Frontal options: 2 frontal "U's" and one "entire front" by Dr. Lindsey McLean VA

[Dr. William Lindsey]

These 3 fellows have significant hairloss but each had a tuft of reasonably good hair right at the front. When folks have this, as I discussed in another thread last week, I'll offer to either do a "U" shaped case or just include the tuft area with the planned case.

 

There are arguments for and against that we lay out for the patient to consider. For the U is that the frontal tuft may not ever go away, and why "waste" precious donor hair in a reasonably good patch; preserving a tuft if long enough, can allow a bit more camouflage of the procedure, and if that tuft were addressed, it would take significant grafts that could help extend the recipient region further back on the crown. Also, if the tuft were to go, a pretty small strip or FUE can be done to address it. Arguments for doing the entire front focus mainly on dealing with the entire front in one surgery and then not having to come back for future loss up there anymore.

 

Last month we had a cluster of folks with similar loss patterns. Shown are 2 "U's" and one "entire front" cases, all of 2800 to 3200 grafts. I personally agreed with each fellow's choice based on their desires, ages, and donor recipient characteristics. I have put up a couple of grown out U's before, and it'll be interesting to see how these 3 grow over the next year.

 

Dr. Lindsey McLean VA

[TakingThePlunge]

Dr. Lindsey,

 

Thank you for sharing these cases with us. I'm looking forward to following the progress of each of these patients.

 

It's great when a physician takes the time to listen and reflect on his patient's wants and needs and provides them with options.

[Dr. William Lindsey]

You are correct. An educated consumer who knows as much as he/she can about options, is a better and more satisfied consumer.

 

Preop discussion and the elimination of "surprises" helps everyone.

 

Dr. Lindsey McLean VA

[Mp96]

That's for sure!!!lol!! I thiink the patient has a right to know what to expect from their surgery....There should be absolutely no surpises in this type of surgury....No matter the circumstances...!!!!!!!!!

[ytoday]

can i ask one question.....initially my surgeon tol me that for the second procedure with him, he would use apprx 1500-1600 graphs....but i found out after the procedure that he actually used only 1350.

 

would you consider something to be wrong with that?

[Dr. William Lindsey]

ytoday,

 

that would seem to be a good thing to discuss with your doctor. As I have posted, we get a count of grafts prepared by the techs and I review the total with the patient at the end of the day. If we don't get the target, the patient will pay less, if we surpass the target, the patient may be asked to pay a little more...but not a lot more.

 

Occasionally we just don't get the target, often because of sparse donor hair. For example, this Friday we are doing a friend of mine's second procedure. We aimed for 2700 the first time and got 2450, mainly due to his less dense than expected donor hair AND his tight scalp. He's been stretching for a month this time but is still tight and I think we'll be lucky to get 2500.

 

More commonly in guys who don't need but 1600 is that we end up with 1800 grafts. Then there is the dilemma of what to do with them. Some guys you can just make room, often in a nearby area or on the crown if we are doing the front. But occasionally they are so dense everywhere, that I am afraid of placing the extras due to the potential for killing good growing hair.

 

That is where preop and intraop communication is important.

 

Go back and discuss this with your doctor, he likely can explain things.

 

Dr. Lindsey McLean VA

[Dr. William Lindsey]

"U" #1 stopped in last week for a 2 month check. Note his scar looks pretty good despite vigorous exercise and his recipient site shows that most of the placed grafts have shed. He'll be back around Christmas for another check.

 

Dr. Lindsey McLean VA