Aesthetic Dimensions

Analysis

Nose

Chin

Cheeks

Ears

Lips

Liposculpture

Eyes

Eye Brows

Face-Lift

Skin Resufacing

Hair

Aging

Consent

Two types of hair flaps are frequently created: the long flap and the short flap. The concept of the flap involves taking hair that is abundant along the sides and the back of the scalp and moving this hair to the frontal area of the scalp.

The long flap has the advantage of taking a long strip of hair-bearing tissue from the sides and the back of the scalp; this flap reaches completely across the frontal scalp to the opposite side. A flap then can be taken from the other side and placed in front of this flap if desired. The disadvantage of the long flap is that it is a staged flap requiring two delay procedures before the definitive transfer. Nevertheless, these delay procedures help increase the reliability of the flap procedure.

This series of drawings illustrates the short flap procedure bilaterally. At far left, the area of excised non-hairbearing scalp that is excised is shown. The flap's vascular supply is evident within the outline of the flap. The center drawing shows transposition of the short flap to fill in the defect after excision of non-hairbearing scalp. At far right, the final result after bilateral short flap transposition is shown with lowering of the frontal hairline.

The short flap has the advantage of being a one-stage procedure but has the disadvantage of being shorter; it reaches only about midway across the frontal scalp. Thus a second short flap procedure from the opposite side may be required to complete the result. Both flaps are based upon an artery and a vein that run within the mid-portion of the flaps. This blood supply allows for a rapid reconstruction of the frontal hairline; results can be seen immediately, without having to wait three to four months as is required with hair transplantation. Flaps also allow for the most dense frontal hairline reconstruction. In selected cases, a few micrograft plugs can be placed just in front of the flap to help camouflage the scarline, if needed. The accompanying drawings depict the two flap procedures.

These drawings show the long flap procedure. At left, the area of excised, non-hairbearing scalp is shown, and the vascular supply of the flap is shown before transfer. At center, the transposition of the flap to fill in the area of excised scalp is shown. At far right, the final result is shown after transposition of the left sided long flap. Note lowering of frontal hairline.