This lady in her mid-50s has fine, long, black hair and has a Ludwig 1-2 pattern of thinning. She prefers to brush her hair straight back and was appropriately most concerned abut her hairline and front.

As for many women with female pattern loss, spreading the grafts out over a large area would not make a significant improvement anywhere. For female pattern loss, we usually prefer to target the key area(s) according to a patient's chosen hairstyle(s). We improve those areas then patients can style that hair to layer over other thinning areas.

This lady had mostly 2-haired fug and had more 1-haired than 3-haired fug. (We did not keep separate counts.) Her 1-haired fug were too far away from their neighbours to be able to pair them into 'follicular families.' We have never tried Dr. Cooley's method of deliberately piggybacking 2 small grafts into 1 incision (under special circumstances) but she might have been a good candidate. With her preference to brush her hair straight back we decided to dense-pack the grafts as close as possible in her central anterior hairline and midfrontal forelock. We used stick-and-place with 20-gauge needles.

As expected, she did get shock loss at the 1 month mark despite using Minoxidil post-op. She concealed this well by wearing a left part and using Toppik until the hair grew back.

After about a 4-month rest, her hair grew about ?? inch per month. At 8 months her hair was growing well but was still only about 2 inches long.

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Cam Simmons MD ABHRS
Canadian Hair Transplant Centre,
Toronto, Ontario, Canada

Dr. Cam Simmons is a member of the Coalition of Independent Hair Restoration Physicians