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The posterior scalp skin thickness is 1.48 mm; [3] the temporal scalp is 1.38mm; [3] and the anterior scalp thickness is 1.18 mm. [3] The scalp contains approximately 100.000 hairs. [citation needed] Hair lines make scalp reconstruction difficult because the hair lines must be respected to attain a satisfying aesthetic result. [4]
During the surgery, the excess forehead and/or scalp is excised and the scalp is advanced to the new hairline. The incisions are made in such a manner (trichophytic) so that hair regrows through and in front of the eventual hairline scar making it undetectable. [4] The scalp has to be separated from the skull going far back almost to the neck. [3]
Scalp reduction became very popular starting in the 1960s and, by the 1980s, was considered one of the most effective treatments for baldness. [ citation needed ] It is not commonly performed today, with around 5,000 men per year receiving hair transplantation [ 3 ] instead of a full scalp reduction surgery. [ 4 ]
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Before surgery all important landmarks and reference points must be identified and marked. Important landmarks are the hairline, frown lines, location of the supratrochlear vessels, outline of the defect, nasal and lip subunits. [1] Then templates are made using the intact side of the nose to make a precise symmetric reconstruction of the nose.
Cutis verticis gyrata is a medical condition usually associated with thickening of the scalp. [1] The condition is identified by excessive thickening of the soft tissues of the scalp and characterized by ridges and furrows, which give the scalp a cerebriform appearance. Clinically, the ridges are hard and cannot be flattened on applying pressure.