Dr. Cam Simmons – A slightly unusual plan for a Ludwig 2 woman.

[Cam Simmons MD ABHRS]

This lady in her mid-30s had a Ludwig 2 pattern of thinning. She had fine, straight, brown but highlighted hair and had a stable donor area. She has an S-whorl and naturally parts her hair on the left.

 

Usually, we would focus on her midfrontal forelock and the first portion of her left part so the hair there could look better and she could style that hair to make other areas look better. She preferred to transplant along the length of her part. At her consultation and pre-op, she consistently parted her hair at exactly the same place. We focused on a much narrower than usual area along her part, knowing that parting her hair outside this zone would eliminate the cosmetic benefit.

 

With her fine hair, we knew it would take a higher density to give her the results she wanted. Transplanting at higher density increases the risk of shock loss but could give her a finished result in one session. Transplanting at lower density would reduce her shock loss but she would likely need a second session to get enough density. She chose the former plan.

 

She had 2725 grafts transplanted in her midfrontal forelock and along her left part in a narrow area. Her hair was fine and her grafts were small so they were transplanted at 64 grafts per sq cm. (This is a much higher density than I would recommend for someone with average-sized grafts.)

 

In anticipation of shock loss, she switched to a right part until the transplanted hair grew in. She used 2% Minoxidil lotion then 5% foam but by 3 months, she reported that she did have significant shock loss. At her 5 month follow-up, her hair was finally starting to fill in but she still needed to wear a right part. At 10 months she neared her final results and when she returned at 18 months, her hair was longer (and highlighted more). Both times, she came in with her hair parted right down the middle of the transplanted area.

 

She will be the first to admit that the shock loss was tough but is very happy with her final results. Despite the shock loss, she is still happy that her results were achieved in one visit instead of two.