This can be minimized by avoiding using a donor height less than 1.5 cm and by minimizing tension at the closure. Correction of defects can be accomplished by serial scar excision or by grafting at the donor scar. They present as a painful pulsating mass at the donor site and are treated with intralesional Kenalog injections, local ligation or excision. Seborrheic dermatitis occurs in susceptible patients and is treated with topical shampoos. Systemic antibiotics and topical steroids are used in cases of secondary infection.
Advantages are less bleeding, pain and postoperative edema, and cosmetically superior results.
The main potential drawback is adjacent thermal damage with impairment of revascularization and resultant poor growth. In contrast, the Silktouch CO2 laser emits a continuous beam of light which is moved at a computer-regulated high speed designed to limit tissue exposure time to less than one millisecond. It allows the maximal use of a limited number of grafts by reducing the need for transplanting, especially in the crown. It also raises the rim hair border superiorly, bringing this natural hair-bearing tissue into a more prominent position. Traditional vertex scalp reduction is indicated for the patient with extensive baldness in whom it is anticipated that the donor area is insufficient to restore the predicted hair loss.