The one-stage preauricular flap for male pattern baldness: long-term results and risk factors.

Following a review of the operative technique for a single-stage vertical flap for reconstruction of the frontal hairline, we present a series of 156 such flaps with a minimum follow-up of 6 months. Risk factors for necrosis or alopecia of the distal end of the flap include retroauricular design and cigarette smoking. There was not a single case of necrosis in nonsmokers with flaps shorter than 16 cm. Finally, we demonstrate that the final appearance of the donor site is directly related to the tension under which it is closed.