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Dr Blake Bloxham

"Like Getting Blood from a Stone" | Dr. Blake Bloxham |1,800 Graft HT | *VID/PICS*

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One of my favorite "Feller-isms" -- and there are many to chose from -- is the phrase: "like getting blood from a stone." For those unfamiliar with this saying, it basically refers to the idea of trying to get "something from nothing" or extracting from a tough source that does not want to give. Like trying to get blood or water from a stone!

 

In the hair transplant field, it refers to the challenge of obtaining a good quantity of quality grafts from a stubborn or barren donor. And unfortunately, it often happens in patients with a large demand (bald area) and this poor donor supply.

 

And that's precisely the situation this patient found himself in. He's a man in his mid-50s with a NW VI hair loss pattern. At first glance, his donor looked pretty good; something that could sustain a large session to tackle his aggressive pattern.

 

On closer inspection, however, his density was well below average as was his laxity. Sometimes these patients are good candidates for an FUE approach, but he came to us seeking an FUT megasession and I also didn't think he was the best FUE candidate all around.

 

So I decided to steal out as much as I could via FUT. I explained the difficultly of the donor to him, and warned him that graft number would not be great. He was hoping for one of the big 4,000+ graft cases, but I told him he would likely be less than 2,000. I also told him the key in these "blood from a stone" cases is strategy. When used properly to maximize the cosmetic benefit, a small graft number can go a long way.

 

I was able to obtain 1,800 grafts (with a large strip that would normally provide me with 3,500 or 4,000 in a better density patient); I used these to reestablish his hairline, densely fill the frontal band, and taper the density in the mid-scalp.

 

He returned 10 months later, and was very pleased with the result! Huge benefit from a smaller graft number.

 

At that time, I put together a video and picture presentation for him -- which I'll share below. But that's not where his story ended ...

Video at 10 months:

 

 

Pictures (more in the video) at 10 months:

 

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At the 10 month mark, he asked me to re-evaluate the donor and see if he could do another surgery to address the rest of the mid-scalp and the crown.

 

Here's how his scar looked at 10 months:

 

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And I was pleased to find that he still had some laxity left and could undergo another strip procedure. I told him that we would again run into the same issue with low graft numbers, but this time he understood what a good strategy can achieve when applied to these "blood from a stone" cases.

 

So he came back (sometime after the 12 month maturation mark) and we decided to go for one more. Here's how he looked the day of his second surgery:

 

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I planned out a very strategic approach in the crown/posterior mid-scalp. I knew I would likely be around the same graft number (and I normally like something closer to 2,500 to do a crown); and I also knew a few "tricks" would be necessary.

 

I ended up extracting 1,500 grafts via FUT and used them to create the illusion of a clockwise whorl pattern to provide maximum coverage with the way he styles his hair (parted left to right). We'll see what the laxity looks like when he heals from this one, but he still has good material back there to take with a non-strip approach regardless.

 

Here's how he looked immediately after the second surgery:

 

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I know he's a good grower, so I suspect that the strategic approach from the second surgery will really provide a lot for 1,500 grafts. And it should be a very big transformation for only 3,300 grafts on a NW VI.

 

So what's the moral of the story? Not all patients have an excellent donor that will yield huge numbers. But this does not mean that we can't extract some "blood" from that "stone" and really use the grafts strategically and intelligently to create an excellent transformation.

 

Hope you enjoy!


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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Really good work Blake, I'm not from the UK but bloody great job! lol


go dense or go home

 

Unbiased advice and opinions based on 25 plus years of researching and actual experience with hair loss, hair restoration via both FUT & FUE, SMP, scalp issues including scalp eczema & seborrheic dermatitis and many others

 

HSRP10's favorite FUT surgeons: *Dr. Konior, *Dr Hasson, Dr. Rahal

HSRP10's favorite FUE surgeons: *Dr. Konior, *Dr. Bisanga, Dr. Erdogan, Dr. Couto

(*indicates actual experience with doctor)

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HS,

 

That was a good one! And thank you for the kind words.

 

Dave,

 

Thanks!

 

Dr. L,

 

Thank you. I find that it's always a "catch 22" when it comes to strip on guys with hard skin (no intrinsic stretch) and poor glide. While you get less tissue, they tend to scar beautifully (another reason why I thought FUT was a better option for his case). Have you noticed the same? I know there is a whole physiological discussion to be had there, but just something I've noted pretty consistently.


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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Awsome result doc,happy for patient.

 

Thank you! He's a great guy, so very pleased to have helped him out.


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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