Before
After

Patient RGL was an early Norwood Class 6 with dark brown hair and average scalp laxity. His donor density was above average. In 1970 he had an old type of hair restoration procedure called a flap, where a strip of hair is removed from the donor area and sewn intact into the hairline. This is called a Vallis flap or free flap, because it is completely removed from the donor area rather than rotated from it. Following the Vallis flap he has two subsequent hair transplant procedures where large grafts were placed on the top of the scalp and at the hair line giving an unnatural pluggy look to the already geometric appearance of the flap.

To decrease the pluggy appearance and harshness of the flap, we removed 44 large grafts and re-implanted them as 142 individual follicular units and added an additional 3,686 grafts over three follicular unit hair transplant sessions.

Slideshow of Hair Restoration

Before Repair - Vallis Flap and Large Grafts
Before Repair - Vallis Flap and Large Grafts
Flap Hair Lifted to Uncover Grafts - Top View
Flap Hair Lifted to Uncover Grafts - Top View
Before Hair Restoration - Right View
Before Hair Restoration - Right View
Before Hair Restoration with Flap - Left View
Before Hair Restoration with Flap - Left View
Plugs Around Flap Exposed - Left View
Plugs Around Flap Exposed - Left View
Flap and Grafts Combed Back - Top View
Flap and Grafts Combed Back - Top View
Position of Hairline - Top View
Position of Hairline - Top View
Grafts Redistributed as Follicular Units
Grafts Redistributed as Follicular Units
After 1st Hair Transplant Session
After 1st Hair Transplant Session
After 2nd Transplant Session
After 2nd Transplant Session
After 2nd Transplant Session - Top View
After 2nd Transplant Session - Top View
After 3rd Transplant Session - Top View
After 3rd Transplant Session - Top View
After Repair and Hair Restoration - Left View
After Repair and Hair Restoration - Left View
After Repair and Hair Restoration - Right View
After Repair and Hair Restoration - Right View
After 3rd Hair Transplant Session
After 3rd Hair Transplant Session

Detail of Hairline

These photos show the stages of the repair beginning with the removal of some of the larger grafts behind the flap and their re-distribution on the right side of the patient’s scalp. Most of the cosmetic improvement is achieved through the three subsequent follicular unit hair transplants where the additional hair was obtained from the donor area.

Top View

Top view with the hair from the flap moved away showing the plugginess of the front part of the scalp and the progression to a more natural look.

Left View

Left view showing the pluggy, unnatural left hairline corrected through a series of graft excisions and hair transplants.

Right View

Right view before and after the repair and subsequent hair restoration.

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Norwood Class



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Sessions



Hair Character



Hair Weight



Donor Hair Density


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