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Dr. Karadeniz - 3650 Grafts FUE


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Young patient with a close to Norwood 4A hair loss.

3650 grafts FUE was performed using a 0.8 mm motorised sharp punch.

The graft distribution was: 900 singles, 1150 doubles and 1600 three and more haired grafts.

A high hairline was designed at about 8 cms, due to both his young age and the exceptionally wide forehead which consumed more grafts than expected. His temple points were slightly brought forward.

The recipient site incisions were done by custom made blades. Coronal incisions were used for the hairline and sagittal incisions for the the rest of the area.

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Ali Emre Karadeniz, MD (Dr. K)

AEK Hair Institute

Istanbul, Turkey

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Looks good, I like the conservative hairline placement. Did midscalp improve on fin?

 

I can't tell exactly if fin improved the mid scalp as it was okay before surgery, but a close look at the photos suggests that it did help. I do believe in the importance of using fin especially in the 20's and 30's.

Ali Emre Karadeniz, MD (Dr. K)

AEK Hair Institute

Istanbul, Turkey

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Am I the only one to think that this looks very thin for 3600 grafts? I zoom in the after pics and it looks very sparse!

 

I mean its 4000 grafts for most its more than half of our donor supply and the hairline still looks like undefined!

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I can't imagine it lower. That wouldn't look right with the side/temporal recession he has. Hairline is right imo
which is exactly why the side/temporal needs to be addressed as well so the face can be framed appropriately.
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Am I the only one to think that this looks very thin for 3600 grafts? I zoom in the after pics and it looks very sparse!

 

I mean its 4000 grafts for most its more than half of our donor supply and the hairline still looks like undefined!

 

I do agree with this to some extent. The result looks good and surely the patient is happy, but this is a lot of grafts in a fairly small area with no temple closure. Furthermore, the patient seems to have very good density with 2.4 hairs/graft and what appears to be a thick hair caliber. To me, I would say this probably looks more like 2.5k grafts.

 

 

But that's just my opinion.

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Its a definite improvement but as has already been mentioned further work is necessary.

I would be a bit concerned as his loss progresses if there may be a donor shortage problem to cover what is lost.

Patients happy thats all that matters.

have a good day

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Dear Number and Busa,

 

It is not very evident from photos how wide the front of this patient actually is, as the third dimension is not completely felt. The transplanted area is about 100 cm2. Given that about 400-500 fine haired grafts were used at the sides, this leaves us at a density of little over 30 grafts per cm2. I actually think the density looks as expected if not better than 30/cm2. Had I lowered the hairline by the slightest, I would be needing more than 1000 grafts more. Some people emphasise a lot on framing, but I think that some patients don't have the luxury to have the ideal framing, otherwise they will run into severe trouble in the future, having an isolated frame in the front without adequate hair behind it.

Ali Emre Karadeniz, MD (Dr. K)

AEK Hair Institute

Istanbul, Turkey

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Dear Number and Busa,

 

It is not very evident from photos how wide the front of this patient actually is, as the third dimension is not completely felt. The transplanted area is about 100 cm2. Given that about 400-500 fine haired grafts were used at the sides, this leaves us at a density of little over 30 grafts per cm2. I actually think the density looks as expected if not better than 30/cm2. Had I lowered the hairline by the slightest, I would be needing more than 1000 grafts more. Some people emphasise a lot on framing, but I think that some patients don't have the luxury to have the ideal framing, otherwise they will run into severe trouble in the future, having an isolated frame in the front without adequate hair behind it.

 

Thank you doctor for the explanation. I didn't understand that it was such large area to be covered from the pics.

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  • 1 year later...
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Hi Dr Karadeniz,

 

When you say wide forehead...what defines a wide forehead and how is this measured? This is something I hadn't yet factored into my HT research and because it obviously has an impact on the attainable density, I would be interested in finding out more.

 

Also, off topic, but do you have any examples of blonde haired patients?

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Density is defined simply by the coverage per area. This is the number of hairs (not grafts) multiplied by the diameter of the hair shaft.

 

People tend to think of a graft number and the expected coverage from this number, but frequently forget considering the area to be transplanted. In small heads with a balding area that is narrow all across the head, 100cm2 may be 2/3 of the balding area, where as in wide foreheads, only the hairline and frontal forelock may be more than 100cm2; just like in this case.

 

Besides, the hairline needs a much higher density for a satisfactory coverage than lets say the midscalp. So in wide foreheads we may end up using 3000-3500 grafts just at the front, in spite of designing a high hairline like in this case.

Ali Emre Karadeniz, MD (Dr. K)

AEK Hair Institute

Istanbul, Turkey

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what are u confused about Mickey85?

 

Dr Karadeniz's name is not listed on the recommended surgeon's list at the time of writing. So was he posting under the status of a recommended surgeon or not? I'd be more than happy with his official return.

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Mickey85 is correct. I am no longer a recommended doctor on this forum because I decided to cancel my sponsorship in August. I was not happy with the way this forum operates and how I and my friend and business associate Joe was treated. When I made the announcement of my departure with detailed explanation of the reasons it was deleted within ten minutes, which is why none of you were aware of my exit.

 

I replied to a recent question on this thread that came to my email account, but this does not mean that I will be back as a recommended doctor. I frequently post on other forums however so I have not disappeared. In fact, I am quite active and quite busy as well.

 

This is my final post on this. Thank you for your kind comments. I wish you all the best.

Ali Emre Karadeniz, MD (Dr. K)

AEK Hair Institute

Istanbul, Turkey

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Dr. Karadeniz,

 

It's interesting that despite the fact that we spoke on Skype and you acted like you understood our point of view and why we handled the situation with Joe the way we did that you would still make statements on our forum that you are not happy with the way your "friend Joe was treated". How about the fact that he to this day makes public knowingly false statements about our community and the way we recommend physicians on his website?

 

I'm not going to get into all the details about what happened leading to Joe's departure and how we made you aware privately of the situation. I'm also not going to get into how we made it clear both publicly and privately to you that we were no longer going to host comments about it which is why your comment was removed.

 

I really thought we came to an understanding when we spoke via Skype. But apparently you can't let the past go and want to mischaracterize our community along with Joe. Certainly that's not characteristics of a physician we want recommended on our community.

 

I am now locking this topic.

 

Bill

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