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Trans-gender patient; One frontal session 3322 hairs; Dr. Mike Beehner


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This 41 y/o male-to-female transgender patient presented for a first HT session in February of this year. The "after" photos were taken only 8 months after the first surgery, so we expect some more density in the coming months. She is coming back for a final, second procedure to "fill in the cracks" and reach the density she would be happy with for the rest of her life.

1661 FU's were placed, with a large number of them going into the temple areas on each side. Her FU grafts consisted of 30% 1's, 50% 2's, and 20% 3-hair grafts.

Note that there is residual scarring from a face lift, bone contouring of the forehead, and a scalp advancement surgery, which we tried to hide with our grafts. These scars also dictate that maximal planting density of grafts is not done. Two of the "before" photos featured below are after her facial surgery to tighten things up.

The photo at the bottom right is a "before" photo but after her facial surgery. Just wanted to show what that procedure achieved prior to our transplanting.

Mike Beehner, M.D.

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Edited by Mike Beehner, M.D.
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that looks very natural

 

i always wondered how with women you can lower the hairline and bring in the sides A LOT with so few grafts.

 

but with men you can't or at least it's not done the same way

 

does this have something to do with the way the hair is placed?

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Wow! This is an excellent case. I love the female hairline design. It's pretty amazing how drastically this can create a feminine appearance. Great work.

"Doc" Blake Bloxham - formerly "Future_HT_Doc"

 

Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

 

All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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In reply to Mickey85's comment on the density of planting, I just wanted to emphasize again that this patient had a lot of bone shaping of the forehead, a hairline advancement, which involves a full-depth cut through the forehead skin and fascia, and also a face lift, and a rhinoplasty - all done in a foreign country at once a few months earlier. The blood supply in that area after all of that surgery dictates that the surgeon "ease up" on the density of planting so that 90%+ growth is realized. The second session, which is coming up, will hopefully fill the gaps enough that it looks "full". Thank you for the other comments.

Mike Beehner, M.D.

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In reply to Mickey85's comment on the density of planting, I just wanted to emphasize again that this patient had a lot of bone shaping of the forehead, a hairline advancement, which involves a full-depth cut through the forehead skin and fascia, and also a face lift, and a rhinoplasty - all done in a foreign country at once a few months earlier. The blood supply in that area after all of that surgery dictates that the surgeon "ease up" on the density of planting so that 90%+ growth is realized. The second session, which is coming up, will hopefully fill the gaps enough that it looks "full". Thank you for the other comments.

Mike Beehner, M.D.

 

Do the surgeries that you mentioned compromise blood flow for life?

I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians.

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I am not a medical professional and my opinions should not be taken as medical advice.

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I reply to Spanker's question as to whether some of the procedures this trans-gender patient had have an affect on the scalp's circulation for the rest of her life or not, I think the rhinoplasty probably did not. The others - the scalp advancement, the face lift, and the bone re-shaping of the forehead - these all involve cuts (some of them full depth all the way down to the peri-osteum which is the lining over the skull bone itself. Certainly the circulation tries to heal to bridge where that cut and subsequent scar tissue is, but I don't believe it is ever quite the same.

As a result, one has to, as I said, "ease up" a little on planting density, because there might not be the usual cross-circulation of blood coming in from the rear as there is with other hairline area surgery. We certainly are saved many times by the scalp's generous blood supply and 10 arteries feeding it, but the great majority of the scalp's blood supply comes from the paired occipital arteries in back and the two superficial temporal arteries near the temple (the pulse you feel when you put your finger on your upper sideburn area.

Mike Beehner, M.D.

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