Scalp Surgery Fact Sheet

The objective

Scalp surgery aims to change the size and position of areas of the scalp so that the patient looks less bald, although unlike hair transplantation surgery, this does not involve transferring the tiny hair follicle units individually. Three main techniques are used within this area of surgery: scalp flap surgery, scalp reduction surgery, and scalp extension.

The procedure

The procedures can be carried out using local anaesthetic and the length of each depends upon what the procedure involves.

Depending on the hair growth, the surgeon may recommend a single procedure or a combination of the three types.

Scalp flap surgery involves three operations over a period of three weeks. A hair-covered section of the scalp is moved to a bald area and then it is stitched back together.

Scalp reduction surgery involves a single operation. Some of the balding skin is removed and replaced by stretching a nearby area of hair-covered skin over the piece of scalp that has been removed. It is then stitched back together.

A scalp extension may involve up to three operations over a few months. Here, an area of the scalp will be stretched and loosened by placing an expansion device underneath it for a few weeks, followed by scalp reduction surgery.

The outcome

Following the procedure, the treated area may be red, sensitive and painful for a short while.

Normally, you can leave the clinic soon after the procedure. You can usually return to work and resume activities immediately, but you will need to avoid hair-washing until the area has healed.

Depending on the type of surgery, you can expect bald patches on the head to be reduced, with an increased number of hair-growing areas, as a result of this surgery.

The risks

All local anaesthesias carry some risk but complications associated with scalp surgery include infection, problems with wound healing and scarring. Haematoma (blood clot), seroma (fluid build up under the skin), nerve damage and the occurrence of asymmetries or irregularities may occur.

Necrosis, where the blood supply is affected and the skin dies, is a risk with scalp flap surgery.

‘Slot deformity’ is an odd-looking indentation along the scar and ‘slot defect’ is where hair grows in the wrong direction around the scar.

The bald spot may actually grow larger as the skin returns to its former position.

Scalp reduction surgery (without a corresponding scalp extension) is only effective in covering small areas of balding skin as most people’s scalps cannot stretch very much.

The costs

In the UK, expect to pay from around £1,600. Abroad, expect to pay from around £800 - £2,000 (USA).

The availability

Scalp surgery is a specialist procedure available at some private cosmetic surgery clinics and specialist hair care clinics within the UK and abroad.

The popularity

Scalp surgery is popular with patients who are not good candidates for hair transplantation yet who would like to reduce the areas of baldness on the head because they are self-conscious. Scalp reduction surgery can also make men better candidates for hair transplantation in the long-term (since they leave less bald patches on the head), so some may opt for this surgery with a view to undergoing hair transplantation in the future.