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Steven Gabel, MD, FACS

High Density Frontal Hairline Revision - Steven Gabel, MD - Portland/Seattle

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This patient is a 34 year old gentleman who was unsatisfied after two prior transplants to the frontal hairline at another clinic. He had his transplants at an institution that has centers throughout the country. He felt that the results were not what was promised. Despite the procedures, he felt the frontal hairline was thin to the point that only a small percentage of the hairs grew, and most concerning, was that what grew was uneven.


Therefore, as I discussed with the patient, our goals would be to design a hairline that would make it even from the right and left sides, and also increase the density in the first to second centimeter.


In one session, 1024 grafts were placed in the first and second centimeter as shown in the photos. It was imperative that the slits were placed in exact locations not to damage the existing hairs, and to make sure that the frontal hairline had the correct angulation and hair direction to blend in with the existing hairs. From a technical point of view, when placing grafts, we put a lot of emphasis on making sure that the natural curvature of the placed grafts are oriented correctly. If the grafts are placed correctly, a more natural appearance is obtained; if the grafts are placed with the natural curvature of the hairs not oriented in the exact direction of the natural hair, the results can be suboptimal.


The postoperative photographs show very closeup detail of the results obtained (the most closeup photographs were obtained using a 60 mm macro lens at a distance of a few inches from the scalp). I wanted the photographs to line up as close as possible between the preoperative and postoperative shots so an objective comparison would be possible, which I present to the patients so they can see the changes. Additionally, I placed a ruler in several of the photographs to show the high density slit and graft placement. The patient felt extremely pleased with the results so far. We look forward to continued improvement in growth and density over the next year.










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Dr. Gabel, this looks pretty solid. Does this person have gel or water in the hair when slicked back as well in the post op photos? I'd imagine that kind of hinders the effect of density as that can compress hair, which may mean it could be much denser than it looks. Was this FUT or FUE? What was the amount of density planted in the front per cm2?

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