This 40 year old Norwood type III-LV vertex, with a strong frontal tuff had a large surface are to cover. We decided to cover a large surface area including the front two thirds of the scalp, the top of the crown, and the lateral area of the crown. This would make his hair thicker, bring out his temporal peaks, and shrink his crown. He had a good donor density, but his skin was tight and I estimated I could get 3,500 to 4,000 grafts on him. We decided to cover a large amount of surface area in the first surgery in order to accommodate his needs. His donor yielded 3,468 grafts. I ended up covering an area of about 150 sq cm with the 3,568grafts. In doing a case like this in some areas I planted as little as 15 fu/sqcm and in some areas 35fu/sq cm. in other areas. At 7 months post op he is filling in nicely and I expect to get more density on the top of the scalp. From the side and front his hair looks a lot thicker. The top view shows the hair to be thicker, but we can still see scalp under the flash lighting. The crown is smaller, but there is still an area of the crown with no hair. As you can see 3,558 grafts over such a large area gives good coverage, but if he wants more density, and to cover the crown, he will have to have a second surgery.

His graft distribution was as follows:

1 Hair FU - 967
2 Hair FU - 1788
3 Hair FU - 605
4 Hair FU - 108

Total FU - 3,468
Total Hairs ??“ 6,790

As good as it gets!! Great job doc!!