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Old 04-02-2009, 06:58 AM
Dr. Jean Devroye, MD's Avatar
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When this young 23 years old patient came to visit me for a consultation, he was full of doubts.
In fact, he already had two Hair transplants, 300 grafts each time. He did not believe anymore in the therapeutic possibilities of a Hair Transplant as the result the two previous surgeries is not visible at all (probably only 200 grafts survived). You can see two scars on his donor area.

His laxity is good, and when he decided to make a mega session I collected a big strip, 36.7 cm??. As his density is good (88 fu/cm??) the estimation was to reach about 3234 grafts.
Finally, we will have fewer grafts than expected because the two scars present in the strip.

2897 Grafts reached, so 6922 hair (2.4 hair/graft).
FU1: 429 FU2: 1232 FU3: 779 FU4: 341 FU5: 53

I developed my usual strategy.

The forelock (zone B) (21.8 cm2)
This zone, quite important for Dr. Michael Beehner and Dr Ron Shapiro, was privileged.
21.8 cm?? covered with 650 grafts so an average of 30FU/cm??. I placed the best grafts there:
FU3: 260 FU4: 341 FU5: 53 so, a density of 30 FU/cm?? or 110 hair/cm2

Zone A (1, 2 and part of 3) (50.3 cm2).
It includes the anterior line transplanted with 429 FU1, the zone right behind it (with about 300 FU2) and then a repartition of 534 FU2 and 519 FU3 on the rest of the area.
At the end, the average density is 35 FU/cm?? so 74 hair/cm??

Zone C (19.9 cm2)
I placed on this zone the 398 FU2 remaining, for a density of 20FU/cm?? so 40 hair/cm??

Remarks

The calculation of the mass index transferred, I have already explained it in a previous post (43 years old Spanish patient- Dr Devroye Brussels.) shows an incredibly low figure. The hair is very thin (an average of 45,5 microns) which gives a surface (on the ground covered by the hair) of only 11.25 mm??, so hardly more than 1/10 of cm??!!!
However, the good number of hair reached (about 7000) and especially their curled aspect permitted to have a great result in terms of apparent density.
It is essential to spread the hair in the best way possible. A visual wall is created in order to obtain a good impression of density when looking at the person. The role of the forelock is essential. The posterior zone was slightly covered because of the lack of grafts. Probably, the patient will have to proceed to another surgery in the future. On the anterior part, there will be no need of adding many grafts.

The anterior line is light and natural thanks to the use of a great number of FU1 (singles). Right behind it, some ranges of FU2 and then there are the FU3 to extend the visual 'frame' towards the gulfs.

For many years now, I've been defending my idea that it is not compulsory to use important densities of grafts to obtain good results. This Hair transplant is also the perfect illustration of my point of view. Remember the doctor who preached 100 grafts per cm??, well in this case he could have covered only 29 cm2

In this case, we privileged the surface rather than the density. A good strategic choice in the repartition of the grafts gives at the end an excellent visual result, on an important surface.

Note that the most important factor is the density in number of hair per cm?? (which varies between 110 and 40 depending on the zone covered) more than the density of the incisions.

If you have any questions, it will be my pleasure to answer you.



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Old 04-02-2009, 08:06 AM
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Incredible writeup and nice result
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Old 04-02-2009, 08:36 AM
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Top quality in every sense
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Old 04-02-2009, 09:07 AM
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Dr Devroye,

Great results most importantly. For only 8 months also. Your write up makes total sense that the coverage and illusion of density prove very effective.

Your presentation is up with the best around, your breakdown, information and great quality photographs.

Great job all round!
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Old 04-02-2009, 02:28 PM
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Looks nice. Get him a comb.
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Old 04-02-2009, 02:40 PM
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This is a well thought out and presented case. Colored diagrams and everything.

Excellent result Dr. Devroye, keep up the great work.

-Dr. F
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Old 04-04-2009, 10:27 AM
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Wow! What a well thought out and judicious use of "hairs". Very well done doctor.
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Old 04-07-2009, 05:59 AM
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Excellent result my friend. Considering where the guy was (and is heading) this is really good.

He is(was) probably twice as bald as me, yet we received almost the same number of grafts. If my result would match this one, i would be very happy - although i would probably take myself to a stylist LOL.

Also, great writeup, please keep doing those. Very educational.
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Old 04-10-2009, 08:10 AM
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Au nom de tous les amis de Nicolas, je f?©licite le dr Devroye pour son fabuleux travail.

English translation added by Falceros (Moderator): "In the name of all the friends of Nicolas, I congratulate Dr. Devroye for his fabulous work."
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Old 04-11-2009, 05:23 AM
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Perfect write-up Doc - it would be great if everyone was so detailed



PJ
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