Experience with a make-it-yourself scalp extender with hooks

Silicone scalp extenders have been shown to facilitate the process of scalp reduction surgery.

This report demonstrates how scalp extender devices can easily be made in the physician's office out of materials that are commercially available.

A scalp extender is made by bonding a narrow strip of Dacron-reinforced Duralastic silicone sheeting to each end of a long strip of plain Duralastic silicone sheeting. A stainless steel plate of hooks is then secured to each end of the extender. At the time of the first standard scalp reduction surgery, one extender device about 3.0 x 5.0 cm is placed in the subgaleal plane, in the transauricular direction, with hooks piercing the galea 1 cm caudad to the dense-in-quantity hair fringe margin. The circumferencial approach will accommodate the placement of a second extender device in the anterior-posterior direction to elevate the posterior hair fringe. To prevent adhesion of the galea to the periosteum around the devices, a sheet of plain silicone 15 x 20 cm is placed over the periosteum before the extenders are inserted. The extenders are replaced with shorter devices 3-4 weeks later.

Usually the average width of bald scalp can be closed fringe to fringe in three operations as compared with five or six operations when using standard scalp reduction procedures.

The scalp extender device described can be custom made in many different sizes. Its use has significantly changed the author's surgical treatment of pattern alopecia.