Scalp Laxity

[JJ09]

Dr Arvind wrote:

JJ09 wrote:

Thanks, when I keep my head level I manage half an inch, however when I tilt my head so as to touch my chin on chest, there is no movement, not much success with the pinch test however, I probably would consider my scalp to be tight.

Dear JJ09,
Please note that there are 2 distinct areas in the back of the scalp that you need to differentiate.

1. The safe donor area : This is where the scalp skin is adherent to the fascia below it. In this part, movement of the skull will make little if any, impact on the scalp skin. In medical parlance, it is the scalp at and above the nuchal lines. The scalp skin is adherent to the nuchal lines, therefore, when you touch your chin to your chest, there is no change in laxity of this area.

2. The area below the nuchal lines - a strip is never to be taken from the area below the nuchal lines. This is the area where, when you touch your chin to your chest, the elasticity reduces.

Trying to increase laxity of area 2 is not much beneficial as the strip is taken from area 1.
Let me know if you need further clarification.
Regards,
Dr. A

Dr Arvind,

Is it safe to say that the multiple strip and scalp reduction surgeries my scalp has endured, may have effected movement, different to a virgin scalp.

 

[hairtech]

Dr. A,

I understand the anatomical verbiage as you are stating in terms of nuchal lines. And not to disrespect your opinion but just asking a question... where is your evidence that scalp exercises... even a simple scalp exercise outside the nuchal lines will not have a direct affect on a scalp laxity in general?

 

[Dr Arvind]

JJ09 wrote:

Dr Arvind wrote:

JJ09 wrote:

Thanks, when I keep my head level I manage half an inch, however when I tilt my head so as to touch my chin on chest, there is no movement, not much success with the pinch test however, I probably would consider my scalp to be tight.

Dear JJ09,
Please note that there are 2 distinct areas in the back of the scalp that you need to differentiate.

1. The safe donor area : This is where the scalp skin is adherent to the fascia below it. In this part, movement of the skull will make little if any, impact on the scalp skin. In medical parlance, it is the scalp at and above the nuchal lines. The scalp skin is adherent to the nuchal lines, therefore, when you touch your chin to your chest, there is no change in laxity of this area.

2. The area below the nuchal lines - a strip is never to be taken from the area below the nuchal lines. This is the area where, when you touch your chin to your chest, the elasticity reduces.

Trying to increase laxity of area 2 is not much beneficial as the strip is taken from area 1.
Let me know if you need further clarification.
Regards,
Dr. A

Dr Arvind,

Is it safe to say that the multiple strip and scalp reduction surgeries my scalp has endured, may have effected movement, different to a virgin scalp.

Dear JJ09,
Multiple strip and scalp reductions will definitely reduce the laxity as well as compromise the density as compared to a virgin scalp.
Regards,
Dr. A

 

[Dr Arvind]

hairtech wrote:

Dr. A,

I understand the anatomical verbiage as you are stating in terms of nuchal lines. And not to disrespect your opinion but just asking a question... where is your evidence that scalp exercises... even a simple scalp exercise outside the nuchal lines will not have a direct affect on a scalp laxity in general?

Dear Hairtech,
I did not say that scalp stretching exercises do not help.
As for benefit from scalp stretching exercise below the nuchal lines, I would suggest a preliminary reading of the anatomy of the scalp. That is available in any textbook of Anatomy.

Let me know if you face any difficulty in understanding after you have read that.
Regards,
Dr. A

 

[JJ09]

Density also €¦of course, my sides are way thicker than the back.

 

[hairtech]

Dr. A,

That makes sense and thank you for the reply... What do you think should be a preliminary protocol for an evaluation below the nuchal lines (what a physician should look for during the evaluation) for the efficacy of a scalp exercise that will provide a significant result for helping a strip... pre-operatively?

 

[Dr Arvind]

Following is a good link where readers can understand the anatomy of the scalp http://emedicine.medscape.com/article/834808-overview

Above the nuchal lines, the scalp skin is adherent to the underlying aponeurosis by bands of connective tissue. The aim of scalp laxity exercises is to loosen these connective tissue.

 

[Dr Arvind]

An interesting/helpful observation that the readers can make on their own scalp :
Put 2 fingers flat on the back of the head in the safe donor area. Then move your neck towards both sides. When the fingers are above the nuchal lines, neck movement will not result in movement of the scalp skin. You can feel this by your fingers.
When fingers are below the nuchal lines, you can feel sideways neck movement causing movement of the scalp skin too.

Therefore, if a strip is excised from below the nuchal lines, there is a much higher risk of scar widening because the constant movement will subject the strip wound to continuous stretch along different directions.

Regards,
Dr. A

 

[hairtech]

There are several divisions of nuchal lines... a highest, superior, median, and inferior nuchal line. The safe zone is well within the nuchal lines. I would hope that no one would take a strip from the nape of the the scalp which is well below the inferior aspect of the nuchal lines.

Anyway a scalp exercise will help.

 

[NotGoing2GoBald]

Bigmac wrote:

Hi JJ09

Heres the video which shows me pinching the skin,the movement you can see looks lots more than i can actually feel.

Hope it helps

bm.

[flash=425,344]http://www.youtube.com/v/zA_vL1Z-QGU&hl=en&fs=1[/flash]

good god your scalp is loose! LOoOOooOOOooOOL dude, i can't even get a finger nail full of skin, YOUR pinching an inch! ROFL )(_:: that's amazing, you should take that bad boy on tour BM. :T:

 

[Bigmac]

Lol Ng.

This is after a few HTs too.

bm.

 

[Nervousnelly]

Bigmac we need to get you a life.:T:At least your not making other movies like Falc.

NN

 

[hairtech]

omg that was funny nn. Actually I made a website that beats falc. Check it out ... http://www.tom.com

 

[Guest]

Here is the first and only valid video to show how to perform scalp exercises. There is another on the web by some other clinic but it has a nurse rubbing her hands over the back of her head. There version is completely ineffective.

How To Perform Scalp Excercises

I'll be shooting a new video in the coming weeks with updated information and clarification but the above video will suffice for now. David, aka "Garageland" who is our new UK representative will post it here for you.

One point in the above video that needs clarification, the exercises need to be performed for a TOTAL of roughly 30 minutes per day but not in one sitting. This can be broken up into smaller increments throughout the day based on your endurance as long as you get a total amount of time equivalent to roughly 30 minutes.

With the influx of video capable devices available today (cell phones, webcams, etc.) I think it is a good idea to take video of one's scalp laxity if considering a strip procedure. Unfortunately pinching the scalp is not the ideal presentation. Moving the back of the scalp and the sides of the scalp vertically on video gives the best information for clinical assessment. We are looking specifically for vertical movement. I hope this helps.

 

[JJ09]

Thanks for posting...look forward to the new video. Z:B

 

[Bigmac]

Nervousnelly wrote:

Another way is to see how much translation or scalp movement there is when you place your hands behind your head and apply pressure and move scalp up and down. You want to see at least a half inch of movement.

NN

Guess i`ll do another video showing the movement in more detail and the pinching of the skin which i`ve read countless times is a part of measuring your laxity.