Dr. Lindsey 3rd stage repair of flap failure. McLean VA

[Dr. William Lindsey]

This really nice fellow has several other posts on the forums. Basically in the late 80s he had a flap procedure on the left side in Australia. The flap was inset too low on the forehead AND the distal half of the flap died. He wore a hat and tolerated this until a few years ago. At that point we came up with a plan to attempt to repair his problem using three procedures. Viewers who wish to see more detailed views of each procedure can likely easily find them by using my name and flap repair as key words on forum search engines.

Shown are preop pictures showing his initial presentation. His first case was a standard strip hair transplant to build him a hairline in the natural anatomic location for a 60ish year old man with the limitations of very fine hair and limited donor quantity due to donor density and flap harvesting and scarring.

Next stage 2, done about a year out from the first case, was to excise his flap-getting about 700 grafts for placement behind his first case, and removing the dead/scarred in flap from his forehead in a modified browlift approach. A few postop pics are shown and he had difficulty with arranging suture removal back home so the scar is slightly worse than I’d expected, although very reasonable.

Finally we did a second strip case a few weeks ago. Shown are a picture of us outside my office before the case, and case pictures of finishing off his crown and adding singles for density up front. I think that even though we waited a year for “part 2” that the forehead incision used for flap removal did decrease growth along the hairline a little.

Overall he and I are really happy with the results. He’s gone from a “hair cripple” to an unremarkable looking man….a huge step. He and his wife are planning on visiting the US in early next year so I may be able to get additional followup and I expect he’ll send pics at 12 months.

There is one other fellow that has contacted me with a similar problem. Hopefully we can work with him too. These cases are a break from the routine and allow thoughtful planning, surgical execution of the plans, and time to all coalesce into an end result.

Dr. Lindsey McLean VA

[wylie]

This is going to be a very nice result. I'm always glad to see endings like this one. This patient does not look to have scarring in the back from the flap removal so he is lucky in this regard. I know the case of the other patient you are speaking about, and have seen his pictures as well. He has bad scarring in the back from two flaps, as well as necrosis in the front. His case is far more complicated, and I know he does not want any additional grafts placed in front.

 

After seeing this result I believe removal of the flaps to be replaced by a thin scar like this gentleman has is his best route. If all those flap hairs could then be placed in the scars he too could go without a hat someday.

[Blake Bloxham]

Cool case! Thank you for sharing.

[Dr. William Lindsey]

Here's a followup, hopefully more coming!

 

Dr. Lindsey