Regular Member kg0 Posted July 10, 2008 Regular Member Share Posted July 10, 2008 ---------------------------------------- Update 1-28-2009 ---------------------------------------- Here are pictures after 6 months. Thumbnails: http://www.kfzy.com/hair/thumbnail_1.jpg http://www.kfzy.com/hair/thumbnail_2.jpg http://www.kfzy.com/hair/thumbnail_3.jpg http://www.kfzy.com/hair/thumbnail_4.jpg http://www.kfzy.com/hair/thumbnail_5.jpg http://www.kfzy.com/hair/thumbnail_6.jpg http://www.kfzy.com/hair/thumbnail_7.jpg http://www.kfzy.com/hair/thumbnail_8.jpg http://www.kfzy.com/hair/thumbnail_9.jpg Full size: http://www.kfzy.com/hair/DSC_0001.JPG http://www.kfzy.com/hair/DSC_0002.JPG http://www.kfzy.com/hair/DSC_0003.JPG http://www.kfzy.com/hair/DSC_0004.JPG http://www.kfzy.com/hair/DSC_0005.JPG http://www.kfzy.com/hair/DSC_0006.JPG http://www.kfzy.com/hair/DSC_0008.JPG http://www.kfzy.com/hair/DSC_0009.JPG http://www.kfzy.com/hair/DSC_0011.JPG I've already sent these questions to Dr. Ross, but if I could get some responses here, I'd be appreciative! 1) Is this a normal result for one surgery, or not because it is scar tissue? It doesn't seem thick enough to be normal. 2) Do you think a second surgery help significantly, or not really? ---------------------------------------- Hello all, I am an 18-year-old male in southern California area. I was born with a condition called "aplasia cutis" - I had a round bald spot about 10 cm2 in area at the crown of my head. The skin of the bald spot is scar tissue. There were never any hairs in the area. Picture: http://www.picvault.info/images/537076154_pic1.jpg In 2006, I had two plastic surgeries to try to remove the bald spot. Immediately after both surgeries, there was no sign of the bald spot, but it soon stretched. Now the bald spot is about the same size, but a different shape. I also have a fairly thin scar down the back of my head where they cut a flap to try to make the scalp reduction easier. Last year, my family moved to California and I went to see a local plastic surgeon and see what the next step would be. She recommended hair transplantation, saying it would work even in scar tissue (which I didn't know before). Since then, I have had consultations with the following practices/doctors: Ziering Medical Dr. Chang (Natural Hair Transplant Medical Center) Ross Medical Hair Restoration Dr. Reed (La Jolla Hair Restoration Medical Center) I've had mixed responses as to whether hair transplants would grow well in my bald spot (scar tissue). Ziering Medical and Dr. Chang were optimistic about it working well. Dr. Ross's technician (after examining it) said something along the lines of, "I think there's a chance it would work," but by the end of the consultation, was much more optimistic, for some reason. Dr. Reed was not as optimistic about it working well. He said my bald spot scar was thin and that that made it less likely to work. He recommended that if I did it, I only do 300 grafts for the whole bald spot and scar line. Dr. Ross's technician recommended 600. (I'm not sure about Ziering, but the rest recommended transplanting follicular units of 2-4 hairs each) So, my questions boil down to... 1) What's the story on scar tissue and hair transplants? I've read multiple times that it works but not quite as well as normal tissue. However, Dr. Reed made it sound as if it may work significantly worse. 2) Has anybody had experience or heard anything about the doctors/practices I mentioned? Ziering is significantly more expensive than the rest and I'm wondering if they're really any better. Thank you so much! Keith Link to comment Share on other sites More sharing options...
Bill - Seemiller Posted July 10, 2008 Share Posted July 10, 2008 Keith, Welcome to our forum community and thanks for the post. Simply put, transplanting hair is a lot like gardening. Transplant hair into a healthy scalp with good circulation is much like planting crops into fertile soil. As long as the crops aren't damaged during the planting and taken care of they will grow. However, transplanting hair into damaged skin (like scar tissue) may result in poor hair growth much like planting crops into poor soil. Sure, some may grow, but some may not. That said, it is clear that you are getting some mixed input from hair transplant physicians you've consulted with. I can't imagine how trying a hair transplant would make things worse however, I certainly understand why surgeons would want to proceed with caution, trying out a lesser number of grafts to see if they grow. It seems quite clear that you may be taking a gamble on this. Whether or not you choose to gamble is up to you. Dr. Reed is frst rate and an elite member of the Coalition of Independent Hair Restoration Physicians. Dr. Ross is currently being considered for recommendation on the Hair Transplant Network. If you choose to proceed, select your surgeon wisely based on evidence of consistent results. Best wishes, Bill Link to comment Share on other sites More sharing options...
Senior Member hatrick Posted July 10, 2008 Senior Member Share Posted July 10, 2008 The doctor who performed my surgery also does a lot of transplants for patients with scars with excellent results. However, he is in Michigan, which is quite a distance. I'm sure you could find a great surgeon closer to you who could produce the same results. I definitely think your a candidate but proceed with caution. Do your research and find a good doc who has done many transplants into scar tissue with great results. My Hair Loss Weblog - Hair Transplant with Dr. Tessler Link to comment Share on other sites More sharing options...
Senior Member thanatopsis_awry Posted July 10, 2008 Senior Member Share Posted July 10, 2008 I would seriously consider a session (if not sessionS) of FUE, if you do decide to try to fill in this peculiar area. Personally, I'm not sure I would brave anything else than FUE trying to rectify this situation. ----------- *A Follicles Dying Wish To Clinics* 1 top-down, 1 portrait, 1 side-shot, 1 hairline....4 photos. No flash. Follicles have asked for centuries, in ten languages, as many times so as to confuse a mathematician. Enough is enough! Give me documentation or give me death! Link to comment Share on other sites More sharing options...
Regular Member Dr. William Reed Posted July 10, 2008 Regular Member Share Posted July 10, 2008 Hello HTN Community. My partner Dr Tim Carman told me about this post and I thought it might be useful to the discussion as well as to the young man initiating this thread to make a few remarks. I saw this young man with his mother yesterday. They aren't interested in expanders which, though they be the best solution, is an understandable opinion in view of what expanders entail. The scarred areas are 10cm2 with half being a long thin scar not shown adjacent to the large scar that is shown in the photograph. A steep angle of insertion for the long thin scar and paper thin scar tissue for the central 50% of the larger one shown in the photo are the important considerations. Both of these considerations decrease the density of grafts that can be placed. Thirty grafts / cm2 seems a reasonable estimate of achievable density. For ten cm2 this equates to 300 fugs. The scar is in an unfortunate spot cosmetically and stylistically, hence my caution for its lack of appearing normal if it serves as the termination of the partline and hence my reservations about his being completely satisfied with pursuing hair transplantation. The grafted hair will never appear exactly like the adjacent normal scalp but it can contribute to decreasing the "contrast" that the bald spot has with the adjacent scalp. It would be best to style with the partline on the other side which can be done in his case and would add to his satisfaction by not having the partline end in the grafted area. Perhaps knowing that there is another long thin scar will have Dr. Feller be less adamant about the exclusive indication for FUE. With multiple scars already present, perhaps another scar which will be only a little over an inch long is not as big an issue as he would feel it to be otherwise. Best regards, Bill Reed, MD William Reed, M.D. Member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member Dewayne Posted July 10, 2008 Senior Member Share Posted July 10, 2008 Dr. Reed: I don't think Dr. Feller responded, unless I've missed it. Perhaps you are referring to thanatopsis_awry's post above, who while a great wordsmith isn't a doctor as far as I know. 100? 'mini' grapfts by Latham's Hair Clinic - 1991 (Removed 50 plugs by Cooley 3/08.) 2750 FU 3/20/08 by Dr. Cooley My Hair Loss Website - Hair Transplant with Dr. Cooley Current regimen: 1.66 mg Proscar M-W-F Rogaine 5% Foam - every now and then AndroGel - once daily Lipitor - 5 mg every other day Weightlifting - 2x per week Jogging - 3x per week Link to comment Share on other sites More sharing options...
Senior Member PLEASE GROW PLEASE Posted July 10, 2008 Senior Member Share Posted July 10, 2008 I agree with fue allthe way Link to comment Share on other sites More sharing options...
Senior Member the B spot Posted July 10, 2008 Senior Member Share Posted July 10, 2008 I don't think you can go wrong either way--strip or FUE to be honest---it is highly unlikely that he will be able to buzz down--although the one case for FUE is to select larger grafts, 3's and 4's b/c it will be just "whatever" comes out of the strip----That would be the only reason I would do FUE Again, I still believe either method will produce good results should he choose this method. Jason Go Cubs! 6721 transplanted grafts 13,906 hairs Performed by Dr. Ron Shapiro Dr. Ron Shapiro and Dr. Paul Shapiro are members of the Coalition of Independent Hair Restoration Physicians. Link to comment Share on other sites More sharing options...
Senior Member thanatopsis_awry Posted July 11, 2008 Senior Member Share Posted July 11, 2008 Yes, please don't mistake my mumblings for that of a doctor, let alone the esteemed Dr. Feller -- I would hate to misdirect someone away from a fin script and they have a seizure. Though, Dr. Thanatopsis.....has a nice ring to it! If only I didn't drop out of school. ----------- *A Follicles Dying Wish To Clinics* 1 top-down, 1 portrait, 1 side-shot, 1 hairline....4 photos. No flash. Follicles have asked for centuries, in ten languages, as many times so as to confuse a mathematician. Enough is enough! Give me documentation or give me death! Link to comment Share on other sites More sharing options...
Guest Dr. Brandon Ross Posted July 29, 2008 Share Posted July 29, 2008 Hello everyone. I performed surgery on this nice young man yesterday, and he has agreed to allow me to post his pictures in this thread. The total number of grafts we placed was 632, with the following breakdown: The large crescent-shaped scar received 357 grafts @ approximately 45 grafts per cm (area of roughly 8 square cm). I was pleasantly surprised that the tissue in this area was reasonably thick, which allowed me to make the graft sites without them being overly shallow and/or with very acute angles. The other 275 grafts were placed throughout the remaining thinner scar @ approximately 45 grafts per cm (roughly 6 square cm). Blood flow to all of the scarred areas in question was very good and I expect his results to be excellent. Brandon Ross, MD Link to comment Share on other sites More sharing options...
Guest Dr. Brandon Ross Posted July 29, 2008 Share Posted July 29, 2008 Here's a picture after the graft sites have been made. Brandon Ross, MD Link to comment Share on other sites More sharing options...
Guest Dr. Brandon Ross Posted July 29, 2008 Share Posted July 29, 2008 And finally, here's what the closed donor incision looks like. Brandon Ross, MD Link to comment Share on other sites More sharing options...
Senior Member wantego Posted July 29, 2008 Senior Member Share Posted July 29, 2008 Hey best of luck with your surgery. I hope you get fantastic results! 4374 grafts-7/2/2008-Dr Rahal 485 singles 2336 doubles 1526 triples 16 quads 9809 total hairs Link to comment Share on other sites More sharing options...
Senior Member thanatopsis_awry Posted July 29, 2008 Senior Member Share Posted July 29, 2008 Best of luck, and keep us posted! ----------- *A Follicles Dying Wish To Clinics* 1 top-down, 1 portrait, 1 side-shot, 1 hairline....4 photos. No flash. Follicles have asked for centuries, in ten languages, as many times so as to confuse a mathematician. Enough is enough! Give me documentation or give me death! Link to comment Share on other sites More sharing options...
Senior Member Dewayne Posted July 29, 2008 Senior Member Share Posted July 29, 2008 Looks great. I hope this young man has a wonderful result and rest of his life. 100? 'mini' grapfts by Latham's Hair Clinic - 1991 (Removed 50 plugs by Cooley 3/08.) 2750 FU 3/20/08 by Dr. Cooley My Hair Loss Website - Hair Transplant with Dr. Cooley Current regimen: 1.66 mg Proscar M-W-F Rogaine 5% Foam - every now and then AndroGel - once daily Lipitor - 5 mg every other day Weightlifting - 2x per week Jogging - 3x per week Link to comment Share on other sites More sharing options...
Senior Member TheEmperor Posted July 29, 2008 Senior Member Share Posted July 29, 2008 Looks good! Even if it all doesnt grow it will make a big improvement. My Hair Loss Web Site - Hair Transplant with Dr. Wong Link to comment Share on other sites More sharing options...
Bill - Seemiller Posted July 30, 2008 Share Posted July 30, 2008 Dr. Ross, Thanks for posting this patients photos. I do encourage you however, to start your own thread by going to Patient Results Posted by Leading Hair Restoration Clinics, clicking on "New", and then "Photo Album". Be sure to include the number of grafts, hair count breakdowns, and any other important detail like you provided above in the introduction. You can then update the album as you take updated photos. Best wishes, Bill Link to comment Share on other sites More sharing options...
Regular Member kg0 Posted July 30, 2008 Author Regular Member Share Posted July 30, 2008 As Dr. Ross said, I had a hair transplant with him yesterday. He did a great job as far as I can tell so far. The surgery itself was not as bad (in terms of pain) as I thought it would be. I felt like I was in good hands as well. Now I just have to wait and see what happens! Keith Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted August 2, 2008 Regular Member Share Posted August 2, 2008 That is a very interesting case. Please post the 6 month pics and I bet they will look good. Dr. Lindsey McLean VA William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Regular Member Under Construction Posted December 9, 2008 Regular Member Share Posted December 9, 2008 Keith, I hope all is going well with your growth. I am extremely interested in your case, as I too was born with aplasia cutis. I am quite a bit older than you (41), and have undergone many procedures to correct my condition. My scars were/are considerably larger than yours. All tolled, I have have 7 surgeries dating back to the early 80's. I too, had some rather unsuccesful scalp reduction surgery. Like your situation, my scars just stretched back over time. I also had some archaic plug grafts done in the late 80's to help fill in the scars. To make matters worse, my existing/native hair began to thin over the past decade. Now that HT technology has improved, I have begun another attempt at repair. So far, it has been a slow and expensive process for me. Please feel free to PM me, as i would very much like to learn how you are progressing. Kindest, D. Link to comment Share on other sites More sharing options...
Senior Member Chuckisduck Posted December 9, 2008 Senior Member Share Posted December 9, 2008 Looks like it should be good. Dr Ross, Did you worry about tension on the donor strip or is the scalp vertex prone to stretching more than the donor area? My Hair Loss Blog - Hair Transplant with Dr. Keene Link to comment Share on other sites More sharing options...
Regular Member kg0 Posted January 29, 2009 Author Regular Member Share Posted January 29, 2009 "Under Construction," it is very interesting to hear from someone with the same exact condition in the same area! I've just posted updated pictures after 6 months. See the original post. Link to comment Share on other sites More sharing options...
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