Ask Dr. Lam

Hello Dr Lam
I was very surprised to learn that the famous British singer Tom Jones has had a scalp reduction, at the ripe old age of 69. He was on a TV talk show, and spoke quite openly
about it, and was very happy with the outcome.
I am the same age as Tom Jones, very healthy, and considering a "Frechet" scalp reduction myself.
I would like to know if you personally use the "Frechet" procedure on men of 69years+, and perhaps you would please comment on the increased risks, if any, of men of my age having hair transplants.
I am asking you because I am very impressed with your honesty and expertise, and I would trust your opinion above anyone else.
As you have often commented, there are far too many bad operators out there who would do anything for the money, so your advice would be much appreciated.
Thanking you Dr Lam
Alan

thanks for your nice comments. i don't perform scalp reductions since the indication for the procedure is rare in my opinion. Frechet does a great scalp reduction but there are very few surgeons who can deliver a safe and good result. The problem with a scalp reduction is several fold. First, it creates a slot deformity so you need typically 2 to 3 reductions followed by a triple flap procedure to recreate the crown. If you run out of hair back there, you can expose the result either as a scar or as a surgically altered appearing crown that would be unnatural. However, in certain respects, that also goes with any crown type transplants.

my feeling as far as safety is that with any procedure you should have a full physical examination before undergoing it. a scalp reduction can be a "bigger" procedure but in the right hands not so much more. unfortunately, scalp reductions are a dying art. there are very few surgeons out there who do it and those who do it oftentimes do not do it well. i think if you are surgically safe to have a procedure, i can at least speak about a hair transplant that in general it is a pretty safe procedure because it is truly just a "skin" operation, i.e., it is not a deep procedure and only under very mild sedation.

finally, as you know scalp reductions are really for the crown not for the front. if your crown is an isolated situation, a hair transplant can work just as well. hope that helps.
best,
sml