Minimal expansion for correction of male pattern baldness

Tissue expansion for correction of male pattern baldness has not gained wide acceptance by patients or surgeons because of the substantial albeit temporary deformity of the expansion. Minimal expansion is an alternative. Scalp flaps can be expanded just to the point of becoming noticeable over 4 to 6 weeks followed by scalp flap transposition and easy closure of the donor site. The temporoparietal (Juri) or superiorly based (Dardour) flaps have been used unilaterally or bilaterally. The entire restoration is completed in approximately 8 weeks, is minimally deforming during the expansion phase, and does not require the patient to alter his lifestyle significantly or to go into hiding. Hair grafts, in contrast, do not begin to grow hair until 12 weeks after transplantation, and the process usually requires four sessions over an 8- to 12-month period with the patient looking temporarily variably absurd. Tissue expansion increases scalp available for flap restorations, which appear more natural than even the most well-executed hair transplants. Minimal expansion makes the process more palatable to the patient and surgeon.