), and the defect is covered with the stretched scalp. The first surgery is often performed under local anaesthesia, but another one under general anaesthesia.

The treatment involves the risk of infection and skin necrosis. Moreover, the head deformation may be difficult to hide during the treatment.

The final result of the treatment compensates all the inconveniences the doctor and the patient suffered from during several months.

Due to its character and the possibility of complications, hair restoration surgery with an expander is reserved only to corrective surgeries of extended scars of the scalp caused by mechanical trauma, burn or an unsuccessful surgery.

ALL THE MENTIONED TYPES OF SURGERIES ARE PERFORMED IN THE KOLASINSKI CLINIC.

Our surgeon will explain to you in details what each surgery consists in and what risk they involve during a consultation visit.

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Body Hair Transplant – Indications

The BHT procedure is most often performed in the following cases:

• to complete the effects of previously performed hair transplantation if the donor area located on the scalp is insufficient
• to perform a slight hair transplant procedure in the area of eyebrows, moustache and beard
• to correct the scarring in the scalp area including those scars remaining after previously performed hair transplant by strip procedure

The best candidates qualified to the BHT procedure are the patients with abundant hair in such regions as chin, chest, back or legs.

Body Hair Transplant – Procedure

The procedure is performed under local anesthesia.

The hair in the donor area are clipped to a 1-2 mm length.

The operator uses magnifying glasses to achieve a significant picture enlargement.

By using a special instrument, single hair follicles (FU) are taken from the hairy skin and put into special containers filled with preserving fluid at low temperature.

The donor area is covered with a dressing that contains antiseptic ointment.

The donor area heals within 5-7 days leaving invisible traces.

The grafts are inserted in the bald region (recipient area) by a well-known four-hand-stick-and-place technique.

The benefits of BHT procedure

• expanding the procedures of hair transplant by using donor areas which have never been taken into account before

• the possibility to correct the scars on the scalp without the necessity to create new scars in this part of the body
• the possibility to correct the scars of the upper lip in men using hair of the same structure taken from the chin area

• leaving minimal usually almost invisible traces in the donor area
• using hair which so far patients have considered useless or even “unwanted”

Disadvantages of BHT procedure

• slightly different nature of the hair than the ones growing on the scalp
• the necessity to anesthetize the extensive donor area
• moderate discomfort of the donor area after the grafts have been taken

The number of grafts used in hair transplantation is limited due to limited possibilities of the donor area on the scalp. Using the grafts taken from other parts of the body expands the possibilities of this procedure without leaving visible traces of surgical intervention.

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