Seong Ho Jeong has completed his PhD from Korea University and Postdoctoral studies from Korea University School of Medicine. He is a Professor of department of plastic surgery, Korea University Guro Hospital. He has published more than 20 papers in reputed journals.
The purpose of this study was to assess the appropriateness of the clinical indications for the various reconstructive methods for burn alopecia and suggest an algorithm for individualized reconstruction. A review of 83 patients who underwent reconstruction for burn alopecia was conducted. Demographics, associated injuries, preoperative ﬁndings, surgical techniques, and postoperative complications were collected. From these data, we classiﬁed reconstructive methods based on the area, the scar quality, and the location of the burn alopecia, and investigated the clinical outcomes. Reconstructive methods included hair grafting (n=13), scalp reduction (n=21), scalp extension (n=14), and scalp expansion (n=37). Hair grafting was mainly performed for reconstruction of small, good-quality burn alopecia located in the frontal or parietal area. Scalp reduction was primarily used in small or medium burn alopecia in which scar quality was good or moderate. Scalp extension was mainly performed for reconstruction of medium and moderate-quality burn alopecia; scalp extension was particularly successful in the vertex region. Scalp expansion was the reconstructive procedure of choice for large, poor-quality burn alopecia. Twenty-eight (33.7%) patients experienced surgical complications and most of the complications were related to alloplastic implants used in scalp extension and expansion. The reconstructive method should be tailored to the conditions of the burn alopecia. Because scalp extension and expansion are associated with a high rate of complications, the authors recommend the use of these methods for large, poor-quality burn alopecia. On the other hand, hair grafting and scalp reduction are more appropriate treatment options for relatively small, good-quality burn alopecia.
Background: Scars in hair bearing scalp present unique challenges. While scar revision is the main tool in the reconstructive surgeon’s armamentarium, at times it may have either contributed to the scar problem or may not be an ideal choice. Hair transplantation offers an alternative in select cases. A review of 12 repair cases is presented with discussion of specific nuances particular to graft placement into scar tissue. Materials and Methods: Review of 12 cases of hair transplantation to repair scars in hair bearing scalp in patients with at least 1 year follow up. Results: All 12 patients had good to excellent coverage of their scars with hair transplantation using follicular unit harvest by either strip or FUE. In 3 patients, particularly dense and fibrous parts of the treated scar showed less growth but still a significant growth yield. Full growth often required 15 months. Discussion: In this series, both strip and FUE graft harvest was utilized. In both techniques, minimal trimming of subcutaneous tissue was performed so that the follicular unit was transplanted with slightly more surrounding tissue than for a standard hairline case. Recipient slits were therefore made slightly wider, averaging 1.25mm and minimal pressure was used in graft placement. Conclusion: In patients with scars in hair bearing scalp, hair transplantation offers an alternative to surgical scar excision. Careful harvest and placement of slightly thicker grafts into properly created recipient slits yields consistent and cosmetically pleasing results.