Slot Correction by the Frechet Flaps in Hair Restoration Surgery

두발재건 환자에서 Frechet 피판술을 이용한 선상 반흔제거

  • Shim, Jae Sun (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Yoon, Eul Sik (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Kim, Deok Woo (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Dhong, Eun Sang (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Yoo, Sang Chul (Department of Plastic Surgery, Korea University College of Medicine)
  • 심재선 (고려대학교 의과대학 성형외과학교실) ;
  • 윤을식 (고려대학교 의과대학 성형외과학교실) ;
  • 김덕우 (고려대학교 의과대학 성형외과학교실) ;
  • 동은상 (고려대학교 의과대학 성형외과학교실) ;
  • 유상철 (고려대학교 의과대학 성형외과학교실)
  • Received : 2006.08.25
  • Published : 2007.05.10

Abstract

Purpose: A common side effect of the scalp reduction is a creation of a 'slot' with the hair growing in the opposite directions away from the scar. Overcoming the unnatural appearance of the slot has been a vexing problem in the scalp reduction surgery. None of the conventional corrective surgical techniques provides a complete and satisfactory aesthetic result. The Frechet flap is a triple transposition flap used for the correction of the slot defect secondary to scalp reduction surgery, seldom needing further scar revision. The Frechet technique provides a solution to the problem of the central slot concealment that is unattainable by other means, such as; Z-plasty and mini-graft. Methods: Authors applied the Frechet technique to Asian patients who had undergone scalp reduction and operated on 4 patients from March, 2000 to January, 2001. Average follow-up period was 13 months. Patients with long scars passing through the temporoparietoccipital zone were excluded. All the undermining was performed in the subgaleal plane, reaching the upper auricular sulcus and stopping just above the nuchal ridge. Results: None of the patients experienced infection, hematoma, nor any permanent hair loss. Transient telogen effluvium at the distal end of flap 2 and 3 was noticeable in one case. Conclusion: In conclusion, the results are aesthetically satisfactory without any significant complications.

Keywords

References

  1. Norwood OT, Shiell RC, Morison ID: Complications of scalp reductions. J Dermatol Surg Oncol 9: 828, 1983
  2. Nordstrom RE: Change in direction of hair growth. J Dermatol Surg Oncol 9: 156, 1983
  3. Frechet P: How to avoid the principal complication of scalp reduction in the management of extensive alopecia. J Dermatol Surg Oncol 11: 637, 1985
  4. Frechet P: Micro and mini hair grafting using the standard hair implantation procedure. J Dermatol Surg Oncol 15: 533, 1989
  5. Frechet P: A new method for correction of the vertical scar observed following scalp reduction for extensive alopecia. J Dermatol Surg Oncol 16: 640, 1990
  6. Brandy DA: Consecutive wide and long single hairbearing transposition flaps in combination with hair transplantation for the management of slot formation after alopecia reducing surgery. Dermatol Surg 22: 355, 1996
  7. Nordstrom RE: Scalp kinetics in multiple excisions for correction of male pattern baldness. J Dermatol Surg Oncol 10: 991, 1984