Patient is a 25 YO male experiencing MPHL affecting the frontal hair line. A conservative hairline was recreated utilizing 1498 FU grafts obtained from a conservative donor strip closed utilizing time-honored plastic surgery closure technique. Donor scar appearance is shown at the 14 month post op mark.
Patient is a 42 yo male who presents with an advanced degree of MPHL. Patient had thinning of the HL/FF/Midscalp and crown early in life with stabilization over last ten years without medications. Total 3757 FU total.
Patient is a 47 YO male with an initial presentation that featured severe bilateral recessions and loss of posterior frontal forelock with a diminished definition of the midline frontal hair line. He underwent a total transplantation of 5845 FU's over two procedures. His graft distribution included an unusually high proportion of three and four FU's, which adds to the total hair mass and cosmetic result.
This is a 42 YO who presented with loss of his frontal hairline and frontal forelock. He had been wearing his hair longer in order to cover the areas of hair loss, but this was becoming too much for him, maintenance-wise. This is a shot of his results at the early stage of four months. He was very pleased as for the first time in "forever" he was able to style his hair shorter. Total FU grafts: 592 ones; 2101 two's; no three's or fours. At this stage he probably has about 35% in growth.
Patient is a 28 year old male with a significant family history for MPHL. We post this case to reinforce the concept of lifetime donor/supply vs lifetime loss/demand, as well as illustrate "what it looks like" seven days after surgery, with short hair; we get that last question very often. Here, our plan includes a conservative hairline with recession, placed behind the existing one, and reinforcement of the midscalp area. It is critical in this patient category to plan for the future by anticipating future losses and NOT attempt to "fill in everywhere". There is a limited donor in every patient that must be respected, and this is usually concurrent with a much larger lifetime demand (area of potential loss requiring transplant). Understanding this lifetime imbalance and creating realistic surgical plans is key to long term transplant success. Also, note the look at seven days post op- if the hair is about 1/2 inch longer, the transplant would be fairly undetectable. It is however, some patient's choice to keep their hair short, so this example is for those considering that option. We are able to accommodate any hair length at surgery. Total: 2528 FU grafts; 728 one's; 1345 two's; 455 three's.
This 48 YO gentleman has experienced mild bilateral recessions and thinning of the frontal forelock over many years due to androgenic alopecia. Patients requiring subtle work such as this often wonder and ask, "What will I look like right after surgery? A week after?" Here ya go. The first eight show his presenting preop condition, the next three his appearance at post operative day one, and the last four at post operative day eight. The small scabbing present will usually all be gone by post operative day 12 - 14. Total grafts: 1821; 799 one's; 990 two's; 32 three's.
Very frequently we are asked what things will look like the day after- this is a one day post op example. Our patient experienced limited male pattern hairloss in the crown area over a total of roughly 35 cm2. When transplanting the crown it is important to follow the patients pre-existing whirl pattern so that the finished result blends seamlessly with the surrounding hair. Total grafts: 1678; 357 ones; 1246 two's; 75 three's. Tricophytic closure, single layer.
Second Procedure: Additional photos are one year post op following 2740 FU procedure to address crown, midscalp, and refinement of hairline and previous frontal areas. 2740 Total FU's :470 1's; 2156 2's; 114 3's. Tricophytic closure. They are the last five photos in the series.
This is a 60 YO male with androgenic alopecia, with thinning predominantly affecting hairline, FF, posterior FF, and bilateral temples and crown. Our plan was to recreate the frontal hairline, FF, post FF, temples and some crown.. Total area was approx 15cm x 7cm = 105 cm2, plus another 40 cm2 in crown. Decision was made to concentrate on the anterior and midscalp portion, allowing finasteride to work on the crown over the ensuing year, noting any effect at that time. Goals: Recreate hairline and FF and bilateral temple recessions, post FF and anterior crown. Wait to see how finasteride affects crown, possibly place 100 or so FU grafts there at this procedure to decrease severity of appearance.
Ellipse 30 cm x 1.0 cm x 110 (est) (in situ). 3099 total, 1029 1’s; 1990 2’s; 80 3’s.
Tricophytic closure.Patient will have second procedure of about the same number in January to address crown.
29 yo male with Androgenic Alopecia causing generalized thinning predominantly affecting FF, posterior FF, bilateral temples and crown. Approx 15 x 7 = 105 cm2 total frontal area, plus 40 cm2 in crown. Goals: Recreate new hairline and FF/post FF and bilateral temple recessions, as well as anterior crown. Patient has been on finasteride x 1 year.
4241 total, 1390 1’s; 2523 2’s; 328 3’s.
Last photo is of donor scar.
This 50 yo patient presents at 6 months following placement of 3770 Fu grafts in the following distribution: 1007 ones; 2591 two's; 128 three's. The majority were placed in the frontal area, approximately 700 FU grafts were placed in the crown primarily in an effort to decrease the apparent size (diameter) of the crown pattern. There is a bit of asymmetry in the new growth which should even out as the grafts continue to grow and mature; approximately 60% of growth has occurred at this time.