[Tonsure reduction. Principles and innovation: scalp lift]

Amongst the surgical procedures for the treatment of baldness, tonsure reduction occupies a very important place due to the quality and the rapidity of the results obtained and the safety of the technique. However, the first descriptions of this technique are only recent, which may seem surprising in view of the fact that the principle of repeated reduction in general and the closure of skin defects by extensive detachment have been known for a very long time. Although the first techniques described were easy to perform, the results obtained were relatively minor and sometimes negligible in the case of poor elasticity of the scalp. Since 1976, techniques have been described using extensive detachment of the scalp. These techniques principally use the cutaneous elasticity of the cervical scalp region situated above the occipital protuberance. They therefore imply the sacrifice of occipital vessels and nerves and survival of the detached scalp depends on the superficial temporal arteries alone. Lastly, to palliate the only disadvantage of this technique, inability to cover the frontal region, we propose the simultaneous combination of the giant reduction technique or scalp lift with an anterior temporal vertical flap with a superior pedicle which, after rotation through 90 degrees, will cover the bald frontal region.