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Available techniques and their uses

Technique of tissue gain with the « Frechet Extender » or scalp extension.

This technique allows to increase the surface of the skin, doubling the surface of the hair bearing scalp and thus eliminates the bald area.

The extender, invented by Doctor Frechet in 1991, consists of a flexible, thin and flat sheet of biolestic with a row of tiny titanium hooks at each end.
It is manufactured in France and patented worldwide.

It is introduced under the skin, stretched and affixed temporarily. At the same time an ellipse of bald scalp is removed, reducing immediately the surface of the bald area.
It does not produce any deformation of the head and therefore the patient can resume his normal life.

By exerting a gentle and permanent linear traction it stimulates the production of collagen and elastic fibres.
As a result after 6 to 12 weeks, the hair bearing scalp gradually extends and progressively replaces the bald area of the top (vertex) and the back of the head which shrinks and can then be removed at the same time as the extender.

The procedure is performed under local anaesthesia on an outpatient basis and the patient can listen to music or rest.
After the operation, his hair is combed and he leaves the surgery without any bandage.

He leaves with an immediate and visible result: his bald area is smaller.
In most instances the surgery is carried out with little discomfort to the patient.

The patient can resume his normal activities usually after 3 days.
The extender is not apparent to the casual eye as there is no deformation of the head.

This is the only technique which treats effectively and totally the top and back of the scalp.

It should be noted that grafts (transplants) can only treat smaller areas of baldness such as frontal or temporal areas, as there is not a sufficient quantity of hair in the “donor zone”. (The donor zone, typically at the back of the head, contains hairs which are genetically programmed to grow all life long).

In the case of a patient with baldness of the crown, the scalp extension procedure will redistribute 15000 hairs uniformly over the area with a totally natural appearance.
In this way all the capital of hair in the donor zone is left intact and will be used to transplant the frontal bald area, simultaneously or later.

When the extender is being removed, the treatment is completed with the “Frechet Flap” by rotating three small triangles of hairy scalp one under another like a puzzle to produce an attractive rounded shape on the top of the head and allow the hair to grow naturally towards the nape of the neck.

Other uses of the Frechet extender ® :

The Frechet extender is also used for the treatment of burns, scalp tumours, pseudo-pelade, scarring alopecia, giant naevi, etc...

Patient avec un extenseur en place.

Patient with an extender in place which shall be removed after 6 weeks.

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Treatment of a stable and moderate crown baldness by scalp extension and Frechet Flap within one month and 2 operations. Please note that no grafting technique could offer such result.

Result obtained after 2 procedures within 6 weeks using the Frechet extender combined with the Frechet Flap.
First procedure
N°1 N°2
N°1 :
Before treatment.
N°2 : One hour later : The extender has been placed under the scalp and some bald skin removed under local anesthesia.
The size of the crown baldness has reduced.
The sutures will be removed after 8 days.
As you can see the head is not deformed.
Second procedure
N°3             N°4
N°3 :
Patient seen 6 weeks after the first procedure.
The hairy scalp of the crown has increased and the bald spot has shrunk.
The extender and the remaining bald skin are going to be removed under local anesthesia at the same time as the Frechet Flap will restore the natural direction of the hair.
N°4 : Two hours after : result of the treatment.
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Result obtained for the treatment of patient of 65 years of age,
combining the extender , the Fechet Flap and grafts. Please note that grafts alone could never achieve such result. .

© Dr. Patrick Fréchet 2008