November 20 2006, 11:33 am PT | Posted in: Hair Transplantation + Other Surgical Procedures
Hi Dr. Rassman,
Can someone who is completely bald (everywhere, except the very back and sides) have a full head of hair like that of a teenager by the triple-flap procedure?
Is there any procedure or combined procedures to give a completely bald person that final result?
Best regards
There was an article in the news last week about this very procedure, which I am assuming is what prompted your inquiry.
The triple-flap is a corrective procedure, generally used to repair patients where slot deformities were created by scalp reduction scars (surgeries that tried to remove the bald spot). This article seems to be misleading, because it does seem to make clear enough that the triple-flap procedure should only be used to repair deformities of the scalp. If there are defects in the scalp that are not the results of multiple scalp reduction surgeries (like a burn), then many of these people need balloon expanders to shift large areas of the scalp. In any event, this is a very specialized field and something that I can not comment without examining you. Please send me photos (you may cover your face) and I will evaluate what you are talking about.
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Balding Forum
Dear Dr. Rassman,
As you know, Dr. Patrick Frechet has performed over 1500 triple flap procedures on men with crown balding. This procedure is mostly used to restore moderate to severe male pattern hairloss. It takes the hair from the sides and brings it up to the top through scalp extensions. It is the only procedure available today that can give total coverage to a class V patient with excellent density. With typical FUT, the densty in the crown is thin at best. With the use of the scalp extension and triple flap, we can double the density of the class V and actually give excellent coverage to the crown.
This procedure is used in the class III vertex through VI and occasional VI. Ages 35 and older are excellent ages for this procedure. PLease see results from this procedure at http://www.drdistefano.com/gallery2.html
thank you for allowing this discussion forum.
Sincerely, Mark S. DiStefano, MD Diplomate ABHRS
This surgery is the last phase of a series of scalp reduction surgeries performed on the patients shown. The fact that the doctor has mastered the triple flap procedures does not change the reality that scalp reduction surgeries have a bad rap in this industry today which are totally justifiable. I know this too well, because I have had three scalp reductions in the early 1990s with scars that could never have been fixed with the triple flap procedure but were successfully fixed with follicular unit transplantation. My opinion today is that scalp reductions are not a standard for this time era and these procedures should not be done for crown balding, contrary to the opinion of the doctor.
Dr. Rassaman,
I am one of NHI’s patients. As of today (2/12/09), it will be one-and-a-half weeks since your associate, Dr. Jae Paul Pak, performed a 1695-graft FUT procedure on me. The aesthetic outcome is as good as any I could have hoped for, and your practice receives my warmest endorsement. Thank you for providing the very best in environment and performance.
Last year, I visited your clinic’s “open house” session and during a group discussion I brought up the topic of Dr. Frechet’s scalp extension surgery for crown restoration and whether it had value for hair loss patients. If I remember correctly, you suggested that only in the most special of cases you would advise a patient to pursue this avenue of treatment, and that scalp reductions had ultimately failed their patients as a viable treatment for balding.
Now that I’ve read your blog posting in response to Dr. DiStefano, I can understand why you might reflexively reject allopecia reduction and similarly-styled surgeries. However, I do feel like this type of galeotomy, modified by Frechet’s findings, may procure benefits unattainable solely through the application of FUT/FUE transplantation. Other patients who were in attendance that day who heard your response to my question likely shuffled the possibility of such a treatment into the “Things NOT to Consider”-section of their mind, when in reality many of those same individuals who were in attendance that day could see a far more productive yield from a combined allopecia modality as suggested by Dr. Distefano (especially the attendees with advanced Norwood allopecia classes, or who possessed poor donor quality).
Ultimately, I have nothing but very positive things to say about the New Hair Institute. I have already made several recommendations of your clinic to others who are considering hair transplantation about its operational excellence, fantastic staff, and the master-class degree of skill in hair restoration which you and Dr. Pak possess. However, when other options are available, I feel that you, as a consultant and physician, are responsible to provide a more candid and thorough explanation of them. Being aware of all the possibilities might just provide someone suffering from baldness with the optimal information that gives them that new lease on life: the type which your clinic gave to me.
Best in All Things,
John Bows