Corrective strategies for poor appearance after tissue expansion for temporal and sideburn cicatricial alopecia

The expanded scalps are usually used to repair the scalp defects. However, hair growth direction and hair density of the expanded scalps may be inconsistent with those of the defective sites, resulting in unsatisfactory results.

The aim of this study was to assess the effect of local flap modification and follicular unit extraction (FUE) on the repair of poor appearance of temporal and sideburn after unsatisfactory tissue expansion.

In our study, 19 patients with problems of hair growth direction or hair density after surgery were treated with the following four methods: single local flap modification; removal of hair follicles by FUE to reduce follicle density; removal of disordered hair follicles by FUE and ectopic transplantation simultaneously; and removal of hair follicles by FUE and ectopic transplantation after local flap modification. The follow-up periods of 19 patients varied from 6 to 30 months, and natural, standardized aesthetic sideburn for each patient was achieved.

All incisions healed by first intention and all flaps survived well. The scars involved in the removal of FUE hair follicles were not obvious.

Our results revealed that the ideal and cosmetic results can be obtained by flexible using of local flap modification, single FUE method, and FUE ectopic hair transplantation to repair the dissatisfied postoperative outcomes of temporal and sideburn cicatricial alopecia after tissue expansion.