Dr. Hasson / 5031 grafts / FUE / 1 session / Hairline-Frontal Zone-Mid / dense pack / 10 months post-op

[H & W Doug]

 

This patient in his mid-40’s from a neighboring province had decided it was time to do something about his receded hairline and frontal zone. It was something that had started to bother him in his 30’s when he noticed his hairline was beginning to erode. He had previously tried a laser cap in hopes that it may improve his hairline to a somewhat acceptable degree. He did not like using it and more importantly he did not see any results which is not unusual in most cases especially where there is little to no existing hair. Certainly, any small improvement, if possible, would not be nearly as significant as restoring the areas with a hair transplant procedure. His initial consultation at the Vancouver surgery center confirmed that his above average donor hair and favorable characteristics coupled with Dr. Hasson and team’s talents would achieve a high-density result and produce the cosmetic impact he was looking for. Considering that with FUE Dr. Hasson can place the grafts at a slightly higher density than would be possible with FUT and given the areas to cover and all other factors, Dr. Hasson felt he would need approximately 5,000 grafts depending on hairline placement. At the end of the day 5031 were required. The procedure was performed over 2 consecutive days. Day 1 consisted of 2,700 grafts of which 300 were single hair grafts,1575 were doubles and 825 were 3-4 hair grafts. Day 2 produced 1326 doubles and 1005 3-4 hair grafts. 2-day totals: 300 singles, 2901 doubles, 1830 3-4 hair grafts.

These photos taken at the clinic at his follow up visit represent the result 10 months post-op.

[Melvin- Admin]

Excellent density 👏 

[stephcurry30]

Incredible result but that ahs to be a typo?

 

5k grafts into the hairline/frontal 3rd?

 

What was the density of the grafts placed? 120 per cm^2?

[JohnnyR]

good result, but 5000 grafts for the frontal third? waste of grafts in my opinion.

[deeznuts]

21 minutes ago, JohnnyR said:

good result, but 5000 grafts for the frontal third? waste of grafts in my opinion.

He's mid 40's so kinda justifiable

[digi23]

5k grafts seems alot for that area? 

Good result.

[Gatsby]

I'm just wondering with a low hairline design why the temple points were decided not to be strengthened? Is this patient on finasteride to prevent any future loss? Great density and thanks for sharing!

[Hair4Days]

Great result, great density.

Does this gentleman have a projected lifetime graft count of 15k or something? I know he doesn’t have mid scalp or crown loss, but you cannot  predict someone’s final balding pattern so I’m curious as to why so many grafts?

[Melvin- Admin]

Guys, 

I don't think the before pictures tell the full story, if you look at the graft placement, he had virtually half of his head dense-packed. I could bet that his hairline before and midscalp was heavily miniaturized with hairs that were on their last legs. 

[H & W Doug]

Thanks for the comments guys!

I agree with Melvin that we’re looking at more than just the front third here. He may be approaching a stage 4a and there is some work in the mid-scalp also. There are many things to consider in this case not unlike any case for that matter. We first want to evaluate the present area to cover and the potential future loss as it relates to the total donor supply. And yes, in many cases you can predict with reasonable certainty someone's final hair loss pattern. In this case it was fairly clear to Dr. Hasson that this patient in his 40s who has no miniaturization in parts of his mid scalp and crown will likely not progress past a 4A.  This doesn’t even factor in whether or whether not he will use medication. Given this conclusion, if donor reserves are adequate, we can be a little more aggressive with the density because we are not going to have to preserve a fair amount of grafts for future potential loss. We then want to find out what the patient’s goals are and if they're realistic. In this case the patient wanted an appropriate hairline and wanted to be as aggressive as possible with density and placement of the hairline. Dr. Hasson then determined that with his hair shaft diameter, relatively straight hair and stable tissue, he could pack at a high density. He also determined that based on the decided upon hairline,  advancement of the temples would not be required and the balance and relationship between hairline and temples would be cosmetically pleasing with the temples left alone . He also notes the native density in the mid scalp and crown and surrounding areas and understands that matching that density or coming close will provide the best cosmetic impact if it poses no risk to attempt to do so.  You can see the transition from transplanted hair to native hair is very seamless and you would not suspect that there's any drop in density from the crown/mid scalp to the transplanted mid- scalp/frontal zone. In an ideal transplant, you want that seamless transition and the density should be high enough that it gives the appearance that the patient had never lost any hair to begin with. If you consider that some may estimate a stage 6 has 230 to 240 square centimeters of bald scalp, a stage 5 may have 200, then it wouldn't be a stretch to say that the area that was covered on this patient was somewhere in the 60 to 70 square centimeter range. The estimated grafts per square cm of the transplanted hair might be in the low 80s. So, if we assume 60 square centimeters of bald scalp times 80 per square centimeters you're going to get around 4800 grafts so it is not an unreasonable number. Maybe the area is actually over 60? Maybe the density is actually more than 80? Most of our patients that come to us for these type of results have high expectations, high standards and they have seen other clinic results with perhaps lower densities and they do not feel it looks as good and that they would be happy with that lower density result. I would also add when patients inquire to our clinic, often times they state the previous doctor they chose did not achieve enough density to make them happy.  I personally think that this is a spectacular result. I understand it is a little hard to put your arms around the numbers when most of the industry is not able to do this type of density and therefore the average number of grafts that you might encounter as an estimate for this area could be as much as half of this. Back to an earlier comment about this being a waste of grafts. It is my opinion that under these conditions of good donor hair, relatively manageable area to cover and minimal potential future hair loss, it's a waste not to use these grafts in this manner. Why save them for a day that's not going to come? They're way better suited where they are now than in the donor bank. And I can tell you this patient would not have been as happy with 2,500 to 3000 grafts in this area. If there's anybody out there that wouldn't want this hairline or density under these conditions,  I would be surprised. However, everyone is likely to have varying expectations and perhaps some would be happy with something less dense which would it still have a fairly substantial cosmetic benefit. There is nothing wrong with that if the procedure is still well executed, especially if density behind is lower, donor reserves are more limited and final hair loss pattern is more aggressive. It all depends on your expectations and what you'd be happy with. For me? If it is possible, give me this hairline and this density in the appropriate areas every time.. 😊

[Viney]

This looks awesome.

[Britanium]

Beautiful work Dr ! I’m envious of this chaps head of hair for his age 😝And yes I can see it’s not just 5k used on the frontal third. 

[OliverAtom]

 

Awesome result but... 5000 grafts????? 😳 😵.  Are we crazy? This is what ASMED clinic has been doing for a longgg time now, placing double the number of grafts that are really needed. 

Sorry, but that hairline would be still completely amazing with just 2500 Grafts, whoever says the contrary, well...

Thanks a lot for sharing!!!