What Does Scalp Reduction Surgery Involve? (photo)

I have a skin graft on my scalp. My surgeon said that scalp reduction surgery would make the area smaller. What does this surgery involve? Would my head have to be shaved? I am a 16 year old female. How long is the surgery?

Doctor Answers 6

Scalp Reduction Surgery to Remove Skin Graft

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The technique is done by stretching and advancing the surrounding normal hair bearing scalp to replace the scar that is removed. Depending on the size and location of the scar expanders can be used to completely remove larger scars.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Scalp Reduction

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I love performing Scalp Reductions and Scalp Shifting procedures.  A direct consultation with an experienced Cosmetic Surgeon is in order for you with your Mother.

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Scalp Reduction Surgery to remove Skin Graft

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Hi Morgan, thanks for your question.

In your situation it sounds as though the aim of scalp reduction surgery is to remove part of the skin graft area on your scalp, which will make your bald spot smaller. I'm unsure of the size of your skin graft, but it may well be possible to have the skin graft completely excised if you have a number of operations spaced a few months apart. Usually an area about 3-4 centimetres wide can be removed from the scalp and then stitched closed. It is not possible to take out a larger area than this in a single operation because the scalp will only stretch 3-4 centimetres at a time.

This type of surgery is quite common and is called "serial excision". It can be used to remove a bald area on the scalp, or to remove a birthmark or even a tattoo. If a patient wishes to have an area removed and it is estimated that this will take more than 3 attempts to achieve complete clearance then surgeon mays suggest an alternative technique involving tissue expanders. The tissue expanders are placed under normal scalp tissue next to the skin graft or birthmark, and are then inflated over time (like a balloon) to stretch the normal skin. Tissue expanders are used because it means fewer surgeries to remove a large skin graft or birthmark. Once they have been expanded they are removed and the stretched skin is used to replace the area of skin graft or birthmark.

I do not shave the scalp when doing scalp surgery because I know that my patients don't wish to have a bald patch, even if it's temporary!

This type of surgery will usually take less than 40 minutes to do, and would be performed either under sedation (combined with local anaesthetic) or general anaesthetic. Your surgeon will give you instructions regarding when you can wash your hair again; usually you will be advised not to get your hair wet for a few days so you may wish to find a hat or scarf to cover your hair when you go out.

Good luck!

Jill Tomlinson, MBBS, FRACS
Melbourne Plastic Surgeon

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What Does Scalp Reduction Surgery Involve?

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 Because you are under 18 years old, please share this answer with your parents.  Scalp Reduction means removing a section of the scalp and can be done to reduce the area of bald scalp, raise the hairline or in this case reduce the scar area.  The length, of the scalp reduction, depends on what is planned and the degree of difficulty but would most likely be an hour or two.  No, typically the hair is parted where incisions are planned...the hair is not shaved.  Hope this helps.


Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Subtotal vs Total Scalp Scar Excision

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Removal of a part or all of your skin graft is done by freeing up the scalp along the sides of it and seeing how much can be moved to replace the skin graft. This may make it possible to just remove a portion of it or all of it. This will determine whether one or two surgeries are needed to get it all out. No hair is shaved for the procedure.

What Does Scalp Reduction Surgery Involve?

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If you've had a skin graft placed due to a burn, injury or scalp lesion removal, then a scalp reduction would involve removing some (or all) of the skin graft and advancing the scalp the close the resulting defect. This can be facilitated with tissue expansion during which a small balloon is placed under the scalp and filled over a period of weeks to stretch the scalp. Galeotomies can also be performed during surgery to help the scalp stretch and cover the defect. The ultimate result and number of procedures you might require depend upon the size of the skin graft and whether or not tissue expansion is performed. I hope this information is helpful.

Stephen Weber MD, FACS

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.