Ask Dr. Lam

Hello doctor

I would like to know please if it is possible to place an extender in silastic on the top of my head and to leave it there because i have a complex since my younger age , the top of my heat is very flat on the backtop and i would like to place this small piece of siilastic so it can make the two laterales sides of my scalp , right and left , lift up and it will make the top of my head more round and narrow , whennow it is flat and wide and with ths silestic piece it will apprach the two laterales sides like you use for the crown approach, please can you tell me f you can do it or if you can advice me about someone hwo is specialized in this

Thank you very much

hi,
thanks for your question. first, an extender will not change your head shape. it is meant only to draw the sides of your hair bearing tissue inward more rapidly and also to prevent stretchback of hair-bearing tissue after the first excision. second, if you just do one scalp reduction with an extender in place, you will have a big ugly open scar and your hair bearing tissue moved in just a little bit. if you do another scalp reduction with extender and you bring the sides even closer together you create what is called a slot deformity since your hairs in your crown come together now resembling a coin slot which is completely unnatural. a crown must be in a whorl pattern to look natural. you will then require at least a third session for a triple flap to create the reduction necessary after that to manage the slot deformity. so in short, an extender should not be left in place and even if it did at any stage of the reduction, all you will be left with is a deformity. if you graft hair into the crown (saying you are a candidate, over 35, good donor density and a reasonable crown size), placing hair there will already lift the flatness of your head by putting hairs there to complete the round shape. don't know if that is what you are looking for but hope that helps.
best,
sml