2500 graft frontal case by Dr. Lindsey McLean VA

[Dr. William Lindsey]

This fellow had noticed significant thinning of his entire scalp over the past few years...came with becoming a father himself, and consistent with his family history. He had a fairly tight scalp and admitted to not being consistent with preop scalp exercises. Nonetheless, we got a nice long thin strip containing around 2500 grafts, roughly 50% singles, 40% doubles, and a few triples. Shown are his preop, postop and day 7 pictures. Like many guys, he had significant swelling on day 3; but called to see if I'd let him go to the gym on day 5. I'll post scar pics at his upcoming followup appointment.

 

Dr. Lindsey McLean VA

 

[phxind]

Dr Lindsey, thanks for presenting examples of your work. What was the donor density in this patient? Can you provide his strip dimensions? Also, I always wonder how the doctor keeps track of the number of slits he makes without getting distracted and losing count.

[Dr. William Lindsey]

phxind,

 

I like long skinny strips. This keeps tension off of the skin edges even with a 2 layer closure we use. So in general my strips are 1.5-1.75cm wide and are as long as it takes to get the goal count.

 

This can vary as today we are doing a guy's 7th transplant, a hairline revision, and he is full of scar tissue and really tight; so we are doing 2 separate 8cm x 0.8cm strips on the sides. But that is not the norm. I can't figure out why the previous guys just didn't excise the scar with each successive surgery....I'll post this next week separately.

 

As to keeping track of the count. There are lots of ways. I know that one of the big chain centers nearby has 2 techs that use click counters and they compare with each other every couple of hundred times they see the docs hand make a slit.

 

At our place, I do the counting, noone is allowed to talk during slit making, and I stop when I finish a section and write the number down on a crude schematic of the preop plan.

 

I tried and failed to post that pic with this posting, so I will add it to the gallery. Its not this patient's schematic, but rather the one from earlier this week.

 

Dr. Lindsey McLean VA

[phxind]

Dr Lindsey, I really appreciate your time answering my questions and adding a schematic to the photo album. Thank you very much. I look forward to seeing the final results of this patient and wish him the best.

[Bill - Seemiller]

Dr. Lindsey,

 

Thanks for posting. Given placement and his hair characteristics, I trust this will be a nice result.

 

What would you project his density will be in the front and behind it?

 

Best wishes,

 

Bill

[Dr. William Lindsey]

He is due in for a scar check this afternoon and if worth putting up pics, I'll do so.

 

He has a little bit of a unique hairline in that its a gentle arc that he desired and not too wide between the temple tufts. But I'd guestimate that we did around 60 single slits per cm along the front. And behind that its around 40 double slits per cm. Again this varies depending on the caliber of the hair shaft as we base our blade size on the unique width of single and double grafts.

 

Dr. Lindsey McLean VA

[Dr. William Lindsey]

This fellow stopped in at 6 months and 2 weeks and has pretty good growth already. He'll be back in the summer and I think he wants to do a second case behind this work.

 

Dr. Lindsey McLean VA