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Old 10-28-2009, 04:54 AM
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This mid 40's gentleman with type VII MPB was discouraged from having a hair tranplant surgery.
He was referred by his friend, after doing a long consultation i made him realize what can be achieved with a hair transplant. Especially if he had a type C density in donor area
He had two surgeries done and last picture is before the third procdure.
he is ever so happy with his new, no bald but thinned out appearence



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Old 10-28-2009, 05:00 AM
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Patients like him are tough decision. As one should knowwhen not to do.
But once I can see if the donor area an donte 5000 to 6000 graftsin total and the expectations are to have some hair rather than full dense packing then I do take chances.
He is very happy and as one must see its all thinning looks rather than bald looks, so now instead of type VII he looks like type IV vertex, and after third surgery that was maily fo cwn, he will have a look of generalised thinness appearence.

Hope this would be appreciated.

The man advantge an density that I can achieve with less number of grafts is because, i still judiciously use 3 to 5 hair grafts. This makes same number of hairs but lesser number of grafts and hence better denser look in the end. Of course without looking pluggy or un-natural.

Naturalness is what i really care for not density
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Old 10-28-2009, 08:55 AM
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His scar looks great and after the 3rd HT, he could use some concealer
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Old 10-28-2009, 11:16 AM
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Dr Humayun,

This looks very good as to compared where he was before-Tough, Tough Case...

What is your definition of type C density. Or Is that your term for donor density per cm/sq? And more importantly, what would you say is his donor density?

It looks very natural, not to mention covering a large area thus far with only 5128 grafts. Good coverage too...

Take Care,
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Old 10-28-2009, 02:41 PM
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Dr. Mohmand,

It takes a real quality surgeon to be able to pull off a cosmetically pleasing result on a patient with such high degrees of balding. I'm sure this patient is very pleased as are you for your patient.

Best wishes,

Bill
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Old 10-28-2009, 03:53 PM
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Dr,

I hope you are not offended by this comment, but this guy looks aweful! For how bald he was and how many grafts you used the result looks fine, but it doesnt look like a natural hairline or balding pattern which makes a transplant obvious no matter how natural the transplanted hairs appear. I will say for what you had to work with you did a good job and if you made it abundantly clear that this would be the result than you are off the hook but never the less the end result isnt very appealing.
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Old 10-28-2009, 05:32 PM
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I think its a massive improvement . This guy was full on bald , it looks natural the docs done a great job with what he had to work with .
ej
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Old 10-28-2009, 10:38 PM
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I don't understand why dakota3 isn't impress with work done for this patient, most docs will not touch this patient because its not easy, almost impossible to get a good result for a type 7 but you did a massive improvement. well done
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Old 10-29-2009, 03:31 AM
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Dear Dakota3

I totally agree with you, but the results are not yet over. He got a third session done at a progressive thining pattern towards the crown.
In a years time he would not have a bald area but a progressive thinning from front to back.

I know he has a big area of baldness on back, but does that mean we should all say no to those people and deny them the right to have HT.

I think if the patient is well versed with the limitation of a hair transplant and provided the donor area of minimum 5000 grafts available then we can provide them with a gentle transformation.

In most if not all cases they regain their lost self esteem and confidence. Its all about the lost self esteem and confidence. Yes you can see that he has a bald crown and this can tell about the hair transplant. I am sure you would have seen a ludwigs type of baldness in men. They have the front 1/3 to 2/3 head covered with hair and back is all gone, that is natural.

My concept of natural ness is about the way a hair line (transition zone) is created. if i cannot see a single line from front and no harsh looking hair line, i am happy.

Type C density means about 50-70 grafts/sq cm. normally its about 90 to 120 depending on the ethnic origin.

but at the end of the day its about making the patient happy within the limits of ethical practise. So no lies no big promises and standing by your commitment/words.
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Old 10-29-2009, 03:33 AM
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by the way my last pictures did not have a flash either. I had to buy Nikon D90 to go around the problem of flash.......
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