Is There a Surgery to Reduce the Size of a Scalp Skin Graft? (photo)

Is there a surgery available to reduce the size of a skin graft on my scalp? I've attached a picture. I'm a young adult, and am very self-conscious about having a bald spot. My surgeon said this is possible, but I'd like some more information in order to make the best decision that I can.

Doctor Answers 7

Modified forehead lift wll remove skin graft.

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I think you need something called tissue expansion, where a balloon is placed under the scalp next to the graft to stretch the normal scalp.

Manhattan Plastic Surgeon

Scalp Reduction To Restore Hairline

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There are several procedures that can be used to remove the skin graft and restore your hairline. The most conservative is a staged excision removing part of the graft at each surgery.  The next approach would be to place a tissue expander in the scalp to expand the scalp skin followed by removal and closure. The final is a scalp flap procedure where incisions are made in the scalp to re-arrange the hair bearing scalp to restore your hairline. All are reasonable options.

Removal of Scalp Skin Graft

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The best technique to totally remove a large scalp skin graft is the use of a tissue expander. The technique, which is described on our website, enables us to totally remove the graft and replace it with normal hair bearing tissue from the surrounding scalp.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Tissue Expansion Needed For Scalp Skin Graft Excision And Hairline Reconstruction

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Given the size and location of your scalp skin graft, your best reconstructive option is a staged approach using tissue expanders. Hair-bearing scalp deficiences at the frontal hairline ar very challenging because all of the expansion must come from behind. Two tissue expanders will need to be placed with a 6 week expansion schedule until enough scalp tissue is created for skin graft excision and a scalp rotational flap.

Tissue Expanders, Scalp Rotation Flap, Hair Transplants

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        Although you could try a rotation advancement flap at the beginning and hair transplants for camouflage, the area appears to quite large.  Usually areas of the scalp larger than 5 or 6 cm, need more complicated procedures like tissue expansion and then scalp rotation flap.  The tissue expanders are unsightly on the scalp and face, and this typically makes this option less appealing.

Scalp defect from skin graft in the temple hair area.

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This looks like a relatively large area of baldness that might be 8 cm in diameter. It is best handled be use of one or two tissue expanders inserted under the scalp above and perhaps in back of the defect. It usually takes six weeks of filling the expander(s) to stretch the scalp sufficiently to perform a second procedure which would be an advancement rotation flap to get hair to fall close to the natural downward growing direction in the temple. It looks like you have a small rim of your native hair at the front of the defect so there can be good camouflage of a narrow scar from the flap procedure. Otherwise some hair transplant grafts might be considered. 

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon

Scalp defect

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The scalp defect can be repaired and recomstructed by tissue expansion.

Tissue expander is inserted under the scalp and once enough skin is expanded then another surgery is needed to remove the tissue expander and advane the skin to cover the skin grafted area. Remember the expansion process gives an effect of thinned hair, may not be as noticable.

Samir Shureih, MD
Baltimore Plastic Surgeon

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.