DrTBarghouthi

Many thanks to you all 🙏🏻🙏🏻

Many thanks for your comment @Berba11

Thank you guys for the kind comments @Gatsby @JC71

Dear community, This is a 39 year old gentleman who was complaining about the lack of beard growth on both cheeks. This has been noticed ever since puberty and seems to be familial. He tried minoxidil for sometime with no success. He elected to go through a beard transplant as it seems that he has no sign of male pattern hair loss in the scalp. Photos were taken at around 8 months from surgery. Surgical details: FUE 0.9 mm punch Total hairs: 3516. Obtained from around 2100 grafts extracted. 1's 1266 2's 2250 Only 1 and 2 hairs grafts were utilised. Bigger grafts were trimmed to that effect. Average of 1.67 hairs/graft. Sites made using 0.9 mm and 1.2 mm Sapphire blades. Before Planning: Immediate: 8 Months:

I think a dermatoller or dermapen will have a similar effect and probably cheaper. No preference regarding models for me. I think trichosol might be less irritating but still many people use PG based solutions with no harm. You can test both. The key is doing something you are happy and consistent with.

Thanks. At such minimal depth you can use the dermaroller or gun and then apply the products. It can be bought from pharmacy. For injectable mesotherapy at greater depths, sterile is advised. I think alcohol containing solutions might cause more irritation but can be tried at the depth you suggested. Anything deeper or injected deeper, I would not recommend at home.

Being on Finasteride is definitely a wise thing. I would suggest given your donor and potential pattern to focus on the frontal 2/3 and stage the crown for later.

Saline solution is fairly universal and can be bought in any pharmacy. You can usually prepare something similar at home too using salt and water if needed.

Thank you all for your kind words and support. Thank you @Melvin- Moderatorfor this great privilege. I hope we can continue to all work together and serve hair loss sufferers through this platform and in treatments.

Yes indeed. That’s what i meant by debridement. However, i thought if ny seeing a doctor he can probably do that under a clinic guidance, in case the skin under is raw or infected.

Yes that is true. But you need to assess how the healing is under the scabs. If skin is healing then the scab is really acting like a dressing. However, if the scabbing is hiding unhealthy tissue, then it needs debridement to improve healing.

I would definitely see someone earlier. Needs good examination. Mayne a hair Transplant doctor in your area so they know what they’re looking at. I am mostly concerned about the bluish discolouration. Maybe needs some debridement to expose the healthy tissue under and promote tissue healing. Some also consider aspirin to improve blood flow.

You’re welcome. Hope it was clear that I had to follow the dominant pattern and direction of his still existing hairs and sort of imagine how it translated in the lost areas too.

Thanks for the question. Yes a cowlick is a rather unusual pattern. In some cases when that cowlick recedes with hair loss, we can just go about making the typical incisions and we ignore what is left from cowlick. However, his cowlick was still quite strong from the recessed areas and front and was extending into his frontal zone behind the hairline for around 2 cm. Have a look at the planning photos. Therefore doing normal incisions in the presence of an almost fully filled cowlick will end up with different direction. Hope this help.

Very nice result!

Thank you @Melvin- Moderatorand @JC71

Dear community, This is a 27 year old gentleman who had an FUE procedure done in Dec 2020. He is a NW 3-4 pattern with a family history of the same. His donor area is of good quality. We did around 2442 grafts for both the frontal and temple recessions. It was noted that he had a strong cowlick pattern on this right frontal hairline and extending deep into his existing hair in the frontal region. Therefore, we had to restore the entire cowlick pattern which entailed making sites that were angled backwards in some areas so as to restore it completely. He is currently on finasteride 1 mg alternate days. Photos were taken at around 12months from surgery. Surgical details: FUE 0.9 mm punch Hairline :482 refined single hairs Total grafts: 2442 Average of 2.61 hairs/graft. Sites made using 0.8 mm and 1.4 mm Sapphire blades. Before photos and planning phase: note the cowlick pattern on the patient's right frontal zone. Immediately after surgery. Also showing the incisions made. Day 10 : 12 months result Close up photos: Comparison photos:

Thank you all for the comments. Life changing indeed for this lovely lady.

You are most welcome sir.

This area is quite sensitive and prone to scarring and redness etc. i would punch out only few to see how your skin responds. If things are favourable you can punch out more. If not or if the punching will be quite dense, you can combine electrolysis or laser removal to reduce the density and eventually some touch ups to have finer looking temple points. Takes some time but you will get there.

Thank you Dr. 🙏🏻🙏🏻

Dear community, This is a 38 year old Lady who was complaining of gradual thinning in a Ludwig 1-4 pattern. She had a total of 1203 FUE grafts in late January 2021. She elected to have an FUE considering the relatively small amounts of grafts needed. We managed to shave a long strip of hair and to extract from it. She is currently on minoxidil 5 % foam once daily. Surgical details: FUE 0.9 mm motorized punch 1:s 231 2's:514 3's: 371 4's: 81 Average hairs/graft: 2.25 Sites made using 1.2 mm and 1.4 mm Sapphire blades. Photos taken 12 months after surgery Before: Immediately after 12 months after:

Thank you. Yes I think a transplanted hairline is the only way to achieve a realistic hairline. No system does that in my opinion. Please feel free to share some photos if you like.

It has to do with the shape and size of scarring. An irregular large scar will have more fibrosed tissue that is obvious and usually the healing is not done in a controlled manner such as in primary closure with sutures. Scars that follow the natural planes of skin heal much nicer than ones that occur at a more irregular plane or are larger. In FUE the circular and small size of the excised skin makes healing much better and less obvious.

Triamcinolone (kenalog) injections.