Scalp Lifting

In 1994, Dr. James M. Swinehart and Dr. Dominic A. Brandy presented a detailed discussion on scalp lifting, a surgical technique for treating male-pattern alopecia by removing large areas of bald scalp. They provided anatomic and technical considerations, including the "Ten Commandments" for successful surgery, which emphasized proper planning, patient preparation, and understanding of anatomy. The procedure, which was not widely accepted at the time, was described as capable of safely and effectively removing significant amounts of bald scalp, potentially in one to three operations. The authors noted that scalp lifting had advantages over traditional scalp reduction, such as removing more bald skin and saving donor grafts. They recommended preoperative scalp massage and expansion to increase laxity and prior occipital artery ligation to reduce necrosis risk. The paper reported minimal complications in over 200 recent cases and suggested future improvements to the technique. The authors concluded that careful attention to surgical details and training could maximize successful outcomes in scalp lifting surgery.