title: Circumferential scalp reduction with a suture-in-place Silastic-Dacron extender.
abstract: BACKGROUND
  Circumferential scalp reduction combined with a suture-in-place Silastic-Dacron extender is described as a viable alternative for those surgeons wishing not to perform extensive scalp-lifting. The primary advantage of the Silastic-Dacron extender is that it allows the time interval between surgeries to be shortened to 1 month.
  
  
  OBJECTIVE
  To incur the benefits of circumferential scalp reduction (minimal stretch-back and decreased slot formation) and the decreased time between sessions offered by a suture-in-place Silastic-Dacron extender.
  
  
  METHODS
  A circumferential scalp reduction is first performed and a tunnel is made under the central bald peninsula. Once this is completed, a 4-cm-wide Silastic-Dacron strip is passed through the tunnel and is sutured to both lateral edges of the galea under tension. The way to determine the proper length of the strip is described.
  
  
  RESULTS
  The combination of circumferential scalp reduction with a suture-in-place Silastic-Dacron extender gives results that are comparable to scalp-lifting; however, more procedures are required and not as much upward movement into the crown is accomplished. The memory of the Silastic-Dacron extender has been found to eliminate stretch-back and quickly improve scalp laxity.
  
  
  CONCLUSIONS
  Circumferential scalp reduction combined with a suture-in-place Silastic-Dacron extender is an extremely viable method to treat patients with extensive baldness. The decrease in slot formation and minimal stretch-back afforded by circumferential scalp reduction and the shortened 1-month time interval between surgeries brought about by the Silastic-Dacron extender make this a procedure that hair replacement surgeons should have in their armamentarium.
authors.affiliation: Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Brandy
mesh_terms: D000505:Alopecia / Q000601:surgery*; D006801:Humans; D011093:Polyethylene Terephthalates; D019736:Prostheses and Implants; D012535:Scalp / Q000601:surgery*; D012826:Silicone Elastomers; D013518:Surgery, Plastic / Q000295:instrumentation / Q000379:methods; D013536:Suture Techniques
chemical_list: D011093:Polyethylene Terephthalates; D012826:Silicone Elastomers