Dr. Carlos K. Wesley (NYC): When Propecia isn't Enough (2228 FU Crown)

[Billena]

This 32-year-old male had been on Propecia (finasteride 1mg) therapy for over a year and hadn't seen the improvement of crown coverage that he desired. He then underwent a 2228-micrograft FUT procedure with Dr. Carlos Wesley in NYC.

 

The patient can be seen both before and one year following his hair restoration surgery to his crown. During the procedure the patient's grafts were stored in a mixture of platelet-rich plasma (PRP) and ACell.

 

 

 

 

 

 

 

[Cant decide]

For that many grafts and with proper styling, I would have expected a better result. In other words, I think for the area covered, 1500 grafts should have been enough for how it is styled now. I do realize crowns take more grafts but even still, I have seen much better results with far fewer grafts.

[NEWHAIRPLEASE]

I think it's a pretty good result. I just hate the idea of losing 2300 grafts to the crown.

[win200]

I think the result is fine; it's just a lot of grafts for that area. I'd really like to see a comb-through video, and an "after" wet hair pic to match the wet "before" one. With the hair that long, it's tough to see how dramatically things have improved. Hair in the crown can swirl around really easily to create a false impression of coverage.

[Dr. Carlos Wesley]

I appreciate your comments and I certainly agree that it's not a good idea to be packing too many grafts into the crown.

 

This patient's pattern addressed (but was not limited to) his crown. It actually focused more on his mid scalp region. The first image in the original post of this thread shows the general idea with the back border drawn with a black wax pencil - the concave arc that bends around in keeping with the eventual crown border extending beneath it. The last image pair in the original post also shows the general pattern borders planned as drawn with a wax pencil. The back border touches the vertex transition point - where the scalp begins a downward slope.

 

To better illustrate this idea, I have attached an intra-operative image of this patient. You can see that the surgical pattern extends well beyond his pre-existing hair into areas of future loss. This ensures that the transplanted hair pattern holds stable, even when the pre-existing hair is lost over the years.

 

 

Another patient in whom the mid scalp (not the crown) was treated with his future crown hair loss in mind can be seen below.