Minaturized hairs and HT

[ShavedDethMonk]

Hi there,

 

How do surgeons approach sections of minaturized hairs? My frontal region is receded though strong with a half a centimeter of minaturized hairs running parallel to the side of the frontal region on each side. Though Im sure many approaches could be done ...

 

So the question is do surgeouns prefer to:

1) shave the minaturized hairs and graft densely in this area, knowing that the minatirized hairs will be gone anyway eventually, if a patient has good donor density to refill that area?

2) graft some in that area but not densely, with the idea that strengthen the area with the understanding that eventually revision work will need to be done.

3)graft densely beside the minaturized section if it is still somewhat dense with the understanding that in 5 years a revision will need to be done because there will be a gap later.

 

Thanks ahead of time for any replies. I am assuming most would opt for number 1 but I cant be sure as Ive only started my learning recently on this topic.

 

SDM

[ShavedDethMonk]

Hi there,

 

How do surgeons approach sections of minaturized hairs? My frontal region is receded though strong with a half a centimeter of minaturized hairs running parallel to the side of the frontal region on each side. Though Im sure many approaches could be done ...

 

So the question is do surgeouns prefer to:

1) shave the minaturized hairs and graft densely in this area, knowing that the minatirized hairs will be gone anyway eventually, if a patient has good donor density to refill that area?

2) graft some in that area but not densely, with the idea that strengthen the area with the understanding that eventually revision work will need to be done.

3)graft densely beside the minaturized section if it is still somewhat dense with the understanding that in 5 years a revision will need to be done because there will be a gap later.

 

Thanks ahead of time for any replies. I am assuming most would opt for number 1 but I cant be sure as Ive only started my learning recently on this topic.

 

SDM

[Dr. William Lindsey]

I leave the choice to the patient. For example we have had several young excutives lately that have chosen to leave a frontal tuft of pretty good hair, and we work all around this so that they can camouflage the procedure with the tuft hair.

 

But I am careful to tell them that at some point we will likely need to deal with that as the tuft hair goes.

 

On the other hand, we had 2 guys lately who just wanted us to pretend the reasonable, although thinning, frontal hair was not there, and just pack the entire area.

 

So we routinely do #1 and #3.

 

I rarely do option #2 as I worry that once the moderate hair there preop, will go, and the patient will think we did no work....when in fact everything left is our transplanted hair, it just just more sparsely placed than usual dense packing. I see patients once a week who almost certainly had this at another clinic, and what they have now is transplanted hair, it is just too thin and looks to them like they did before their surgery.

 

That being said....we are today doing a man's crown who has regions of very thick hair and regions of thin hair. Its almost like the continents and oceans on a map. So his "continents" of good hair we are really not working in, and we are packing his "oceans". I generally would just put grafts everywhere, but he has really good clumps of thick hair that I hate to injure. He is in his 50's and I think those hair "continents" may be non-miniturizing areas.

 

Dr. Lindsey McLean VA

[ShavedDethMonk]

Thank you very much for the information I was looking for and so quickly. Good luck with traversing the 'continents' through the 'oceans', be careful around the Cape of Hope in Africa :-)

 

Best regards.

[mmhce]

This is a very good question and had often wondered what is the typical approach by surgeons to deal with the situation of *miniaturizing* hair (still there, but will go in a few years time)

 

I had asked the question in another thread, I had posted, about the continuing advancing MPB causing the hair transplant appear patchy as the MPB advances.

 

I have a few questions with respect to this:

 

1.Is it that the patient is given the option about how to deal with this, or do surgeons practise standard dense packing throughout the native atrophic region?

 

2. I was told by a surgeon that in checking the FU density for a transplanted area, the native atrophic hair is also counted in this. Thus 45 FU/cm2 may actually include some hair that is native and atrophic. Is this true?

 

 

3. Following a hair transplant, with MPB continying to advance in remaining atrophic hair, what is the average length of time would pass, before a patient would require another hair transplant to maintain the illusion of density?