Dr Carman 2176 FU Grafts 6 Month Post Op

[Dr. Timothy Carman]

Our patient is a 42 YO male with presenting complaint of androgenic alopecia resulting in loss of the frontal hairline, frontal forelock, midscalp and crown. In addition, his donor has a density of an average of 80 FU/cm2. This case illustrates the use of a limited number of grafts to recreate a natural look that is designed conservatively enough so that remaining donor is not utilized solely to support a non-conservative hairline approach. This allows for future use of grafts in the midscalp, along with donor available as needed to address future losses. Patient is currently on finasteride 1mg/day. Total grafts 2176; 1's = 1140; 2's = 1025; 3's = 11. Closure of strip donor site is tricophytic.

And remember, at this stage he has about 60% growth present.

Edited February 14, 2011 by Dr. Timothy Carman

[baldingbro]

Dr Carman, The result looks very natural. But I guess this person needs a crown work for a better look. I support a conservative approach for higher NW class patients or younger patients heading for a higher NW class.

What is the size of the area covered in this session.

[Blake Bloxham]

Dr. Carman,

 

Thank you for sharing this result with the community. For the 6 month mark, I think the patient looks good, and I agree that the work is refined and age appropriate. I'm curious (as well) does this patient have any future plans to address the crown region?

[Dr. Timothy Carman]

The area covered is approximately 70 cm2. Our plan includes a second session which will focus on the midscalp and anterior crown. The reality of a presenting NW class such as this is the large area of "demand" and the limited amount of "supply" available in such a patients donor reserve. This sceanario requires careful discussion and planning between the patient and surgeon, because, IMHO, trying to spread the supply to BOTH the crown and the frontal hairline leads to a dilution of the supply which results in either a "grafty" look despite the use of FU grafting, or a less than cosmetically significant improvement from baseline. Concentrating on the frontal and midscalp area places the donor in the most cosmetically appreciated areas for improvement, again, IMHO. Again, however, this area of discussion is affected as well by whether the crown is more significant than the frontal view to the patient or not. Should the crown be more important, then the limited donor would be focused there.