Some very good points made by whiskey. This type of cosmetic surgey is also referred to as a "brow lift", and from my experience is mostly sought by women who do not have and/or not been formally diagnosed with androgentic alopecia. They simply desire a lower hairline rather than the one given them by mother nature. There are some cases involving men however IMO those males with genetic hairloss should never consider such a procedure because as was already mentioned, they run the high risk of continued haiross due to the progression of male pattern baldness, and then what to do with the scar that's left visible. :freaked: Or I'll ask the younger patient, "what are you going to do when you get older and now the low juvenile looking hairline appears unnatural"? Are you going to have that hair removed when you're forty or fifty years old? :freaked:
I have never been an advocate of cosmetic flap surgery as well. In fact this approach of surgical hair restoration dates back centuries in Asia. Note that in most cases there are scalp reductions done between the flaps or hair bearing scalp. OUCH!! Talk about scarring?! Just ask anyone who had a scalp reduction, especially the "mercedes method", where the scalp is pulled in three directions, tissue removed, and then closed with sutures which when healed leaves a scar pattern that looks like a peace sign from the sixties. I have physically seen many patients who had this mercedes method done in the eighties when it was more popular and most of them had open-donor (plugs) procedures that coincided with the scalp reduction procedures.
Some of you guys know how I continually warn patients that male pattern baldness is indeed progressive so guess what happens to the patient who continually loses hair around their plugs and scars? The scars show and lots of times stick out like a sore thumb. That's a tough place to be and cannot be reversed. Most of the patients I have conversed with tell me if they had to do it over again, NO WAY.
Thankfully more advanced methods in isolated extraction techniques can now thin out plugs by removing some of the FUs within the plugs so they don't stand out as much visually speaking. This is especially helpful to the patient with a wide color contrast. Bottom line? There is far more hope for the repair patient utilizing FUE extractions even from the body although I am not a proponent of patients doing large BHT procedures simply becuase of the lack of clinical documentation on yields.
IMO patients with male pattern baldness and especially those with virgin scalps should REALLY THINK TWICE regarding brow lifts, flaps, and scalp reductions. And I also agree with whiskey that pics really do not do the justice on these type of procedures. I mean the ideal is to physically see patients face-to-face on any type of cosmetic surgery and especially the ones where scarring is left in a high visual impact area like the frontal scalp, face, etc.
Remember one thing. Everyone heals differently. There are never any guarantees on post-op scarring "anywhere" on the body.
Lastly, hairlines are something that commence in FUs of primarily ones and occaisionally twos here and there, but mostly ones. That's how mother nature establishes hairlines and why a natural hairline is designed that way surgically speaking. When utilizing a flap, which edge do you bring to the hairline area? :shock: I just don't think a flap taken from the sides (rim) area is going to look natural in the frontal zone of the scalp, that's my opinion.