The Anchor Flap: A Surgical Technique for Treating Extensive Frontal Baldness

The document details the Anchor Flap, a surgical technique for treating extensive frontal baldness, developed by Patrick Frechet, M.D. It involves creating and rotating a 100 cm² anchor-shaped flap from the occipital region to cover the bald area, ensuring natural hair growth direction. This is combined with scalp extension to address baldness on the top and posterior scalp within 2 to 3 months. The flap is vascularized by the superficial temporal artery, and the procedure is done under local anesthesia across 6 days, with additional post-rotation steps. The technique requires careful patient selection, targeting only those who are highly motivated for this aggressive treatment. The author reports excellent aesthetic outcomes, with natural hair direction, high density, and minimal scarring—though the frontal scar may need micrografting. Risks like necrosis are reduced by avoiding tension and vasoconstrictors in the flap. The procedure has been successfully performed on 10 patients, including those with multiple scars, using Minoxidil and a delay tactic before flap rotation. The conclusion is that the Anchor Flap is an effective and rapid solution for extensive baldness, but it demands specialized surgical expertise and should be executed by experienced teams to prevent complications.