Do Hair Flaps Provide Better Coverage for Norwood 5 or 6 Patients?

My question is regarding hair flap surgery or if you call it scalp flaps. If a person is a Norwood 5 or 6 balding pattern and cannot achieve desired result from hair transplants would one be able to get full coverage or density from undergoing hair flap surgery? If there is not enough donor hair will a person get more coverage from hair flap surgery? — M.K.

A Norwood 5 or 6 can achieve adequate or desired density from follicular unit transplantation if he has sufficient donor hair and the surgery is performed by a qualified surgeon. Only a handful of surgeons can produce such a result. A flap procedure is not generally recommended by the top hair restoration surgeons. A flap can produce an unnatural hair direction and angle. A scar is created right at the hairline. Generally, high density up front and a significant drop off or lack of hair behind also contributes to an unnatural appearance. It is not as natural as a true follicular unit grafting procedure. If the patient has average donor area characteristics, the overall result of a follicular unit hair transplant will be superior to the flap even if the density is not as high.

— Jerry Wong, MD

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