Regular Member Wen-Yi Wu M.D. Posted October 23, 2014 Regular Member Share Posted October 23, 2014 31 y/o patient, Norwood class V, did not want Finasteride, only on Minoxidil for past one year. We recommended two sessions. The first session would cover frontal and midscalp area. 2 nd session on the crown 2 to 3 years later. Total number of grafts 3439 grafts Splitting of grafts: 1 h 1585 2 h 1763 3 h 91 Wen-Yi Wu M.D. FISHRS 吳文藝醫師 Fellow ISHRS International Society of Hair Restoration Surgery 國際植髮醫學會 金章醫師會員 Diplomate ABHRS American Board of Hair Restoration Surgery 美國植髮醫學會 專科認證 Taiwan Hair Transplant 台灣萌髮診所 8F, 21 Section 3, Nanjing East Road, Taipei, Taiwan 台北市南京東路三段21號8樓 Telephone: 886-225011383 email : wu@hair7838.com www.hair7838.com LINE : taiwanhair Wechat: taiwanhair What'sApp: +886972978333 Dr. Wen-Yi Wu is recommended on the Hair Transplant Network Link to comment Share on other sites More sharing options...
Senior Member KO Posted October 23, 2014 Senior Member Share Posted October 23, 2014 That's phenomenal. Do you have his hair caliber in microns? 3382 FUE Lupanzula http://www.hairrestorationnetwork.com/eve/185463-3382-grafts-lupanzula.html Link to comment Share on other sites More sharing options...
Senior Member TakingThePlunge Posted October 23, 2014 Senior Member Share Posted October 23, 2014 Great plan and excellent work as always Dr. Wu! David - Former Forum Co-Moderator and Editorial Assistant I am not a medical professional. All opinions are my own and my advice should not constitute as medical advice. View my Hair Loss Website Link to comment Share on other sites More sharing options...
Regular Member Wen-Yi Wu M.D. Posted October 23, 2014 Author Regular Member Share Posted October 23, 2014 That's phenomenal. Do you have his hair caliber in microns? Yes, I do agree with your thinking. The importance of the hair shaft diameter cannot be overstated. It is the most important predictor of " coverage" in hair restoration surgery. The total volume of hair determines the visual impact. Doubling the hair density doubles the hair volume, while doubling the hair diameter quadruples the hair volume. Most Asian patients have coarse hair caliber. Likewise, this patient's hair caliber reached almost 90 microns Dr. Wen-Yi Wu is recommended on the Hair Transplant Network Link to comment Share on other sites More sharing options...
Senior Member CAMPBELL Posted October 23, 2014 Senior Member Share Posted October 23, 2014 Outstanding !! Link to comment Share on other sites More sharing options...
Senior Member Loags79 Posted October 23, 2014 Senior Member Share Posted October 23, 2014 I would judge this as 7/10. The hairline is quite weak. Coverage is satisfactory. I certainly wouldnt classify this in the realm of outstanding. my HT thread: http://www.hairrestorationnetwork.com/eve/175267-dr-radha-fut-3261-grafts-photo-word-heavy.html Link to comment Share on other sites More sharing options...
Senior Member KO Posted October 23, 2014 Senior Member Share Posted October 23, 2014 Seriously? He made a dramatic cosmetic improvement on a Class 5 with 3400 grafts, hairline to crown. That's extremely good IMO. Furthermore, as the Dr stated, this is just Step 1. 3382 FUE Lupanzula http://www.hairrestorationnetwork.com/eve/185463-3382-grafts-lupanzula.html Link to comment Share on other sites More sharing options...
Senior Member CAMPBELL Posted October 23, 2014 Senior Member Share Posted October 23, 2014 Everyone has different benchmarks to what is good in their mind. It'd be pretty mundane if we all saw things exactly the same. I standby my original impression. Plus, as was stated initially this is a two step process Link to comment Share on other sites More sharing options...
Senior Member Loags79 Posted October 23, 2014 Senior Member Share Posted October 23, 2014 I'll tell you what i think would've better. Use of 3500 odd grafts for hairline and front 2/3rd of the scalp. Forget about the crown for the first HT. Also, this guy is not no meds so in 5 years he will look far far worse in the front than what he appears now. People put too much value on crown coverage. Crown is overrated. Get a good permanent hairline so the viewer cannot see through you. I see the first stage did cover crown. Better that the 500-800 grafts gone into crown be used on hairline. my HT thread: http://www.hairrestorationnetwork.com/eve/175267-dr-radha-fut-3261-grafts-photo-word-heavy.html Link to comment Share on other sites More sharing options...
Senior Member KO Posted October 23, 2014 Senior Member Share Posted October 23, 2014 Alrighty then. Let's build a wall of hair and be ass-bald behind it. Good thinking. 3382 FUE Lupanzula http://www.hairrestorationnetwork.com/eve/185463-3382-grafts-lupanzula.html Link to comment Share on other sites More sharing options...
Regular Member Wen-Yi Wu M.D. Posted October 23, 2014 Author Regular Member Share Posted October 23, 2014 I'll tell you what i think would've better. Use of 3500 odd grafts for hairline and front 2/3rd of the scalp. Forget about the crown for the first HT. Also, this guy is not no meds so in 5 years he will look far far worse in the front than what he appears now. People put too much value on crown coverage. Crown is overrated. Get a good permanent hairline so the viewer cannot see through you. I see the first stage did cover crown. Better that the 500-800 grafts gone into crown be used on hairline. I do agree with Loags. Frontal and midscalp should be the area of major concern for the first session in most situations. Leave the crown for future sessions. However , most patients nowadays want to cover as much area as possible in one session, which is difficult for class V patients. After discussions with the patient, he agreed to have a high hairline, which is 9 cm from the glabella in this situation; and put the extra grafts as far back as possible. With this high hairline design, we had some grafts to transplant up to the upper arc of the vertex. Thus the overall crown baldness appeared smaller. The patient is happy with this design and outcome. To me, thorough discussions and understandings with the patient are more important . Small adjustments of the principle and norms can be made as long as the outcome are still within normal range. Thanks for your comment, Loags ! Dr. Wen-Yi Wu is recommended on the Hair Transplant Network Link to comment Share on other sites More sharing options...
Senior Member Loags79 Posted October 23, 2014 Senior Member Share Posted October 23, 2014 (edited) Understood Dr Wu, you placed the graft where the patients wanted it. In my opinion, a slightly denser (even by another 200-300 grafts) hairline would've made the 1st session a knockout. Looking forward to the 2nd HT, I'm sure the hairline would be addressed, the patient looks like he's got the donor and hair caliber to have a great result. Alrighty then. Let's build a wall of hair and be ass-bald behind it. Good thinking. better a wall than a picket fence Edited October 23, 2014 by Loags79 my HT thread: http://www.hairrestorationnetwork.com/eve/175267-dr-radha-fut-3261-grafts-photo-word-heavy.html Link to comment Share on other sites More sharing options...
Regular Member Wen-Yi Wu M.D. Posted October 24, 2014 Author Regular Member Share Posted October 24, 2014 Understood Dr Wu, you placed the graft where the patients wanted it. In my opinion, a slightly denser (even by another 200-300 grafts) hairline would've made the 1st session a knockout. Looking forward to the 2nd HT, I'm sure the hairline would be addressed, the patient looks like he's got the donor and hair caliber to have a great result. better a wall than a picket fence Agree Loags ! Another important point to consider in this patient is his young age and timing of vertex transplant. When the crown area is still big and bald after the 1st session, most young patients as in this case will come back for the 2nd session ASAP , as planned initially. This is not a good thing either. Many experts in hair transplant advocate crown transplant at least after 35 y/o; some even say after 40 y/o; for the fear that the crown will keep on expanding . If the crown is transplanted at an early age and if a halo effect does occur finally; then the patient will have to come back for another repair at the risk of depletion in donor supply. However,when the crown appears smaller in size after the first session, many patients would change their mind and might delay the second session for the crown transplant at a later time because the first outcome appears to be more ACCEPTABLE. This is actually my intention for this patient. To delay the 2nd session as much longer as possible; while maintaining a good coverage of the front and midscalp areas. I do not want him to come back too soon for the crown transplant when he is still young. I will be more comfortable when he comes back for the crown, let's say at 40 y/o. Again, communication and mutual understandings is the utmost important step in order to have a happy patient. Thank you Loag for sharing your fruitful comment. Dr. Wen-Yi Wu is recommended on the Hair Transplant Network Link to comment Share on other sites More sharing options...
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now