*VIDEO/PICS* Hair Transplant AFTER SMP?? Dr Bloxham - Feller & Bloxham, NY

[Dr Blake Bloxham]

Hi Everyone,

 

Recently questions were asked about SMP and hair transplant surgery. Specifically, can you have SMP BEFORE a hair transplant, and what would the surgery be like afterwards? Problems? Post-operative appearance? Members seemed interested.

 

Interestingly enough, I actually did a procedure this week on a patient who previously had full scalp, permanent, SMP several years before.

 

I thought members may be curious, so I made a video presenting his case. It goes over a lot of the details:

 

 

 

Also, here are pictures from his consult, and his "before and after" shots (2,900 graft FUT):

 

 

 

 

 

 

 

I had extensive discussions with this patient regarding how the SMP would affect the surgery; how it would look when the results matured; how it would look in the post-operative "ugly duckling" phase; styling options; and whether or not the SMP could be altered in the future.

 

I assume members may have similar questions, so ask away!

 

Hope you enjoyed and found this interesting.

[Dr Blake Bloxham]

Realize I should have shared this from the beginning:

 

Here is the thread where this question was originally brought up:

 

SMP before FUE?

 

Some "cross talk" going on, so I wanted to link it.

[Wwiizzkkiidd24]

interesting for sure. not sure if you went through this in the video I haven't watched it but I see you started transplanting behind the smp hairline, was there any reason for this? I'm guessing he didn't get a permanent smp so it will fade over time leaving the hairline you created.am i right? good work btw looks very clean.

[Dr Blake Bloxham]

Wwizz,

 

Good catch. This was actually what we probably discussed the most thoroughly before actually scheduling a procedure.

 

Ideally, the transplanted hairline would have been integrated right up to the SMP hairline. However, that wasn't possible in this patient for two reasons:

 

1) Because the SMP hairline was placed too low to begin with

2) The patient had a below average donor supply, and we needed to be strategic with the grafts

 

I ended up designing a hairline approximately 1cm above the original SMP hairline. We discussed it and decided this would give him the most styling options and natural appearance for a few reasons:

 

First, it's important to always remember that hair in the frontal portion of the scalp always points forward at an acute angle (almost like it's growing downward). This means that unless the hair is aggressively slicked back, it always projects forwarded and is then swept back on itself. For most hair lengths, this means the base of the hair shaft is actually about 1cm further back than it appears. Thus, his hair should appear around 1cm lower -- and cover up the SMP area -- when styled.

 

Second, we also discussed how some men do a frontal "hairline fade." Here's an example below:

 

 

As you can see, this individual purposely "buzzes" the first few cm of his hairline and then styles the rest longer.

 

The transplanted hairline in this patient should provide a similar effect (though based on the way he plans on styling his hair, I don't think it will really show in this fashion).

 

So in an ideal world, his SMP hairline would have been at an appropriate height, and I could have worked right up to the frontal portion. However, that wasn't the case, so we had to really get a bit creative!

 

Thanks for the kind words too!

[Dr Blake Bloxham]

Spex,

 

Yeah, it definitely was not ideal! He's coming in for staple removal soon, so I'll update the thread. He should have a bit of a "buzz cut" look at that point, so it might be a good opportunity to see what it may look like grown out.

 

Yes, very, very low. We discussed using a laser. He may be able to use it on the very front. However, I do have some concerns about using a laser that close to the new follicles. If he does want to look into this further, I'll make sure this particular type of laser wouldn't affect the hair follicles.

[gillenator]

Dr. Blake,

 

Wow...you did some amazing work on him and I think he looks much better.

 

And who knows, he may be starting a new trend....

[Dr Blake Bloxham]

Thanks Gillenator! You never know;he just may be!

[Dr Blake Bloxham]

Hi Everyone,

 

I wanted to update the thread with some new images:

 

The patient came in for his staple removal earlier this week. He was 14 days post-operative at the time. And I must say, the combination of the SMP with his short buzz cut (he left it a little longer around the healing FUT scar to hide it) really looked great. I was pleasantly surprised by how well the SMP obscured the redness too.

 

Here's a few pictures:

 

14 days post-op from 2,900 FUT: