Dr. Patrick Mwamba Posted October 30, 2012 Share Posted October 30, 2012 This 40 years old patient ,NW 3 vertex in hair loss scale came for a repair case : He had 3 previous hair transplants by strip technique(3000 grafts). Result : wrong hair angle direction , pluggy look ,pitting , a damaged receiving area with bumps (cobblestone), And big scars in the donor. His goal was: 1. To look natural, 2. To fill in his back scar, 3. To lower his frontal hair line and frame his face so that he will stop wearing a hat all the time. Surgery 1 plan : -Removing the plugs ( to minimize the scarring ,we usuallyclose the punch holes with a suture ,nylon 5/0 , for 3 to 4 days. In this case , we left it for only one day because we had to graft the area ) -Lower FHL with hairs above the nape area, build back the temples pointes in harmony with the new hair line ( otherwise the result may look unnatural ). -Increase density in frontal zone . This area was fibrotic and whitish because of previous work and had poor blood circulation. (poking test ,bled after 20 sec or plus) -Fill in scars in the back . Total graft number : 4025 grafts in 4 days . After 9 months : -yield was very good in the virgin area ( temples pointes ,FHL). You will notice a difference in hair strenght and pigmentation between his FHL and temples pointes. Indeed hairs for the FHL originated from lower donor area above the nape hairs . - The pluggy look was corrected. -Poor growth in the scarring area in frontal zone . -Good coverage of the scar in the back ( not illustrated in our pictures). Surgery # 2Plan (9 months after surgery 1) : -We decided with the patient to lower the density in the temples pointes by removing the grafts and relocating them in FHL and frontal zone . -We completed the FHL with grafts from regular donor area for a total of 969 grafts . Results : Natural look with a low solid hair line , in harmony with temples pointes density . No pluggy look . Good growth in frontal zone that was grafted at low density . Next step : Reinforce some patchy area in the frontal zone to complete the work. Repair case requires patience and sometimes more than one procedure in order to meet some kind of expectations if possible. Follow us: Facebook - Youtube - Pinterest Dr. Patrick Mwamba is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
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