Updating reduction and flap procedures for baldness

Corrective surgery for baldness now includes scalp reduction, hair-bearing flaps, and punch autografts. When baldness is mild to extreme in the vertex or anterior vertex, scalp reduction is usually indicated. By reducing the bald area of patient with extreme alopecia, a dense back-ground of hair is provided for implants in both the anterior vertex and frontal regions. Hair-bearing flaps are recommended for those with a marginal outline pattern of excessive baldness and for those with very fine, sparse hair who wish to attain strong and dense frontal growth. Using these advancements results in immediate or "instant" hair. All available adjuncts should be considered for adequate coverage and a natural appearance in the extremely bald patient.