Dr. Lindsey 6 month check on 2700 on very fine haired man with short haircut McLean V

[Dr. William Lindsey]

This fellow stopped by last week. He’s 6 months out from a 2700 graft case with decent early growth. Shown are periop, 1 week, 1 month scar check, and 6 month pictures. He’s likely to thicken up more by the 12 month anniversary and I suspect we may do a second case.

 

 

 

He’s got a bit of an interesting problem in that he has VERY fine donor hair, keeps a pretty short haircut, and has a lot of surface area to cover. We agreed on a pretty conservative hairline that ought to look natural whether or not he proceeds with a second case.

 

 

I’ve asked him to chime in on this thread.

 

Dr. Lindsey McLean VA

[Blake Bloxham]

Seems like a good plan. Thank you for sharing!

[BicFighter]

Looks good, Dr. Lindsey. Can I ask why the patient only opted for 2700 grafts when he had so much area to cover from the start?

[Dr. William Lindsey]

Excellent question. Answer...because that is all I could get out of his strip. He has the trifecta of 1. Large patch of real estate to cover 2. Thin donor hairs (if he was a thick haired middle eastern man..those 2700 would do a bang up job covering way more than they did in this fellow) and 3. A donor strip that was far from densely packed.

 

Now, you might say, and it would be reasonable to question, why not just take a wider strip?

 

The answer is pretty straight forward in this man. He wanted to make sure he could keep a pretty short hairstyle in the back of his head so getting a good scar was critical. I think we could have probably doubled the width of his strip, or maybe close to double it and get 4500 grafts BUT I'm not sure that I'd have gotten his head closed without significant wound tension and almost certainly an average or below average scar that would probably not have been covered by his short donor hair.

 

And lastly I personally favor a 1.7cm wide strip in everyone because I'm pretty sure that will likely result in a pretty good scar. I posted a thread sometime last year on how I grade my own scars and given about 120 cases per year, I usually get a handful of perfect scars, 3 or 4 bad scars, and mostly above average scars. As its tough to predict who will wind up with those 3 or 4 bad scars...its critical that patient and I both plan for that as a possible outcome and do whatever we can to minimize that risk, and for me its keeping the strip 1.7 cm in width. I've been in practice long enough to also have seen a bunch of guys who at one age were certain that 1 inch long hair was their life long desire and they "didn't care about the scar" only to find that a few years later they want a shorter style and they were either glad they got a good scar OR they present at my place for a revision.

 

Excellent question though. I hope that addresses my thoughts on it for you.

 

Dr. Lindsey McLean VA

[Questionmark]

Thanks for your explanation, doc, which is as always very interesting and coherent. I anyway just once wanted to say this here, that I am impressed by the way you are taking part in this forum!

[Dr. William Lindsey]

Thanks for the positive comment questionmark. I do my best to call it like I see it, whether its hair, face work, raising kids, and marriage. Helps me avoid more trouble than alot of my neighbors seem to find.

 

Dr. L

[agenteye]

Nice work Dr. Lindsey. I always look forward to seeing your posts and your excellent patient results!! This one was no exception!!!

[Spanker]

Dr. Lindsey,

 

I find it interesting that you didn't comment on his CVG. I am not a doctor, so I am not diagnosing it of course but it seems that the gentleman has a mild case of Cutis Verticis Gyrata.

 

Many people of the years have come to the forum over the years asking about it, so I wanted to add the words into this thread so that it could be found in a search.

 

Did you find that the hair is growing evenly in these areas? Could you add a top-down shot in his update?

[thepatient2]

Experiencing good growth and pleased with the results thus far. Looking forward to seeing the end result. I may decide to add a bit more hair at some point, but no decision on that yet. I say this because my goal was to frame my face and that has been achieved. I will say this, I am very glad I chose Dr. Lindsey for my procedure. I give him a big thumbs up! Yes, I am the patient.

[Dr. William Lindsey]

Thanks for coming on and posting! I really appreciate your 2 cents. And of course let me see you at the 12 month mark.

 

Spanker...he really has a mild case of it if he has it at all. When not edematous from injections and procedure trauma his scalp looks better than mine, but I agree you could make a case for CVG from 2 of those pics. Interestingly I too get lines that could be mistaken for CVG when my head is shaved and I have had too much sodium from a long training session. It resolves once I've diuresed out the extra fluid though.

 

Good call.

 

Dr. Lindsey