Advantages of the paramedian scalp reduction

The paramedian scalp reduction as compared to the midline (sagittal) scalp reduction provides distinct advantages, particularly in the patient who has undergone reconstruction of the frontal hairline. The paramedian approach causes less distortion of the frontal hairline, allows greater direct visualization of the advancement flaps, permits more extensive undermining, creates less stretchback, provides for coronal advancement of the hair-bearing occipital donor site, and allows for a greater amount of camouflage of the scalp reduction scar during the immediate postoperative period. Surgeons should be knowledgeable and capable of providing varied forms of scalp reduction procedures to meet the specific needs of the various patients that present for hair replacement surgery.