Monday, April 5, 2010

Scalp Reconstruction – an Article Review

The March issue of Plastic Surgery Practice has a very nice article on scalp reconstruction (full reference below). The short article is an overview of HRS (hair restoration surgery) options for massive hair loss resulting from illness or injury.

The degree of deformity generally determines the treatment choice. Advancements in HRS in the past 2 decades are significant in yielding natural and almost undetectable results. Using a combination of HRS and cosmetic and reconstructive techniques, most deformities can be treated effectively.

There are many HRS techniques available, including follicular unit transplantation (FUT), follicular unit extraction (FUE), scalp reduction, scalp flaps, and tissue expansion.

The article gives some nice tips for use of tissue expanders:

  • Planning is critical. Patient/family counseling regarding temporary deformity is crucial.
  • It is best to overestimate the needed expansion and choose the largest commercially available expander that fits the patient’s anatomy.
  • The vertical dimension is the most important factor providing the greatest gain in flap expansion. When the distance over the expanded tissue minus the base width of the expander is equal to 120% of the defect width, the expansion is complete.
  • Overexpansion even by a modest amount will increase patient safety by providing excess tissue to cover the defect, allowing closure with minimal or no tension.
  • If the entire defect cannot be removed and the residual defect is significant, leave the expander in place for a second expansion.

The article also mentions Operation Restore , a charity program which matches prospective hair loss patients with volunteer ISHRS physicians to obtain hair restoration services to help restore the physical and emotional wellness of the individual. The foundation will provide financial, travel, lodging, and medical assistance to eligible patients. The ISHRS Pro Bono Program was also featured in Association Forum Magazine.

Other posts you may find interesting:

Scalp Avulsion Injuries

Eyebrow Reconstruction

Hair Transplantation

REFERENCE

Scalp Reconstruction: An Aesthetic Challenge; Plastic Surgery Practice, March 2010, pp 14-18; E. Antonio Mangubat, MD

Reconstruction of Acquired Scalp Defects: An Algorithmic Approach; Plastic & Reconstr Surg, Vol 116(4):54e-72e, September 15, 2005. Leedy, Jason E. M.D.; Janis, Jeffrey E. M.D.; Rohrich, Rod J. M.D.

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