Tissue expansion and flaps for surgical correction of male pattern baldness.

The author describes how to use a long, non-delayed temporo-parieto-occipital (TPO) flap across the total frontal hairline, and tissue expansion for coverage of the bald area behind the flap. This concept can be used successfully in extensively bald patients where two TPO flaps would not be sufficient to cover the total bald area. An even growth of hair is achieved. When the hair "reserve" is good, quite dense hair can be reconstructed. The flap described is performed under local anaesthesia without delays and does not have the risk of postauricular necrosis sometimes seen with certain designs of TPO flaps.