A scalp reduction, also known as an alopecia reduction (AR), is a surgical procedure that creates a high-density appearance by removing the areas of the scalp that are experiencing hair loss. It was first coined by Dr. Sparkuhl in 1978, and he called it a “surgical excision of redundant tissue from one or more areas of scalp alopecia”. Although it can achieve results that are hard to replicate with traditional grafting procedures, it can come at a significant cost.
An AR procedure follows these steps:
Sometimes, the scalp is vigorously massaged for weeks before the surgery begins. This is to increase the scalp’s laxity. A scalp with a high level of laxity means that more of the scalp can be removed with less of a chance for complications.
It is not uncommon for a surgeon to use a scalp reduction in combination with a traditional hair transplant for maximum density but there is a danger of combining both procedures during the same operation. If there is too much trauma to the overall scalp then the interruption of blood flow can increase the chances of scalp shock loss as well as necrosis.
An ideal candidate for an AR procedure displays the following characteristics:
An AR procedure can be unsuccessful due to:
The chance of complication increases with the size and scope of the operation. A major scalp reduction may also be called a “scalp lifting”. This invasive procedure almost always involves severing blood vessels and nerves so that more of the scalp may be moved in a single sitting. While this does cut down on the number of procedures required, and may allow a surgeon to remove a larger portion area of scalp at once, this method always increases the likelihood of complications, and can even leave the scalp feeling completely numb forever. Nonetheless, an AR of any size always poses the risk of: