Another way to treat baldness is scalp reduction. In this technique, the surgeon cuts a strip of skin from the bald area and sews the edge of the scalp together. The stretched skin moves hair on the sides of the head closer to the top, thereby reducing the bald areas to be covered by a hair transplant.

"If everything goes well, side effects from the surgery should be relatively minor. There's overnight pain, temporary swelling that might appear after a day or two, and a sensation of numbness that could last for weeks or months until nerve endings re-grow. Extraction of the scalp plugs leaves faint scars, but if the procedure is done correctly, the scars should be hidden by the remaining hair. More serious but rarer side effects include postoperative bleeding, which may require additional stitches, and infection, which is treated with antibiotics," said the editors of Consumer Union's "The Medicine Show."

While scalp reduction and punch grafting (another variation of hair transplantation that we discussed earlier) are medically accepted and have been performed on over 250,000 Americans yearly, not all people will benefit from them. In the first place, depending on how large the bald area is, the patient may require up to four transplantation sessions to cover up baldness. This may cost as much as $15,000.

Next, the scars and stitches on the head can be psycho­logically damaging to the squeamish. This is true if the bald area is large, making the healing and hair-growing process visible to the world.

A bigger problem is finding a qualified dermatologist who can perform these procedures well. With so many quacks around, the patient could easily spend a large amount of money and end up with less than ideal results - if not complications.

"There's considerable debate among dermatologists about whether hair transplants offer enough cosmetic improvement to be worth the time, cost, and discomfort. A major problem is finding a surgeon who can produce good results. Since any licensed physician can perform the surgery, it's easy to end up with transplanted tufts of hair that look like uneven rows of corn. You could also find yourself with a surgeon who uses controversial techniques. One such procedure is to transplant a large flap of scalp instead of tiny grafts. Not only does that increase the chances of visible scarring, but in some cases the flaps won't take, and you lose all the transplanted hair," warned the editors of "The Medicine Show."

To avoid trouble, ask a trusted doctor to refer you to a reliable dermatologist. Don't be ashamed to investigate. After all, your head - and hair - are at stake. (Next: Will minoxidil help hair grow?)

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