Hairline - frontal half reconstruction

[Gencheff]

Patient had procedure mid September 2009, to recreate hairline and augment existing hairs, working all of Zone I and into Zone II.

1,180 20 gauge single follicular unit

1,020 19 gauge two hair follicular units

Total 3,220 hairs

 

 

[hairloser1]

This is the type of HT that kinda makes me cringe. There's so much diffuse thinning and miniturization taking place. In the top-down picture you can clearly see the typical horseshoe pattern has already developed.

 

By adding 2000 grafts into the front section of thin and miniturized hair this just seems like a classic case where he may lose (shockloss) a lot of the existing hair permanently from the HT. If this happens, then what will his net gain be? Just looks like a recipe for disaster to me. Of course, I could be completely wrong and it might be a great result and big improvement.

 

We don't know if he is has been on meds. If this was me, and I really wanted to get a HT, I would get on meds for awhile and then go in to a doc and have him buzz it down and give me no less than 4000 grafts. Then, of course, stay on fin. With 4000 grafts there may still be shockloss of course, but at least there's a lot more grafts to help increase the net gain of hair.

[Bill - Seemiller]

hairloser,

 

You make some good points however, I want to add my opinion.

 

Honestly, assuming the patient has realistic expectations, diffuse thinners can actually be great hair transplant candidates. Inevitably as hair loss continues, transplanted hair will begin to replace natural hair. But assuming the patient is prepared for the possibility of multiple procedures and has enough donor hair available, diffuse thinners can achieve a smoothe transition from a diffuse thinning natural head of hair to a natural head of permanent transplanted hair.

 

Don't get me wrong. I'm not dismissing the risks involved. I'm only pointing out that as long as the patient accepts the risks and the doctor and patient strategize for worst case possibilities, diffuse thinning patients can be great candidates.

 

Best wishes,

 

Bill

[Blake Bloxham]

Much, much improved photo presentation doctor. I hope the result turns out well. Is the patient on any medication?

[Gencheff]

Patient is in his late 40's with stable loss and is on preventative therapy. What is also important is that this patient expects to lose more to the back half and wants to get a jump on his reconstruction to the frontal scalp by adding to his thinning. He fully expects yet another restoration to the frontal half. Fortunately this patient is blessed with excellent donor and can easily have another 2+ procedures. All my patients have to expect more hair loss if they haven't lost all recipient hairs, but given this patients age, preventative hair loss therapies, desire, donor density and expectations he was an excellent candidate. Also, should the patient lose more hair a diffused thin look can still be very natural in appearance when done with follicular units.