Donor strip width

[Chops]

I asked earleir what the average donor density was and the general consensus seemed to be 80 FU/cm2.

 

What do you think the maximum width of strip the average patient can take from their donor is? I'm talking about more than one procedure.

 

Also would it be fair to say that donor density is relatively uniform from the back to te sides?

[Chops]

I asked earleir what the average donor density was and the general consensus seemed to be 80 FU/cm2.

 

What do you think the maximum width of strip the average patient can take from their donor is? I'm talking about more than one procedure.

 

Also would it be fair to say that donor density is relatively uniform from the back to te sides?

[Bill - Seemiller]

Chops,

 

Assuming a 30cm long strip is harvested every time and you have 80 FU/cm2, in order to obtain 7200 grafts in your lifetime, tissue approximately 3cm wide will have to be harvested. It's most likely a bit more since with subsequent sessions, the existing scar will also be removed. The trichophytic closure technique used every time may also play a role.

 

But these are just base numbers and will vary for each patient.

 

Best wishes,

 

Bill

[Chops]

Hi Bill,

Are you saying that 3cm width is generally achievable in the average patient?

[Dr. William Lindsey]

3cm is pretty wide. Wider than our customary 1.25-1.75cm strip. Depending on the patient, a 3cm strip width will sometimes result in a mighty tight closure...and the scar potentials associated therein.

 

Dr. Lindsey McLean VA

[Bill - Seemiller]

Dr. Lindsey,

 

Chops is talking about in more than one procedure. Unless a patient has a scalp as elastic as a rubber band, 3cm isn't going to happen in a single session

 

Chops,

 

I am suggesting that the average patient has between 6000-8000 grafts available in their donor supply in a lifetime via strip. Therefore, I'd say harvesting 3cm of tissue over multiple procedures may indeed be doable depending on the patient.

 

Best wishes,

 

Bill

[mmhce]

"and the scar potentials associated therein."

 

Is it that, the wider the extracted strip, the greater the scar tissue?

[latinlotus]

Chops is talking about in more than one procedure. Unless a patient has a scalp as elastic as a rubber band, 3cm isn't going to happen in a single session

 

 

I have seen some fat guys with a few folds of skin in the back of their head. I am pretty sure that taking 3 cm width strip in one session would not be a problem. Then again, it is highly unlikely that they would go for HT as they are probably not very appearance conscious, since they don't care about their weight problem.

 

On a separate note, it may be coincidental, but it seems to me that most of these guys are African-Americans.

[Bill - Seemiller]

mmhce,

 

Harvesting a wider strip doesn't necessarily equate to a wider scar. When a strip is removed, no matter how wide it is, both sides of the wound are pulled together and sealed with the intent of creating a very fine thin scar. Closure technique, patient physiology and postoperative care will ultimately determine the final width of the scar.

 

Best wishes,

 

Bill

[Dr. Bernardino Arocha]

One of the most important factors in determining how wide a strip can be harvested has to do with tissue elasticity. The greater the tissue elasticity the wider the strip that may be harvested. Elasticity varies across the strip; it is greater in the back, less in the sides, so the width of the strip varies across the strip. The donor density also varies across the strip as does the per cents of the break down of hair number follicular units, that is there are more 1 and 2 hair fu in the temple area and more 3,4, and 5 hair fu's in the occipital area. I do not routinely measure tissue elasticity before surgery, but after thousands of surgeries I have a very good feel from just the tissue response to my tumescence procedure. The volume the tissue can accommodate is proportional to the tissue elasticity.

[Jotronic]

Hard to say what the average is over time. Some can have as much as three cm over time and some even more. Dr. Wong, who calls me a mutant for laxity, estimated at one time that with my first two procedures from Dr. Norris, then the three subsequent procedures with him, that I've have nearly five or six cm removed over time.

[Chops]

5 or 6 cm Joe but that would be nearly the width of your whole donor at the back, unless you have an extremely tall head!

 

Also wouldn't that amount of tissue removal, even with extreme elasticity, have an impact on skin towards your face. Kind of like a lateral facelift, lol.

[Dr. William Lindsey]

I agree with Latinlotus. I have seen heavy necked, not necessarily fat guys, but just guys (and some females) with mounds of extra skin in their donor region.

 

I personally haven't done any transplants on them...but I distinctly recall the dermatologist in the next building sending over a guy like this to have me remove a lipoma (benign fat tumor) from this area. After excision, that mass was about the size of a regular soft ball--not a baseball--but a soft ball. Just to close the scalp without a large amount of extra skin, which may or may not have contracted overtime to a normal appearance, I had to excise several cm of scalp in an elipse, similar to a strip. He was a black guy, and wound up with virtually no detectable scar. Probably because even with that excision of alot of scalp, he had no tension on the wound edges.

 

Skin tension is the main predictor of bad scarring. It must me minimized for best results, and even that is no guarantee.

 

Dr. Lindsey McLean VA

[mmhce]

He was a black guy, and wound up with virtually no detectable scar

 

This raises another issue, that I am not sure is dealt with in other threads.

 

Is the appearance of scar tissue on a person of colour, more distinct/unsightly, than a Caucasian, after they have had hair transplant surgery?

[Dr. William Lindsey]

Sure

 

I posted a bunch on that too. Statistics that I recall from a paper that I wrote on keloid treatment in a 1996 Archives of Facial Plastic Surgery article suggested that Blacks have 10 times the keloid risk, and Asians have 7 times the risk as do Whites.

 

2 caveats to that:

 

1. An increasing percentage of our society has some mixed race heritage.

 

2. If you have a bad scar result, your risk was "100%".

 

I am white, am supposedly half german, 1/4 english, 1/4 scottish; yet I am fairly dark skinned and I have 3 hypertrophic scars--1 from surgery, 2 from trauma. So is the issue that I have genes from darker complected races in me, or just bad scar luck??? Who knows. Thus it is hard to predict for any individual. We can only quote trends and risk factors.

 

Overall, in my opinion, skin tension is the key. You take a person with minimal scar potential and do a big bad closure, and I bet they will look worse than someone with a higher risk that has a great closure. Well maybe not one for one risk, but take 10 of each of those, and I would put my bet on the better closure group having better results.

 

Dr. Lindsey McLean VA