Is There a Place for Scalp Flap in Modern Hair Restoration Surgery?

  • Kenichiro Imagawa


Punch graft has never been popular in Asian countries as its corn-row appearance is more conspicuous with the coarse black hair of Asians. On the other hand, scalp flaps were well accepted and have enjoyed popularity since the 1970s. There are many types of scalp flap (Table 1); however, I will concentrate on my experience with the Fleming and Mayer flap, which is the modification of Juri’s flap first described in 1980 [1]. When compared with the punch graft, flaps have the advantages of achieving immediate results, no temporal hair loss, outstanding density, and the possibility to re-allocate a large amount of hair.
Table 1.

Various types of hair-bearing flaps

Temporo-parieto-occipital (TPO) flap

Juri 1974

Occipital flap

Juri 1975

Temporo-parietal (TP) flap

Elliott 1977

Microsurgical free flaps

Ohmori 1980

Superior-based temporo-parietal flap and temporal flap

Nataf 1984

Expanded BAT & TAT flaps

Anderson 1987


Hair Loss Donor Density Plant Center Partial Necrosis Inexperienced Surgeon 


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  1. 1.
    Mayer TG, Fleming RW (1992) Aesthetic and reconstructive surgery of the scalp. Mosby Year Book, St. LouisGoogle Scholar
  2. 2.
    Seery GE (2004) Introduction to flap procedures. In: Hair transplantation, 4th edn. Dekker, New York, pp 795–796Google Scholar

Copyright information

© Springer 2010

Authors and Affiliations

  • Kenichiro Imagawa
    • 1
    • 2
  1. 1.Yokobi ClinicYokohamaJapan
  2. 2.Japan Society of Aesthetic and Reconstructive SurgeryJapan

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