Dr. Mohebi---Pre/Post-op for 2995 FUT grafts on Class VI Patient-- Post-op dates: 10 day and 11 months

[Robin-at-USHR]

On 2/26/2009, Dr. Parsa Mohebi performed a FUT Hair Restoration procedure on a 44 year old male with:

??? Hair loss pattern -- Class VI

??? Hair color -- Black

??? Hair character -- Straight

??? Hair thickness ??“ Thick

 

Treatment Plan as of 2/18/2009 (date of consultation):

??? Finestride 5mg --- ?? tablet per day to stabilize and/or prevent future hair loss

??? FUT Hair Transplant procedure--2500+ grafts

 

FUT PROCEDURE PERFORMED:

 

A Follicular Unit Strip Transplantation with 2995 total FU:

??? 504 ??“ single hair FUT

??? 1651 ??“ double hair FUT

??? 840 ??“ triple hair FUT

 

Size of Donor Strips Cut:

??? First -- 17 x 1.7 cm

??? Second -- 11 x1.5 cm

 

(While some clinics will give you exactly what you pay for down to the penny, it is not unusual for patients of Dr. Parsa Mohebi to receive additional grafts during surgery free of charge. We offer estimates on needed graft numbers during the consultation, but some patients reap the benefit of receiving additional grafts while in the surgery. We have all patients pay for surgery up-front (unless approved for financing), so for example, if while in surgery the doctor determines that he thinks you would REALLY benefit from an additional 250 grafts, he would likely perform the work for these grafts without payment and include them into your pre-paid charge. By doing this, Dr. Mohebi believes all of his patients will always leave his office 100% satisfied with their procedure and hopefully feel comfort knowing that their personal happiness with the outcome is more important than the dollar number they are paying.)

 

**Please be aware that not ALL patients receive additional grafts free of charge. This occurs only if the doctor is in surgery and feels it would be extremely beneficial for the patient to do so and/or would dramatically improve the overall outcome of their procedure.

 

 

[Blake Bloxham]

I'm slightly confused as to why there are two sizes of donor strips listed? Didn't this patient only undergo one FUT procedure of 2500 grafts?

[Parsa Mohebi, MD]

Good observation and great question Future HT Doc. We use a special tool called Laxometer in our operating room right before our strip hair transplant surgeries to increase the preciseness of hair transplant procedures. The tool allows us to measure the laxity of the scalp and determine the widest safe size for the strip to be removed.

 

In the last annual meeting of International Society of Hair Restoration Surgery (ISHRS) in Amsterdam Holland, I presented a new method of strip removal for mega and giga session hair restorations as "Sequential Strip Removal in Strip Hair Transplant Surgeries".

 

We know that removing wide strip in some patients may increase the closure tension on both sides of the donor wound. That may lead to telogen effluvium or necrosis of those areas. I introduced sequential removal of strip to avoid this type of side effects.

 

In this method I measure the laxity of the scalp using Laxometer before strip removal in three areas on right, middle and left. Then we remove the widest safe size strip from the left side and close the wound. We then measure the laxity of the intact side of scalp on the right side. If we see reduction in laxity or mobility of scalp on the second portion, we adjust the size of strip on that portion accordingly. If there is no change in the laxity of the second portion, it indicates that we can safely remove the strip with the same width from the second portion too.

 

I have not seen any severe donor complications since I started using this method. I will put the abstract of this that presentation in our web site soon.

 

Thanks again for good observation and the great question.

[dakota3]

For 2500 grafts I'd say this is a pretty good result. I'd be interested in seeing recent scar pics. Dr. Mohebi do you use deep sutures as well as staples? The reason I ask is because in the after pics it looks as though the staples are spaced pretty far apart and it seems more tension could be applied to the scar with fewer staples. Thanks in advance for your response.

[Blake Bloxham]

Very interesting doctor. I've heard of these types of tools before, but haven't heard much concerning this harvest method. Like Dakota, I'd love to see some healed scars!

[Robin-at-USHR]

Thank you for your inquiries Dakota and Future HT Doc. I have posted the requested photos into our patients photo gallery for your review. The final 2 pictures in the album are the right and backside views of the patients scarring. These photos were taken at the patient's 10 month follow-up appointment on 12/22/2009. Thank you both again for your interest, and I hope these photos help

 

Robin -at-

US Hair Restoration

16661 Ventura Blvd, Suite #313

Encino, CA 91436

T: (818)788-8363

F: (818)788-8366

[Parsa Mohebi, MD]

Whether using deep layer or not has been a matter of controversy. We had a nice panel discussion in the last annual meeting on one layer vs. two layer closure. Many hair transplant surgeons are using only one layer closure because there have been no evidence that closing the donor wound with two layer necessarily gives a better result.

 

I personally used to close all donor wound in two layer. Now and in the last year I have been getting more selective when it comes to wound closure. Many patients may not need to have two layer closure because of their loose scalp and the fact the proper approximation of skin edges with minimum tension is doable with only one layer.

 

In addition to that using Laxometer allows us to measure the laxity of the scalp and be able to determine the widest safe size for the strip. In this patient we had very reasonable closure tension and we closed in one layer.

 

Spacing between the staples or sutures also is something that you should evaluate during surgery and as you put the staples in. There should not be a set number for that and it may change from patient to patient. We do not have to put too many staples if perfect alignment of the skin edges are possible with less.