Each procedure has its inconveniences and costs, and each patient must judge these for themselves. Flaps are surgery and have a more significant recovery at the time of the procedure. Plugs are more of an ongoing process but carry less risk and time off work. Overall, the results of routine scalp reduction have been disappointing. Although the removal of 2 or 3 cm. of bald skin in a loose scalp may be successfully accomplished, this may create a noticeable scar after the area has healed and the overall impression of baldness remains.
Some doctors routinely combine scalp reductions to their graft sessions.
Be aware that the before and after pictures they show you are their best ones. This can dramatically improve the results compared to a routine scalp reduction. In this case, a balloon is placed underneath the area of skin with hair and gradually filled up with water to stretch the skin. However, a large area of bald skin can be removed and comfortably replaced by the expanded skin. The hair density is reduced, but usually not noticeably.