4,000 FU case, Dr. Paul Shapir, 6 month follow up

[Dr. Paul Shapiro]

This 34 year old male came in for his 6 month follow up visit today. He is very happy with his work.

He is a Norwood type IV ??“ V and the males in his family have significant balding. He has significant balding in his crown but has not been on propecia. He did not want to go on propecia at the time of surgery. As you can see he looks like he has lost some more crown hair over the past 6 month so we started him on propecia today.

In a case like his there is always the decision to make of if we should cover more area and get less density or cover less area and get more density. Since he has the potential of becoming a Norwood type VI we decided to cover a larger area. I covered 130-140 sq.cm. of scalp with 4,000 FU. I went back to the top of the crown but did not do any crown work.

This resulted in a good coverage of hair with a natural look in 6 months. I do expect to see some more growth and greater density at his one year follow up visit. As I said he is very happy with the transplant already and he feels that we have accomplished his goals.

[NewJack]

Looks great for 6 months . He looks much younger

[aaron1234]

Great work again Dr. Paul. You are showing some fantastic results for only 6 months. I'm really looking forward to seeing their full matured results after a year.

[Bill - Seemiller]

Dr. Paul,

 

Thanks for yet another detailed presentation and excellent photos. This patient is progressing very nicely for 6 months. I expect great things to happen over the next several months. I hope you'll post his final results in another 6 months.

 

All the Best,

 

Bill

[M1A1]

Dr Paul Shapiro,

 

Nice write up and result. Actually, the yield looks very good for 6 months...Not to mention not using propecia...Do you thin rogain foam would help this patient?

 

 

Dr. Shapiro, would you say the density you planted is around 30 fu/cm-sq? Moreover, do you know if he will have a follow-procedure? By the way, what was his donor density, length & width of his scar?

 

The smile on his face says it all...

 

Thank you,

[Dr. Paul Shapiro]

M1A1

This patient's donor strip was taken out in multiple sections. For the middle section I took out a 19.5 cm long by 1.6 cm wide strip. On the sides I decreased the width of the strip to 1.4 cm and took out two small strips totaling 9.5 cm long. I did not take a photo of this patient's donor density but by doing the math I took out a total of 44.5 sq.cm of donor and dividing that into 4,000 FU he donor density was 89 FU/sq.cm which is a little above average.

I would say that on average I planted at a density of 30 FU/sqcm.

This patient did not indicate that he wanted a second procedure. He still has 6 months of growth left and he is very happy with his coverage even at 6 months. He went from looking very bald to having a good frame of hair. For many patients this meets their expectations. But for other patients they would like more density or to have more crown coverage. Of course since he is only 34 years old and has the potential to become a Norwood Type VI we would have to be very judicious where we plant the graphs if he wants a second session.

Dr. Paul

[Raphael84]

Great results. I like them a lot. The density at the point already looks hugely impressive to me. The visual improvement on this patient is huge. Very impressed!

[Sparse]

That's a nice transformation for 6 months.

 

Dr. Shapiro: How would you describe the patient's hair characteristics? It's hard to tell from the pics, but I'm guessing his hair is a bit on the coarse side? Was that a factor in your decision to go for high coverage (>130cm2) at relatively low density (30 grafts/cm2)?

 

P.S. Are those pics with flash or without?

[Dr. Paul Shapiro]

Originally posted by Sparse:

That's a nice transformation for 6 months.

 

Dr. Shapiro: How would you describe the patient's hair characteristics? It's hard to tell from the pics, but I'm guessing his hair is a bit on the coarse side? Was that a factor in your decision to go for high coverage (>130cm2) at relatively low density (30 grafts/cm2)?

 

P.S. Are those pics with flash or without?[/quote

 

Sparse:

Yes, I would describe the patient's hair as more on the coarse side and the density achieved is about 30grafts/sq.cm.

In deciding the surgical plan it is always a co-operative decision with the patient and the doctor. In this man he was more concerned with covering a larger area of scalp then getting the higher density. He wanted to go from looking bald to having hair. Some men would rather have more density in the front ?? of their scalp and have less coverage and others are more concerned with coverage. And this patient also has a larger area of scalp to cover then the average man.

As for the photos they are taken with a Flash. I know there are some who think that it is superior to take the photos without the flash, but I think there are advantages and disadvantages to both methods. I think what is most important is to take the photographs using the same method for before and after so then we will have as similar photos as possible to compare. I do agree that at some angles using the flash may make the hair look a bit denser, but at some angles the flash will make the hair look thinner. Also I find the when using the flash we get much better detail of the hairline and the colors and skin tone more accurately reflect what we see with our eyes. Today I took some photos of my hairline and top of my head using both flash and not using flash. I am starting to thin but not enough to get a hair transplant. All these photos were taken using a tripod in my office. The overhead light is the usual office florescent light.

As you can see the detail is better with the flash photo. In the photo of my front hairline, the photo taken without a flash is a bit more see throught then the photo taken with a flash. But from the top the photo with the flash is more see through then the photo without the flash.

Photography is a complex tricky subject. Not only is flash or not flash important, but the angle the light is coming from, the type of indoor lighting used, the shutter speed, the distance and angle one is holding the camera at are importatnt. And when taking a photo out of doors the angle of the sun and what direction one is facing makes a big difference. So my feeling is that it is most important to be constant as possible with the photos.

I hope this is helpful

Dr. Paul

 

Below are photos of my hairline and top of head with and without flash