Dr. Rafael de Freitas - 3.097 Grafts, 7.082 Hairs - Patient with Lichen Plano

[De Freitas Clinic]

Patient´s details

Sex: Male

Age: 26 years old

Hair characteristics: Brown-blond / thick caliber / Straight

Level of alopecia: DIFFUSE CICATRICIAL IV FOR STABLE LICHEN PLANO PILARIS

Surgical Plan: Restoration of the frontal line, entrances and central area in 2 days of intervention.

 

OBS: Due the patient's underlying disease with changes in the dermis and epidermis by hyperkeratosis, parakeratosis by lymphocytic inflammatory infiltrate, the growth of the implanted area was as expected in the scarred skin reaching about 85%.

 

Grafts breakdown

3.097 Grafts distributed in:

1 Grafts - 495 = 495 hairs.

2 Grafts - 1,360 = 2,720 hairs.

3 Grafts - 1,101 = 3,303 hairs.

4 Grafts - 141 = 564 hair.

HAIRS 7,082 ÷ 3,097 FOLLICLES = 2.29 HAIRS/FOLLICLES.

 

Postoperative medication:

Finasteride 1 mg

Dutasteride 0.5 mg

Corticosteroids

 

Before

 

Design

 

Placement

 

3 Months later

 

6 Months later

 

12 Months later

 

Wet hair

 

Comparatives

 

Video

 

We hope you like it. Have a nice week!

 

 

 

 

 

 

[Britanium]

Really like it ! Excellent pics provided here. Resounding success 👏

[Mycroft]

Looks like this was a tricky case, and a huge impact on the entire scalp for the graft count.

[Melvin- Admin]

10/10 presentation. Your clinic should have workshops on how to present cases. The results are fantastic 👏🏼

[De Freitas Clinic]

1 hour ago, Melvin-Moderator said:

10/10 presentation. Your clinic should have workshops on how to present cases. The results are fantastic 👏🏼

Thank you, Melvin. I appreciate your words and constant help.

Best regards! 🙌 👐

[shami26]

Thank you for posting doctor.

I have Cicatricial Alopecia also. Did this patient ever go on Doxycycline or Anti-Malarial tablets, or was the topical steroid enough for him to stabilize the condition?

[TrialAcc]

Amazing results. 

I didn't know cicatrical alopecia had a measurable scale. Why does it mirror the norwood scale? Or is it just AGA sped up by cicatricial? 

[TrialAcc]

52 minutes ago, shami26 said:

Thank you for posting doctor.

I have Cicatricial Alopecia also. Did this patient ever go on Doxycycline or Anti-Malarial tablets, or was the topical steroid enough for him to stabilize the condition?

Does yours also mirror MPB/AGA? Combination of both? 

[shami26]

3 hours ago, TrialAcc said:

Does yours also mirror MPB/AGA? Combination of both? 

I think mine is a combination of Cicatricial Alopecia and MPB even though I still have some hair on my hair line.

[TrialAcc]

4 minutes ago, shami26 said:

I think mine is a combination of Cicatricial Alopecia and MPB even though I still have some hair on my hair line.

Hmm I wonder if I should get checked for this, I have insane itch and red spots where I'm losing it. 

[shami26]

7 minutes ago, TrialAcc said:

Hmm I wonder if I should get checked for this, I have insane itch and red spots where I'm losing it. 

You can get a biopsy by a dermatologist if you want to diagnose it.

[TrialAcc]

1 hour ago, shami26 said:

You can get a biopsy by a dermatologist if you want to diagnose it.

Will do. Are you doing anything to treat?

[shami26]

1 hour ago, TrialAcc said:

Will do. Are you doing anything to treat?

Right now. I am trying .25mg finasteride for the MPB.

I still need to talk to my dermatologist about treatments for the Cicatricial Alopecia.

[home1212]

patient had severe hair loss but fortunately an excellent donor, the hairline artistry and restoration is literally beautiful here! top notch result for sure 

Edited April 17, 2021 by home1212

[De Freitas Clinic]

On 4/17/2021 at 5:09 PM, home1212 said:

patient had severe hair loss but fortunately an excellent donor, the hairline artistry and restoration is literally beautiful here! top notch result for sure 

Thank you very much for your appreciation. We are glad to know that our content is to the liking of the forum and useful for those who are interested in the situations we expose. Best regards.

[Gatsby]

From a perfect candidate to a perfect result! Congratulations and thanks for sharing!

[deeznuts]

Completely unrelated to the patient in question but I was wondering if you had any examples of temple peak restoration. Mine aren't terribly receded being a NWII but I'd like it'd look a bit unnatural I think without them getting restored

[De Freitas Clinic]

3 hours ago, deeznuts said:

Completely unrelated to the patient in question but I was wondering if you had any examples of temple peak restoration. Mine aren't terribly receded being a NWII but I'd like it'd look a bit unnatural I think without them getting restored

Thank you for your query. Of course, here you have a link where you'll find a case of temple peak restoration. I hope it will be useful for you.

https://www.clinicadefreitas.com/project/injerto-capilar-tecnica-fue-3-105-foliculos-2/

Best wishes!

Edited April 19, 2021 by De Freitas Clinic

[mcr7777]

On 4/14/2021 at 4:04 AM, TrialAcc said:

Hmm I wonder if I should get checked for this, I have insane itch and red spots where I'm losing it. 

I'd definitely recommend getting a dermatologist/hair specialist to examine your scalp for signs of inflammation.  I had the same as you and was diagnosed with lichen planopilaris.  Treatments are needed to stop shedding (mine is finally getting better).  

 

You can even buy a digital microscope on amazon for about £18/less than 20 USD.  You should be able to see if there are worrying signs like redness around the hair follicles. 

 

 

 

[TrialAcc]

On 4/24/2021 at 12:45 PM, mcr7777 said:

I'd definitely recommend getting a dermatologist/hair specialist to examine your scalp for signs of inflammation.  I had the same as you and was diagnosed with lichen planopilaris.  Treatments are needed to stop shedding (mine is finally getting better).  

 

You can even buy a digital microscope on amazon for about £18/less than 20 USD.  You should be able to see if there are worrying signs like redness around the hair follicles. 

 

 

 

I have visible redness all along by thinning area, don't need a microscope for that haha. I'm happy to hear it's improving, what treatment have you been using? 

Edited April 26, 2021 by TrialAcc

[mcr7777]

I am on lymcecycline and topical steroids and have just started hydrochloroquine too. No sides form these (unlike fin which made my condition a lot worse and caused sides).

 

I'd suggest seeing a dermatologist that specialises in hair loss - ideally one that knows about scarring alopecias.  A lot of people seem to get misdiagnosed due to ignorance of many general derms about the condition.  This means treatments are delayed and lots of hair is lost before a diagnoses is made - this happened in my case.  It wasn't until I got the digital microscope that I realised myself what it was.  You don't regrow hair from LPP loss so suggest getting diagnosed as quickly as you can if you think it might be what you have.

 

 

 

 

[TrialAcc]

5 hours ago, mcr7777 said:

I am on lymcecycline and topical steroids and have just started hydrochloroquine too. No sides form these (unlike fin which made my condition a lot worse and caused sides).

 

I'd suggest seeing a dermatologist that specialises in hair loss - ideally one that knows about scarring alopecias.  A lot of people seem to get misdiagnosed due to ignorance of many general derms about the condition.  This means treatments are delayed and lots of hair is lost before a diagnoses is made - this happened in my case.  It wasn't until I got the digital microscope that I realised myself what it was.  You don't regrow hair from LPP loss so suggest getting diagnosed as quickly as you can if you think it might be what you have.

 

 

 

 

Okay thanks for the information. No chance of regrowth at all? That's pretty depressing!

[mcr7777]

3 hours ago, TrialAcc said:

Okay thanks for the information. No chance of regrowth at all? That's pretty depressing!

 No hair doesn't grow back if lost to LPP - that's why it's important to get diagnosed early if you think you might have it. A lot of people seem to be completely unaware of lichen planopilaris (like I was)  and even derms and doctors frequently misdiagnose it.  

The digital microscope is useful as there are certain details you can see only with the microscope (e.g. scale around the follicles).  Seb derm is another possible cause but I don't think this generally causes as much hair loss and maybe less intense pain/burning compared with LPP.

[cpfm]

20 hours ago, mcr7777 said:

 No hair doesn't grow back if lost to LPP - that's why it's important to get diagnosed early if you think you might have it. A lot of people seem to be completely unaware of lichen planopilaris (like I was)  and even derms and doctors frequently misdiagnose it.  

The digital microscope is useful as there are certain details you can see only with the microscope (e.g. scale around the follicles).  Seb derm is another possible cause but I don't think this generally causes as much hair loss and maybe less intense pain/burning compared with LPP.

Thank you for your input and knowledge.

I think I also need to pay a visit to a derm.

Question though - will using Nizoral (Keto) help or reduce inflammation?

[mcr7777]

It might help a touch with itching but it's not one of the main treatments I find other shampoos better for soothing the scalp.

You might want to try Euracin shampoo or head and shoulder anti itch as they helped me while I was waiting to be seen by a derm.  

If it is LPP you have or a scarring alopeia, more targeted meds are needed if you want to bring down inflammation.