This 37 y/o male first presented in 2003 and since then has had 4 medium-size sessions, averaging around 1200-1300 grafts each (3500 hairs average each surgery), which included filling in the anterior temple regions and temporal points which had eroded and thinned out over time.
It is our belief that many men need this temple area filled in so that this area "holds up" the frontal transplanted area. Otherwise it looks unnatural, almost like a hairpiece.
When we did this gentleman, we were only placing around 130 FU's each time on each temple at each session, but presently we use the lateral slits, which enable us to get them much closer together, and we average 200-250 per side at a surgery, enabling us to complete the task much sooner.
Mike Beehner, M.D.

Dr. Beehner,

If you get the chance to read this I have a few questions regarding this patient that you can hopefully answer.

1. Why do you list this patient as a NW 6? To me, he looks like a NW 6.5 who is moving towards a NW 7.

2. Because this patient is relatively young, but also extensively bald, it would seem as though he is likely to progress to a NW 7. If that is the case, why didn't you use your frontal forelock pattern?

3. Why do to the temples on such a bald man? Was it his preference? Do you know how many grafts were placed in his temples?

4. Are there any top down shots?

TC17,
Thanks for your comments. I'll try to answer the questions you posed. We just got back from the annual ISHRS meeting in Amsterdam, thus the delay in answering.
I certainly would agree with you that he is probably a "6.5", but in choosing between labeling him a VI or VII, I definitely would come down on the VI class. One way to tell a pure VII patient is iin the top down view; if you can see a rim of hair, then it usually is a VI. A VII will almost show no hair from this view. At his initial consultation visit in 2003, his width across the top was 12.5cm of baldness, which actually isn't that terrible given his age. You describe him as "relatively young," and from some standpoints he is, but the young men in their early and mid 20's are another whole world away in terms of being able to reliably predict where they are going to end up. I chose to simple fill him in from side to side for a number of reasons. Given his age, his preference for filling things in if possible, his donor density and scalp laxity, it was my judgement, based on experience, that I could easily accomplish what we set out to do. He wanted a somewhat youthful lower hairline in front, and I felt his temple hair as it existed would not "hold up" or support that type of hairline, so therefore including the temples made sense and he agreed with this plan. Most of my "forelock" patients are true Class VII's or are so young that I am planning for the worst with such a plan. Most of the balder men that I have posted and performed forelock plans on have had a width across the top of around 14-16cm.
As to the number of FU's used in the temples, he had 398 placed on the right and 388 on the left. The ones in the very front are all 1's and all the others are 2-hair FU's.
You asked to see a top-down view of the head, and I have added a before and after photo from that vantage point. They are at the end of the row of photos with this patient's listing.

Mike Beehner, M.D.