He seems to be content on where he is but on the otherhand he is on here. Hes got an awful lot of space to cover.
Dr Feller . Why wouldnt massive fue bring about the same issues as strip , as far as shockloss?
Just curious as you docs are the experts but if necrosis was going to happen wouldnt it of happened to the surrounding hair.
It looks healthy and dense.
If it was my head I would laser the front and fue the scars or two revisions , and call it a day
Ive seen some great results with laser resurfacing also

It`s good to know there are some options,choosing what is best is the difficult bit.
For many year ive been fairly content with it but maybe something should be done.Having to skip out of mates weddings and anywhere where your not supposed to wear a baseball cap has become abit boring really.
I will post a front view later on in the day...

Necrosis (outside the flaps) did not occur during or after the flap surgery because of the great compensatory ability of the scalp. It is this ability that allows HT to work in the first place.

But now that he has had the flap surgery, the compensatory ability of the scalp has been significantly reduced. Perhaps even to the point where it cannot tolerate the trauma of a strip procedure.

Due to the flaps, a large amount of vasculature no longer exists in the posterior temple areas. It is these blood vessels that aid in supplying the superior donor area after a strip procedure. Without them the chance for wound infection, poor healing, and necrosis are increased.

It basically becomes a gamble to do the aggressive strip procedures he would need. It doesn't mean a strip can't be done, and there is no guarantee that necrosis will result, but the CHANCES are markedly higher.

So high in fact that should necrosis occur and the patient decided to bring a law suit for medical malpractice the surgeon would have virtually no defense.

The first question asked by the plaintiff's attorney to the surgeon would be" Didn't you know that the vasculature to the donor area had been compromised by the flap surgery prior to your elective strip incision?"

Any answer the surgeon could give would show him to be negligent.

__________________
Feller Medical, PC
Great Neck, NY

Dr. Alan Feller is a member of the Coalition of Independent Hair Restoration Physicians

Providing Hair Transplants and Platelet Rich Plasma (PRP) Treatments

Thanks for that but you recommended massive fue .
Wouldnt the there still be higher chancesof necrosis since fue is still cutting in the scalp all over. Ive seen some terrible shockloss from fue in a couple of case. I only ask for this patient.

That's a good question PGP, but the answer is NO.

Because no areas of contiguous skin are cut in RESPONSIBLE FUE cases, there is very little vascular compromise. Also, since the wounds are so small, relative to a strip procedure, they heal very quickly and require less vascularization. Finally, since there is no tension on FUE wounds to close, unlike strip, there is no further compromise of the vasculature due to tight stretching.

This is the power of FUE and this case is where it's application would be most appropriate.

Dr. Feller

__________________
Feller Medical, PC
Great Neck, NY

Dr. Alan Feller is a member of the Coalition of Independent Hair Restoration Physicians

Providing Hair Transplants and Platelet Rich Plasma (PRP) Treatments