Severely deformed former transplant patient treated with first surgery; Dr. Beehner

[Dr. Michael Beehner]

This 54 year old man was treated for his hair loss with a collection of bizarre surgical procedures on the scalp. He has been very self-conscious of his appearance, and, although well educated, he has been restricted to menial jobs where he can wear a hat all the time. He was limited financially, but we worked out a plan that in a single session would at least make him feel better about his appearance. One of the photos shows the various zones we decided to transplant with the limited donor hair he had available. He received a total of 1340 grafts, of which 1040 were FU's (30% 1-hair; 60% 2-hairs; 10% 3 hairs.) and 300 were small round 1.3mm diameter MFU sites in the large front-central area delineated on the photo showing his plan. He hopes to return for a second session in the coming year. The "after" photos were taken almost exactly one year after his surgery. His initial off-shore surgery was performed 25 years ago. 

Mike Beehner, M.D.

[forgotpassword]

Doctor: what did the surgeons do to this patient 25 years ago? I can't remember seeing something this horrifying

[Spanker]

This looks like malpractice to me. Wow. 

[Raphael84]

Poor guy! At least he is on the right path now!

[Baldrick101]

It looks like some sort of flap or scalp reduction surgery gone badly wrong. Well at least he is on the mend now, good work. 

[Dr. Michael Beehner]

The two flaps of hair that you see coming in from each side in the front are what were called "Elliott Flaps." They came from the hair on the side of the head and back above the ears. This was then twisted slightly and directed in toward the front to look like a dense front hairline. For the life of me, I can't figure out why there is a full-thickness scar across the front. My hunch is that the surgeon at that time thought and hoped that the two flaps being brought into the front would actually meet each other and constitute an intact hairline, but that it didn't work out as he hoped. 

Flaps of hair in hair restoration surgery are virtually extinct now. There was a group in California that last performed them, and I'm not aware if they still offer them. They, along with most people that made flaps, most commonly used the TPO flap (temporal-parietal-occipital flap). They kept intact the full length of the artery on the side of the head to make sure this long flap (twice as long as the ones seen on my patient) kept its blood supply. The biggest fault with the flap approach to hair restoration is that it is a terrible waste of the precious donor supply. So many hairs get used in such a small area, whereas with FU transplanting we can spread that same amount of donor hair over a large area and visually create much more overall fill and density.

Mike Beehner, M.D.

[Raphael84]

@Dr. Michael Beehner Thank you kindly for the education. Keep up the great work!

[gilgamesh]

Jesus what a horrifying procedure.  I wonder if we will one day look back at what we do now and think, "We used to do that?!"

Excellent, excellent work as always Dr. Beehner. Thank you for sharing an unusual and challenging case, you are a credit to the art.