Postoperative Necrosis Following Bilateral Lateral Scalp Reduction

The document reports on three cases of postoperative necrosis following bilateral lateral scalp reduction, a surgical procedure intended to reduce the area of baldness. The author, Martin G. Unger, M.D., F.R.C.S. (C), observed a significantly higher incidence of this complication than previously reported, with his own practice experiencing a 20% incidence rate. One patient was unable to return to work for over two months due to the necrosis. The severity of the complication could be extreme, with some cases in Australia resulting in the loss of the entire hair-bearing portion of the scalp. Dr. Unger had performed approximately 4,000 scalp reduction operations without postoperative necrosis before trying the bilateral lateral reduction. Due to these findings, both Dr. Unger and Dr. Marzola, who had a 100% incidence rate of necrosis in his practice, have abandoned the procedure. Dr. Unger advises other physicians to consider safer alternatives for scalp reduction that, while taking more time, avoid this serious complication.