Frontal Cowlick - Dr. Taleb Barghouthi- Vertex Hair clinic. 2442 FUE grafts- 1 year result

[DrTBarghouthi]

Dear community,

This is a 27 year old gentleman who had an FUE procedure done in Dec 2020. He is a NW 3-4 pattern with a family history of the same. His donor area is of good quality.  We did around 2442 grafts for both the frontal and temple recessions. It was noted that he had a strong cowlick pattern on this right frontal hairline and extending deep into his existing hair in the frontal region. Therefore, we had to restore the entire cowlick pattern which entailed making sites that were angled backwards in some areas so as to restore it completely.  He is currently on finasteride 1 mg alternate days. 

 Photos were taken  at around 12months from surgery. 

Surgical details:

FUE 0.9 mm punch

Hairline :482 refined single hairs

Total grafts: 2442

Average of 2.61 hairs/graft. 

Sites made using 0.8 mm and 1.4 mm Sapphire blades. 

 

 

Before photos and planning phase: note the cowlick pattern on the patient's right frontal zone. 

 

 

Immediately after surgery. Also showing the incisions made. 

 

 

Day 10 :

 

 

12 months result

 

 

Close up photos: 

 

Comparison photos: 

[Britanium]

Excellent work here 👍🏽 

[Melvin- Admin]

Excellent work, the hairline looks impeccable.

[DrTBarghouthi]

Thank you @Melvin- Moderatorand @JC71

[HappyMan2021]

Hi @DrTBarghouthi I have a question about the cowlick aspect of this. So a cowlick is a section of hair that stands straight up or at an angle at odds with the rest of the hair. 

When you say you "restored the cowlick", does that mean you recreated the cowlick pattern with the transplant grafts as well? 

My confusion is that I feel no one would ever intentionally want a cowlick. Could you have not just made all the transplant grafts "normal/non cowlick" and this could have camouflaged the native cowlick behind the new transplant grafts? thanks. 

 

Edited February 12, 2022 by SadMan2021

[DrTBarghouthi]

2 minutes ago, SadMan2021 said:

Hi @DrTBarghouthi I have a question about the cowlick aspect of this. So a cowlick is a section of hair that stands straight up or at an angle at odds with the rest of the hair. 

When you say you "restored the cowlick", does that mean you recreated the cowlick pattern with the transplant grafts as well? 

My confusion is that I feel no one would ever intentionally want a cowlick. Could you have not just made all the transplant grafts "normal/non cowlick" and this could have camouflaged the native cowlick behind the new transplant grafts? thanks. 

 

Thanks for the question. Yes a cowlick is a rather unusual pattern. In some cases when that cowlick recedes with hair loss, we can just go about making the typical incisions and we ignore what is left from cowlick. However, his cowlick was still quite strong from the recessed areas and front and was extending into his frontal zone behind the hairline for around 2 cm. Have a look at the planning photos. Therefore doing normal incisions in the presence of an almost fully filled cowlick will end up with different direction.

Hope this help. 

6 minutes ago, SadMan2021 said:

Hi @DrTBarghouthi I have a question about the cowlick aspect of this. So a cowlick is a section of hair that stands straight up or at an angle at odds with the rest of the hair. 

When you say you "restored the cowlick", does that mean you recreated the cowlick pattern with the transplant grafts as well? 

My confusion is that I feel no one would ever intentionally want a cowlick. Could you have not just made all the transplant grafts "normal/non cowlick" and this could have camouflaged the native cowlick behind the new transplant grafts? thanks. 

 

 

[HappyMan2021]

3 minutes ago, DrTBarghouthi said:

Thanks for the question. Yes a cowlick is a rather unusual pattern. In some cases when that cowlick recedes with hair loss, we can just go about making the typical incisions and we ignore what is left from cowlick. However, his cowlick was still quite strong from the recessed areas and front and was extending into his frontal zone behind the hairline for around 2 cm. Have a look at the planning photos. Therefore doing normal incisions in the presence of an almost fully filled cowlick will end up with different direction.

thanks, this was helpful!

[DrTBarghouthi]

18 minutes ago, SadMan2021 said:

thanks, this was helpful!

You’re welcome. Hope it was clear that I had to follow the dominant pattern and direction of his still existing hairs and sort of imagine how it translated in the lost areas too.