Consecutive wide and long single hair-bearing transposition flaps in combination with hair transplantation for the management of slot formation after alopecia reducing surgery.

[BACKGROUND] Because the Frechet-style triple hair-bearing transposition flaps use up a great deal of scalp laxity from both occipitoparietal areas, it is virtually impossible to perform simultaneous donor harvesting for hair transplantation. The flaps in this technique are also prone to tip necroses due to their narrow width and pointed tips. This article presents a sequential protocol that dramatically and easily treats the slot, while simultaneously allowing hair transplantation to be performed to the frontal area.

[OBJECTIVE] To present a simple method that combines hair transplantation with consecutive wide and long single hair-bearing transposition flaps for the management of slot formation after alopecia reducing surgery.

[METHOD] A wide and long single hair-bearing transposition flap is first performed. The area directly inferior and contralateral to the side from where the superior flap is transposed is then used for donor harvesting. This method is repeated with each progressive hair grafting session until the desired result is accomplished.

[RESULTS] In the over 100 cases performed by the author to date, the results have been consistently excellent with complications nonexistent thus far.

[CONCLUSION] Using consecutive wide and long single hair-bearing transposition flaps is a safer, more aesthetically pleasing, and easier way to manage slot formation when compared with the triple flap technique. Besides these advantages, it affords the surgeon the opportunity to work on the frontal hairline immediately after the flap procedure is performed.