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What is Hair Flap Surgery?

Hair flap surgery is an outdated hair restoration method where the surgeon takes a “flap” of hair-bearing tissue from one side of the scalp and inserts it into the anterior region of the scalp. This extremely invasive operation is no longer in favor due to a lengthy recovery process that requires hospitalization along with a long and likely list of possible complications. It has also fallen out of favor due to the overall unnatural apperance it presents if not performed correctly as well as the reduction of options for subsequent surgical procedures to address continued hair loss. Much better hair transplant options exist today.

How is Hair Flap Surgery Performed?

To perform this operation, a surgeon generally follows these steps:

  • A long strip of tissue on the side of the scalp is cut on three sides in order to leave the blood supply intact.
  • The strip is twisted around and repositioned to lie across the hairline.

As the patient recovers, the repositioned scalp strip begins to grow hair.

A surgeon may also choose to completely sever the “flap” tissue for a wider repositioning range, though this method is typically reserved for burn victims or car wreck survivors.

Does Hair Flap Surgery Provide Satisfactory Results?

Most would agree that hair flap surgery provides inferior results compared to more modern hair transplant methods, especially considering the long and painful recovery process. More recent hair transplant methods have a quicker recovery time without the accompanying disfigurement.

Since this type of surgery repositions a large segment of scalp tissue, it leaves the patient with a new hair pattern that does not flow normally. Essentially, the newly-created, artificial hairline is now facing the wrong way, and the hair’s natural growth pattern has been disrupted in such a way that hair can actually grow upwards, away from the hairline, as opposed to downwards and forward like normal. This is why it is not uncommon for patients to have trouble styling their hair after this procedure.

In addition, a large bump appears on the part of flap that was not cut, where the tissue was pulled and rotated. There is no remedy for this bump – it is permanent, and part of every hair flap surgery.

Complications from Hair Flap Surgery

The main reason why this type of surgery has been largely discontinued is because of the high amount of potential complications, which include:

  • Necrosis – This style of hair transplant is a major surgery with lots of bleeding. If any area of the scalp is removed from the blood supply for too long, the tissue will die. This condition can spread if untreated.
  • Infection – The intense amount of deep surgical incisions and a large radius of exposed tissue makes patients of this operation especially prone to infection.
  • Scalp shock – The scalp may go through a type of reactive trauma that causes the existing hair to fall out.
  • Heavy scarring – The area that has been repositioned can be dramatically altered in texture and appearance.
  • The forehead skin can become too lax and slope over the brow, causing an exaggerated appearance.
  • The flap must be positioned absolutely correctly or else it will be quite noticeable.
  • Extreme structural changes – The scalp can shift out of place so much as to cause other areas to reposition as well. The ears can be pulled out of alignment or the neck can begin to intrude into the occipital scalp.

Currently there is no legitimate reason for flap surgery to be performed on an elective basis.

Return to the Hair Transplant Glossary

Further Reading

  1. What is Tumescence
  2. Strip Surgery
  3. Follicular Unit Transplant (FUT)
  4. FUSS
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