2700 graft frontal procedure in Korean by Dr. Lindsey McLean VA

[Dr. William Lindsey]

This nice fellow was in with a significant family history of hairloss and a brother who had had minigrafts down the street. Going for the patient is a profuse supply of thick dense donor hair and a stretchier scalp that I expected....to the point of which I think we could have gotten 3500 with a tension free closure. Problem is that you don't know how stretchy that scalp REALLY is until the strip is out, and asians have a higher incidence of scar problems...further shown in his brother. Going against this patient is the typical color mismatch between white skin and very dark hairs which aren't really amenable to wavy hairstyles.

So after a couple of consultations we proceeded with 2700 grafts with dense placement along the hairline. He did a very good job of staying clean and his scar looks typical. He'll be back at Thanksgiving for a scar check.

Dr. Lindsey McLean VA

[Bill - Seemiller]

Dr. Lindsey,

 

Looks like nice clean work. I look forward to seeing how his results turn out.

 

Given this patient's advanced hair loss, does he plan on having more work done to target the back half? Is he on Propecia and/or Rogaine to help keep the existing hair he has?

 

Thanks for posting.

 

Bill

[azn_guy]

...to the point of which I think we could have gotten 3500 with a tension free closure.... asians have a higher incidence of scar problems

 

Hey Dr. Lindsey, It looks like you did a great job on this patient...Well done! Looks nice and clean.

 

How many grafts do you think this patient has left?

 

Based on the fact that asians have a higher incidence of scar issues, would you elaborate on what you mean by this? Are you saying that scar stretching is the main issue? As a HT surgeon, what precautions do you take to minimize this?

 

Assuming you're able to get 3500 out of one session and you notice the donor strip scar stretches, obviously this would not be the ideal scenario. So would it be advantageous to break up the session into into a 1800 session, then another 1700 session?

 

Since this patient was Korean, I know for a fact that Koreans have very fair skin, like many other asian races such as Japanese and Chinese from the North. With that said, can we safely assume that asian people that are from the south such as Vietnamese/Thai/Indonesian/Philippines/Pacific Islanders tend to have better "Hair color to Skin" ratio since they tend to have tanner skin?

 

As you guys know, I am personally interested in this case

[Dr. William Lindsey]

Thanks and I agree he did a better job than most at keeping clean.

 

As to the scar...about 13 years ago I wrote a paper in the Archives of Facial Plastic Surgery I believe, on Keloid treatments. I referenced a few studies showing that black people had 10x a caucasian's scar risk, and asian's have 7x a white person's scar risk. From personal experience and having done over 3000 facelifts, I can say that I think I had maybe 5 scar problems on blacks, 2 on asians and 5 on whites, but probably the percent of patients was 10% black, 3%asian, and the rest white.

 

Bottomline, I worry a bit more in non-whites about scars, but so far we have a pretty good experience in everyone with scars. More than race, getting a tension free 2 layer closure is in my opinion the most important, whether on the face or scalp.

 

Dr. Lindsey McLean VA