Regular Member Dr. William Lindsey Posted August 16, 2013 Regular Member Share Posted August 16, 2013 This fellow had a strip surgery performed in his area several years ago. He had both a poor hairline and a wide scar. We excised his old scar and did 1400 grafts to pack his hairline. Other than getting a traffic ticket after the surgery…his recovery was uneventful, he had his sutures removed at his town, and he sent an occasional picture at 2, 3, 4 and 7 months, and a final picture at a year. He stopped in today to address 3 small areas of new thinning via FUE. A Feller 1.1mm punch was used to harvest FUE’s which were placed in the designated areas. He’ll hopefully send pictures over the next year so we can see progress. His hairline work from our case 2 years ago really is a dramatic improvement, and we narrowed a 1cm scar to about 2.5mm. Not perfect, but a significant improvement that allows easy coverage with fairly short hair. I took a picture of his head with his quite short hair, showing the crease where his scar is, but really a limited scar. A close up of the scar is shown in the FUE “hole” and “perforation before extraction” pictures. The whitish material on the FUE’s in the last few pictures are his dermis (undersurface of the skin) which is light in all races, and contrasts with his dark epidermis. The fact that his hair is quite curly makes this a bit more noticeable. Dr. Lindsey McLean VA William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member Nick153452 Posted August 18, 2013 Senior Member Share Posted August 18, 2013 Definite improvement Dr. Lindsey. Gongrats My Hair Loss Website Surgical Treatments: Hair transplant 5-22-2013 with Dr. Paul Shapiro at Shapiro Medical Group Total grafts transplanted: 3222 *536 singles *1651 doubles * 961 triples, *74 quadruples. Total hairs transplanted: 7017 Non-Surgical Treatments: *1.25 mg finasteride daily *Generic minoxidil foam 2x daily Link to comment Share on other sites More sharing options...
Senior Member Spanker Posted August 18, 2013 Senior Member Share Posted August 18, 2013 Did you get a 3cm wide strip out of the pt on a second surgery? If that scar is a cm wide, I would estimate the strip width to be 3 cm. I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians. View Dr. Konior's Website View Spanker's Website I am not a medical professional and my opinions should not be taken as medical advice. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted August 29, 2013 Author Regular Member Share Posted August 29, 2013 No Spanker, 1.7-2cm is about as wide as I ever go, so as to limit tension of closure. His scalp just retracted that far naturally.... 3 layers of closure got him together pretty well and I'd guess his "new" scar is about 3mm wide. Not perfect but a big improvement. A similar scar and scalp retraction is shown in a case I posted several years ago on an Irish fellow who'd had trouble with 2 or 3 surgeries in the UK. I think the title includes the words: irish, dr. Lindsey, 1500, and scar and I think we did him about January 2009. It has dramatic pics of scalp edges retracting and I last heard from him at 4 months and his scar was probably a "B" at that time. Not bad considering we got 1500 and removed a 1+cm scar. Dr. Lindsey William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member xtatic5 Posted August 30, 2013 Senior Member Share Posted August 30, 2013 Do you find it difficult to perform fue on black patients? What's your average transection rate for these patients? What sized punch do you use for white patients? Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted September 17, 2013 Author Regular Member Share Posted September 17, 2013 Absolutely. Ideal FUE patients are straight thick hair'd individuals and you can slide that FUE punch right down the shaft and get hair very easily. The curlier the hair the more its like trying to FUE out a corkscrew. That being said I think we've now done FUE on 25 black guys, most with a Feller 1.0 or 1.1mm punch. I do have a 1.2mm punch that I've resorted to on occasion but I think its scar is a bit noticable. In guys with straight hair, white or otherwise, almost exclusively we use a Feller 0.9 or 1.0mm punch. Good question. Dr. Lindsey McLean VA William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member xtatic5 Posted September 17, 2013 Senior Member Share Posted September 17, 2013 Thanks doc. I would have loved to have gotten FUE but I was told that it was too difficult on my curly hair. In hindsight, I probably should've insisted. My scar isn't bad but I'll probably get a little FUE into it so that I can shave down. During my surgery they let me look through the microscope at my grafts, they were slightly curved. Not exactly a corkscrew but I get your point. So I guess the idea is to use a punch large enough to envelope the entire "C" and if it cannot then it will just transect. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted September 24, 2013 Author Regular Member Share Posted September 24, 2013 You are absolutely correct. And my use of the word corkscrew is a bit of an exageration. Nevertheless....unless you are planning to have a really short haircut and you are a poor scarrer, I'd always push strip. Cheaper, easier on patient and doctor/staff, and most importantly...more consistent at providing results. I think strip provides pretty reliable results, at reputable offices, probably 90+% of the time. That corresponds with what I've seen in my office over the past 8 years, and what I gather from a few select hair doctors that I know. FUE is very variable. Even in the best of hands. I see one case per 2 months that have poor results from FUE by very good doctors with a good track record. Particularly thin hair'd patients, I personally feel that FUE is like transplanting very fragile trees in your yard...if you so much as stun that root ball, that tree will either die or not do well. Same with hair. There is definitely more trauma to the root ball with FUE than with strip. Dr. Lindsey William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted September 27, 2013 Author Regular Member Share Posted September 27, 2013 Our patient sent pics this week, showing 1 month with a little shock loss, and recovery commencing by the 2 month pics. I reminded him that for our new hair to start growing will be a while longer. I suspect we'll get follow up pics around Christmas and I'll put them up. Dr. Lindsey McLean VA William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey 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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