Obliteration of alopecia by hair-lifting: a new concept and technique.

A new concept and technique of treatment of male-pattern alopecia are described. The concept is to remove, in serial stages, segments of skin that measure about 3 cm by 7 to 10 cm from the bald area of an alopecic scalp, and to raise the remaining hairy portion into the previously bald area.The technique consists of undermining the skin in the normal plane of cleavage between the galea and the sub-aponeurotic loose connective tissue after each removal of bald skin and "lifting" of hairy skin into the operative defects as they are obliterated by primary closure. By this method, which we call hair-lifting, the patient benefits also from an associated partial face-lift. Whatever remains of baldness after as much hair-lifting as feasible has been performed, is filled with "punch" grafts or free or pedicled strips. Each stage of the procedure is done under local anesthesia. The entire procedure is particularly suitable for tonsure baldness in men and even in the skull-cap type of androgenic alopecia in women.