A special tissue expander in combination with extensive scalp-lifting

Although posterior closure of male pattern baldness is usually accomplished in two procedures when using extensive scalp-lifting, there is the occasional patient who will require three operations because of very poor scalp laxity. A newly developed horseshoe-shaped tissue expander was designed for these patients so that a third procedure could be eliminated. This differential expander is actually placed during the first extensive scalp-lifting operation. This differs from the conventional placement as a separate preliminary operation. The significant salient features of this expander and the technique of placement are discussed in detail.