4072 hairs placed in one-pass on 29 y/o male; Dr. Beehner

[Dr. Michael Beehner]

This 29 year old male had a transplant session performed in Novemter of 2010, which comprised 1436 grafts, equal to 4072 hairs. The plan was to do 2-3 sessions in total, so this set of photos only shows the results from the first session, which the patient was quite pleased with and helped frame his face in a way that didn't exist before the surgery.

He had 1036 FU's placed, including 580 of them at the front hair line zone, and also 400 DFU grafts of 4-5 hairs each placed within the frontal and mid-scalp regions. The "after" photos are taken 18 months after the first transplant, when he returned for his second surgery, which we feel will be all he needs for the next several years.

Michael Beehner, M.D.

[Cant decide]

Dr B - This is about what one should expect for that number of grafts. Why was such a modest procedure done when he clearly could have benefitted from 3000 in one pass?

[Dr. Michael Beehner]

Dear "Can't Decide:"

When you refer to doing 3000 grafts on this man for his first session instead of the 1400 plus that we did, I am quite sure you are referring to using FU grafts. In fact, we do offer that choice to each patient.

The square area we filled in with this patient's first procedure was the entire top of the head except for the downhill crown/vertex in back, which is a fairly large area. 1500 FU's spread over that area would look like nothing was done. By using the 400 MFU grafts, each of which is dissected under the microscope to contain either 2 or 3 relatively close FU grafts into one graft of 4-5 hairs, we are able to achieve a visual density in the center which with FU grafts would require the 3000 you mentioned. The difference in cost between the two procedures is six thousand for one and almost thirteen thousand for the larger. Here in upstate New York State, many more patients can afford the smaller cost procedure than the expensive one, and in fact it turns out that 80% of our patients with this extensive amount of baldness do choose the "combination" graft approach and do plan to come in for two procedures. Someone bald who chose the 3000 FU route instead, would also almost always need to come in for a second procedure also.

So my intent in even sharing this patient was to simply show that using some DFU's and TFU's can enable the hair surgeon to fill in both the frontal and midscalp regions in a way that makes a significant improvement even with the first procedure. I certainly am not saying that he is done with surgery. Hope I was able to clear up that point for you.

Mike Beehner, M.D.

Mike Beehner, M.D.

[Cant decide]

Great, thanks doc.

[Spanker]

First, I am not a doctor, so take it for what it's worth.

 

This is an interesting surgery as a base. I still feel that smaller fu's give better coverage when you are talking the same number of hairs. Doing MFU's will help with coverage if you are reducing the number of grafts, but hair for hair, smaller fu's in my opinion will give better coverage. A friend of mine demonstrated his thoughts on this when we spoke about this subject. I will demonstrate it below.

 

Here is 30 dots that represent hair fu's:

 

 

Here is what 32 dots (6.25 percent more hair) looks like in a 4 and 5 hair unit:

 

 

This is open for debate, and I mean no disrespect, it is hard for me to see the advantage, except for economics, to go with larger units when talking about the same number of hairs.

Edited August 7, 2012 by Spanker

[Dr. Michael Beehner]

Spanker,

Using your drawing of MFU grafts, I assumed an arbitrary angle of light being directed to the scalp from the left of the picture down to the right at 45 degrees. This simply demonstrates my point that I think a graft of three or more hairs (even a 3-hair FU!) blocks light from reaching the scalp better. Providing that the surgeon angles the grafts at a relatively acute angle, so that "shingling" occurs, if you just took the mid-scalp region in the top-center of the scalp as an example, and you placed 250 DFU grafts averaging 4.5 hairs apiece on one patient and then placed 500 2-hair FU's evenly distributed on another identical patient in the same square area.....that the scalp beneath will be less visible to the viewer with the DFU grafts because of the light blocking properties of the larger grouping of hairs.

In truth, a DFU graft of 4 or 5 hairs would have a slight gap between the two groups of hair, as it does preserve that gap and doesn't compress it to the point it disappears.

The other point that bears mentioning is that research studies to date show 100% yield of MFU follicles, vs an average of 90% for FU grafts (over 40 studies done, and they range all over the place, but average at 89.1%)

Mike Beehner, M.D.