Refining the hair-bearing flap.

The availability of hair-bearing flaps offers patients a more extensive choice of corrective procedures for baldness. The hair-bearing axial temporoparietal-occipital (TPO) flap which we prefer is based on the superficial temporal artery and extends well past the posterior midline. The procedure is performed in the office. The "instant" and exceptionally dense hair which grows in patients with sparse, limited, and finely textured hair is a distinct advantage over the hair transplanted by punch autograft technique. Since the surgery involved is formidable, the patient must be highly motivated, well-informed and advised realistically about the results available with this procedure. A well-planned and properly executed TPO flap procedure is the best method for obtaining the density of hair and the appearance desired within the shortest time.

The meaning of surgical margins.

In an effort to define the pathological term surgical margins, 11 pathologists were interviewed regarding the meaning of the term margins. In addition, 25 plastic surgeons were queried regarding their decisions based on pathology reports of margins. We found nonuniformity of processing specimens and ambiguity in the use of the term close when describing specimen margins. Among the plastic surgeons there was also variability of opinion regarding handling of patients with pathology reports with close or involved margins and a lack of appreciation of the differences and the meanings of various methods of processing tissue.