Elasticity Of Scalp: Self Testing

[BenUK]

Hi Everyone,

 

I have a question that I hope you can answer. How can you test your own elasticity in the scalp? I mean is it just a case of seeing how much you can pinch between your fingers or when HT surgeons do this do they use some kind of device?

 

I ask because I'm at the start of my journey towards surgery but my skin on my scalp feels tight and thin, I can't pinch enough to be able to lift it, if that makes sense,( unlike my stomach where I can pinch a whole lot more then I'd like ).

 

Many thanks in advance, so glad I found this site.

[Cam Simmons MD ABHRS]

Ben UK

 

Good question and nice avatar.

 

Scalp flexibility is an important factor for FUT and donor strip removal. Scalp flexibility is determined by how much the skin can stretch and how much the upper layers of the skin can glide over the bottom layers. Scalp exercises can increase the scalp flexibility but not always. A tight skin closure increases the risk of getting a wide donor scar so the safe width of the donor strip should be determined based on the flexibility of the scalp.

 

Doctors have different ways to assess flexibility. Some make a qualitative assessment. Others use Drs Mayer’s and Paul’s method or caliper. With that method vertical marks are made 5 cm away from the midline and the scalp is compressed horizontally and the movement of the marks is measured. Ratios are used to determine how wide a safe strip can be. Other doctors, like me, use Dr. Jerzy Kolasinski’s method of determining vertical scalp laxity or VSL. A horizontal mark is made and a ruler is held to the skin. The skin is pushed and the upward movement and downward movement are added together. I take multiple measurements and use the total in each area as the maximum safe width of the strip at that point. It is not exactly what Dr. Kolasinski intended but it works for me.

 

It would be very difficult to measure your own scalp flexibility. Even men with flexible scalps won’t be able to pinch much scalp, like we can on our bellies. However, you can push your hands against your scalp and move it up and down to get a feel for how much it moves. A friend or family member could get a rough VSL measurement. You would need help interpreting the results of the Mayer-Paul method.

 

Of course, your doctor can assess your scalp laxity at a consultation.

[RCWest]

Thank you for that information Dr. Simmons! I've always wondered exactly how they check that.

[BenUK]

Thank you Dr for such an in depth reply to my question.

 

May I ask one more question then regarding laxity of the scalp.

 

Scalp Exercises: How much do they work in reality? If someone has a non lax scalp and performed an hours worth of exercises every day for say 4 months would that achieve much greater laxity and inturn result in more grafts? Or will being diligent in the exercises still only result in a small increase in laxity?

 

Many thanks

[BenUK]

And as an aside.....would I be right in thinking that if a patient was having a FUE procedure that scalp laxity is not an issue, it's only in strip surgery where laxity is an advantage?

[Garageland]

Hi Ben UK

 

Scalp exercises do work and if you were to spent half an hour a day every day for 3/4 months leading up to your procedure you will improve this and thus enable the doctor to harvest more grafts, as for just how many no-one can be sure, but I greatly improved my laxity to vastly improve the number of grafts I got and I know lots of others that have done the same.

 

There is a video on our website that Joe posted showing more information on how to perform them, I don't think I can link you to it. And yes they are only usefull for strip patients.

[Tom60]

I never knew that! Thanks for the cool and useful advice. I'm going to get ma exercise on.

 

Will it help with the recovery process?

[BenUK]

Thanks Garageland!

 

Knowing the importance of them now will certainly motivate me to keep at them once I've booked my surgery.

[stamos]

I remember reading an Emperor's post, stating that scalp excs help for more grafts but stretch the skin and therefore somehow increase the crown's bald area.

[Dr. William Lindsey]

All of the above sounds fine. Or you can do what I do when a patient is sitting here for a consultation. Reach behind your head with both hands and squeeze your scalp together, like you are bunching up below and above the strip to be excised. If its pretty movable, you probably have a loose scalp. If its really tight, start exercising.

 

Dr. Lindsey McLean VA

[Tom60]

awesome tip! Thanks doc.