Testing Scalp Laxity for a Hair Transplant

Dr. Cam Simmons is a member of the Coalition of Independent Hair Restoration Physicians.

I am balding and want to know if my scalp is loose enough for a hair transplant. How can you test your own elasticity in the scalp? Is it just a case of seeing how much you can pinch between your fingers or when hair transplant surgeons do this do they use some kind of device?

Scalp flexibility is an important factor for follicular unit transplantation (FUT) and donor strip removal. Scalp flexibility is determined by how much the skin can stretch and how much the upper layers of the skin can glide over the bottom layers. Scalp exercises can sometimes increase the scalp flexibility but not always. A tight skin closure increases the risk of getting a wide donor scar so the safe width of the donor strip should be determined based on the flexibility of the scalp.

Doctors have different ways to assess flexibility. Some make a qualitative assessment while others use the method pioneered by Drs. Mayer and Paul, or caliper. With that method vertical marks are made 5 cm away from the midline and the scalp is compressed horizontally and the movement of the marks is measured. Ratios are used to determine how wide a safe strip can be. Other doctors, like me, use Dr. Jerzy Kolasinski’s method of determining vertical scalp laxity or VSL. A horizontal mark is made and a ruler is held to the skin. The skin is pushed and the upward movement and downward movement are added together. I take multiple measurements and use the total in each area as the maximum safe width of the strip at that point. It is not exactly what Dr. Kolasinski intended but it works for me.

It would be very difficult to measure your own scalp flexibility. Even men with flexible scalps won’t be able to pinch much scalp, like we can on our bellies. However, you can push your hands against your scalp and move it up and down to get a feel for how much it moves. A friend or family member could get a rough VSL measurement. You would need help interpreting the results of the Mayer-Paul method.

If you are experiencing hair loss and considering surgical hair restoration, your physician can assess your scalp laxity at a consultation.

Dr. Cam Simmons

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David – aka TakingThePlunge
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