If you’re beginning to lose your hair, you may have looked into surgical procedures to treat hair loss and help you maintain as much of your hair as possible as you get older.
Scalp reduction surgery, or alopecia reduction (AR), is a type of surgery that involves surgically removing the parts of your scalp affected by hair loss and replacing them with skin that contains active, growing hair follicles.
As one of the oldest surgical procedures for treating hair loss, scalp reduction surgery has, since the mid-1970s, been in use.
Although it was once one of the most effective surgical procedures for treating hair loss caused by male pattern baldness, scalp reduction isn’t very popular today. Instead, most men with hair loss opt for more modern procedures such as hair transplant surgery.
Nonetheless, scalp reduction surgery still offers advantages that may make it worth considering if you’re losing your hair.
Below, we’ve explained what scalp reduction is, as well as the basics of how the surgery works for you as a prospective patient.
We’ve also listed the key advantages and disadvantages of scalp reduction surgery, as well as information on other surgical procedures and medications for treating hair loss caused by male pattern baldness.
Scalp reduction surgery is a surgical procedure for restoring hair. It involves surgically excising (cutting away) the areas of your scalp with extensive hair loss, then stretching the areas of skin with dense, thick hair to replace the removed skin.
Put simply, the procedure involves covering the bald areas of your scalp (typically the hairline and top of the scalp) with the hair-bearing skin from the sides.
Although this doesn’t actually increase the number of hairs on your scalp, it helps to create the appearance of fuller, thicker hair.
Compared to modern hair restoration techniques, scalp reduction is a relatively old procedure. It was first developed around 1977 and was practiced throughout the late 70s, 80s and 90s as a treatment method for extensive hair loss.
As mentioned before, scalp reduction surgery isn’t for everyone. It’s generally recommended for men above the age of 40 with Norwood Grade 4, 5 or 6 hair loss (in other words, significant hair loss on the frontal scalp and crown).
It’s also usually recommended for men with stable hair loss and dense hair on the sides of the scalp (the area that’s used to cover the balding patch).
Several methods are used to perform scalp reduction surgery. The most common involve skin removal from the areas of the scalp affected by male pattern baldness in an ellipse, three-way (also known as “rocket ship”) pattern or an S-shaped or M-shaped pattern.
If you’re considering scalp reduction surgery, your surgeon will pick the most effective incision type based on your hair loss pattern, scalp laxity (how tight or loose your skin feels) and other factors.
The principle behind the surgery is to remove as much of the hairless scalp as possible, while protecting and preserving your hair-bearing skin.
After removing the areas of skin with hair loss, the surgical wound is closed, covering the hair loss affected area and creating the appearance of a fuller, thicker head of hair.
Scalp reduction surgery is sometimes combined with other surgical procedures, such as hair transplant surgery. Transplanting hair can allow for extra coverage and improved thickness in certain areas of your scalp.
Scalp reduction surgery offers several advantages. The biggest of these is that it can create the appearance of a fuller head of hair in men with extensive hair loss. Performed correctly, a scalp reduction can often create a convincing, aesthetically pleasing result.
A second advantage of scalp reduction surgery is that the hair used to cover up the bald area of the scalp is sourced from the back and sides of the head.
This hair is more resistant to DHT (the hormone that causes male pattern baldness) and is less likely to fall out in the future.
From a surgeon’s perspective, most scalp reduction procedures are easy to perform and have a relatively high safety factor. These advantages made scalp reduction surgery a popular option for treating hair loss prior to more modern techniques.
Scalp reduction surgery was very popular in the 70s and 80s. However, it’s declined in popularity as newer, better surgical techniques were developed for treating hair loss.
One reason for scalp reduction surgery’s decline in popularity over the last several decades is its lengthy list of disadvantages. These include:
Scalp reduction surgery was once a relatively popular treatment for hair loss. Today, it’s largely been replaced by newer treatment options, such as hair transplant surgery and science-based medications like finasteride and minoxidil.
A hair transplant is a cosmetic surgical procedure that involves extracting hairs from the back and sides of your scalp (areas resistant to DHT), then transplanting to your hairline, crown or other parts of your scalp with noticeable hair loss.
Since these hairs are less affected by DHT, they’ll continue to grow even if you’re genetically prone to male pattern baldness.
Hair transplants can vary in magnitude. If you have extensive hair loss, you may need to have several thousand hairs harvested and transplanted.
If you only have a mild receding hairline, a smaller transplant may be enough to completely restore your hairline.
Although early transplants were infamous for their “pluggy” appearance, modern hair transplant techniques involve extracting and transplanting just a few hairs at a time, allowing for a hairline with a natural look and feel.
Hair transplant surgery can be highly effective, but it isn’t cheap. Depending on the size of your transplant, your location and the surgeon you choose, you can expect to spend anywhere from $3,000 to $15,000 or more to undergo hair transplant surgery.
Several FDA-approved, science-based medications are available to slow down or stop hair loss and stimulate the growth of new hair:
Although scalp reduction surgery was a popular option for treating hair loss in the past, it’s far less common today due to its less-than-ideal results and risk of scarring.
Instead, most people looking for a surgical option for treating hair loss use hair transplantation surgery, a procedure that involves harvesting hairs and physically transplanting them to areas with noticeable hair loss.
In addition to hair transplantation, FDA-approved medications like finasteride and minoxidil can slow down or stop hair loss, allowing you to gain control over male pattern baldness and retain your hair as you get older.