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What not to do....put a transplant over an artificial scalp bone


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This lawyer walked in a few weeks ago with a history of having an acrylic implant placed a few years ago to camouflage a skull asymetry. He then went somewhere on the west coast and had 100 minigrafts placed. A few months ago the same doctor did 200 minigrafts to the crown and shortly thereafter the patient developed chronic oozing.

 

I treated a severe case of cellulitis with antibiotics and vinegar rinses and his infection resolved....fortunately without seeding the implant and thus requiring removal.

 

He has an area of dead skin that will slowly come off and we'll see what develops.

 

Its an unusual case, I haven't heard of this in the literature. If any patients or doctors have heard of this, post something. I may have one of our residents write this up for the literature.

 

Dr. Lindsey McLean VA

 

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William H. Lindsey, MD, FACS

McLean, VA

 

Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians

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This lawyer walked in a few weeks ago with a history of having an acrylic implant placed a few years ago to camouflage a skull asymetry. He then went somewhere on the west coast and had 100 minigrafts placed. A few months ago the same doctor did 200 minigrafts to the crown and shortly thereafter the patient developed chronic oozing.

 

I treated a severe case of cellulitis with antibiotics and vinegar rinses and his infection resolved....fortunately without seeding the implant and thus requiring removal.

 

He has an area of dead skin that will slowly come off and we'll see what develops.

 

Its an unusual case, I haven't heard of this in the literature. If any patients or doctors have heard of this, post something. I may have one of our residents write this up for the literature.

 

Dr. Lindsey McLean VA

 

534102571_73A331CBFE4453DC478B16A6BFDBA5CB.jpg.thumb 454102481_CAB65E4A692A7FD8A47F8428AEF66D6A.jpg.thumb

 

 

William H. Lindsey, MD, FACS

McLean, VA

 

Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians

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Dr. Linsey

 

Can you give a little more detail? He had an implant placed centrally? and how big is the implant? Do you know where the incisions are for the implant? Also, where did they put the grafts - are they spread out over then entire crown or just at that central necrotic area?

 

Interesting situation.

Steven Gabel, MD, FACS, FISHRS

Diplomate, American Board of Hair Restoration Surgery

Diplomate, American Board of Facial Plastic and Reconstructive Surgery

Diplomate, American College of Surgeons

 

Gabel Hair Restoration Center

Portland, Oregon

503-693-1118

Email Dr. Gabel directly at drgabel@gabelcenter.com

Dr. Gabel's Website

 

Dr. Steven Gabel is a member of the Coalition of Independent Hair Restoration Physicians.

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Dr. Gabel,

 

I don't know the answer to those questions. This lawyer is "supposed" to be getting me his op notes but has not done so yet.

 

My best guess is methylmethacrylate, under the galea at the crown. He has a small area that is pluggy in the same region, but central to that pluggy area is this eschar.

 

So we are just guessing. He is do in in an hour for a progress check and eschar debriedment. If I get more info, I'll post it, otherwise when pics are worthwhile, I put them up again too.

 

Dr. Lindsey McLean VA

William H. Lindsey, MD, FACS

McLean, VA

 

Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians

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Dr. Gabel,

 

Here is his pic today. Exposed implant. Still hasn't gotten op notes, but I think he will need this removed and 2 flap reconstruction.

 

A very interesting problem.

 

Dr. Lindsey McLean VA

William H. Lindsey, MD, FACS

McLean, VA

 

Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians

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