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  1. This man in his early 30s had past cranial surgery for an eye tumour. The surgery was successful but he was left with irregularity of his skull and hair loss in and around his surgical scars. He also developed a Norwood 3 pattern from AGA. He was most concerned that the recession was making his skull changes and scars more conspicuous. He had tightly curled, black, average to coarse donor hair, good scalp flexibility (despite his past surgery), and average donor density for an African American man. His donor density was about 85 fu per sq cm in the occiput and 75 fu per sq cm on the sides. After his neurologist cleared him for surgery, we transplanted 2774 follicular unit grafts, focusing on his left and left temporal hairlines. We intentionally brought his left temporal hairline a little further forward than his right to hide the depression better but the design was still within the range of normal hairline asymmetry. We also transplanted grafts into his scars. Transplanted hair does not grow as well in scarred or thinned skin as in “virgin” skin, especially if dense-packed. We therefore reduced the transplanted density in those areas to optimize the survival of the grafts that were transplanted. 13.5 months after his hair transplant, he is happy with his hairline and that it is easier to hide his past surgery. He does take Finasteride but is prepared to return for more hair transplantation if and when his genetic hair loss progresses.
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