A philosophy and strategy for surgical hair restoration: a 10-year experience.
BACKGROUND
Three principal strategies have evolved for surgical hair restoration: follicular grafting, scalp reduction, and flap rotation.


OBJECTIVE
Although grafting techniques have assumed a preeminent rank as the cornerstone of modern hair-replacement therapy, scalp reduction and rotation methods should not be entirely dismissed.


METHODS
Over the past 10 years of clinical experience, the authors have relied on all three methods of hair restoration, carefully tailoring the optimal surgical approach to the patient's expressed concerns and particular regional hair deficit.


RESULTS
We have found that scalp reduction and rotation provides a considerable density of hair unmatched by any grafting technique for the vertex and frontotemporal regions, respectively.


CONCLUSIONS
Also we have concluded that the former yields the most natural result for a patient with significant crown baldness who desires hair restoration in that area. However, micro- and minigrafting still represent the overwhelming majority of our operative cases. This article attempts to review the surgical methodology and philosophy that have guided our approach to hair restoration.
Lam
Samuel M
SM
Lam Facial Plastic Surgery Center, Dallas, Texas, USA.
Hempstead
Brian R
BR
Williams
Edwin F
EF
D000505:Alopecia / Q000601:surgery*; D006197:Hair / Q000637:transplantation*; D006801:Humans; D011183:Postoperative Complications; D011300:Preoperative Care; D012535:Scalp / Q000601:surgery*; D013524:Surgical Flaps; D014182:Transplantation, Autologous / Q000379:methods