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3000 FUHT - 1 year update + case discussion


#1

Dear readers,

The following patient underwent a 3000+ FUHT procedure in June 2006 at our centre.
He visited us for his second session in June 2007.

Following are the Before HT pictures taken in June 2006.


#2

The following pictures were taken when the patient visited us one year later, i.e., in June 2007.
All pictures taken without flash and in soft, non shadow light.


#3

The young/first time HT patient

This young male patient underwent his first HT in June 2006.

When a patient wishes to go for an HT, some important things that should be impressed upon him are

  1. that he is most likely to need more hair transplants in future.

  2. that it is not possible to predict his future extent and speed of hairfall.

If he is not ready for the possibility/need of further hair transplants, he should not go for the first one.

Proper donor hair management and planning is essential.

In this patient, the first HT focussed on a starting point behind the forelock, covering the front and top areas to frame the face.
If the forelock hair persisted, as they do in some, they act as a useful adjunct. If, and when, they fall, the patient has various options still available.

Starting a hairline below the forelock can result in a situation where, if the forelock hair shed, the patient may be left with a thin/empty spot in the centre of his hairline.

The patient, aware that his hairloss can progress to higher norwood levels, can plan his hair transplant strategy.
He may choose NOT to go for any HT.
He may choose to go for a gradual approach.
He may choose to wait till he feels his hairfall has run its course and then go for an HT.

This patient has chosen the graduated approach.
The first session FUHT, in June 2006, was followed, in June 2007, by a 2000 FUHT procedure concentrating on the crown and the whorl areas.

At the same time, in June 2007, he also underwent a test BHT session in the original forelock area that had thinned.

With 5000 FUHT grafts, in 2 sessions, he has addressed his present areas of hairloss.

The grafts were transplanted at a density of 50-60 grafts per sq cm in front (June 2006) HT.
The grafts in June 2007, were transplanted in the crown at an approximate density of 40 per sq cm.

He still has FUSE/fue grafts available from the scalp donor areas, as well as body donor hair. These are available for future use should,

  • his hairloss progress further, and,
  • for hairline/temple lowering and refinement.

I welcome fellow HT doctors and forum readers to contribute with their inputs and queries.


#4

For those interested in viewing higher resolution, larger size picture, I have posted the following one.
This picture shows the result of 2006 HT in wet hair and also focusses on the hair parting. The part is one of the areas that need special attention and is so often overlooked.


#5

To give another perspective, here’s a picture with the hair combed in different ways.

» Dear readers,


#6

Dr. Sangay,

Great to see fuse beginning to live up to its promise in terms of numbers.

In transplants from your clinic, I have often felt that the hairline design is a little unimaginative. I have wondered if this is the due to the natural ethnic variation in hairline of Indian patients and whether caucasians have more complex angulation or you may simply disagree with this observation.

There are a few other comments but the one question jumps out at me. Why did you not do all 5000 in one go?

Great improvement from your clinic as usual


#7

» Dr. Sangay,
»
» Great to see fuse beginning to live up to its promise in terms of
» numbers.
»
» In transplants from your clinic, I have often felt that the hairline
» design is a little unimaginative. I have wondered if this is the due to
» the natural ethnic variation in hairline of Indian patients and whether
» caucasians have more complex angulation or you may simply disagree with
» this observation.
»
» There are a few other comments but the one question jumps out at me. Why
» did you not do all 5000 in one go?
»
» Great improvement from your clinic as usual

Hi Marco,
Just saw your post and was reminded of what Balloonman said.
This is not FUSE/fue. Its FUHT. Strip.

Its also not Indian v/s other styles. We just follow the patient’s own hair directions. Thats what we did in this case.
I am glad you like the result. The patient did too.

Let me know if you have any further queries.


#8

» » Dr. Sangay,
» »
» » Great to see fuse beginning to live up to its promise in terms of
» » numbers.
» »
» » In transplants from your clinic, I have often felt that the hairline
» » design is a little unimaginative. I have wondered if this is the due to
» » the natural ethnic variation in hairline of Indian patients and whether
» » caucasians have more complex angulation or you may simply disagree with
» » this observation.
» »
» » There are a few other comments but the one question jumps out at me.
» Why
» » did you not do all 5000 in one go?
» »
» » Great improvement from your clinic as usual
»
» Hi Marco,
» Just saw your post and was reminded of what Balloonman said on another
» site.
» This is not FUSE/fue. Its FUHT. Strip.
»
» Its also not Indian v/s other styles. We just follow the patient’s own
» hair directions. Thats what we did in this case.
» I am glad you like the result. The patient did too.
»
» Let me know if you have any further queries.

Dr How many grafts in your estimation would be needed to cover the crown to match the frontal area.


#9

» » Dr. Sangay,
» »
» » Great to see fuse beginning to live up to its promise in terms of
» » numbers.
» »
» » In transplants from your clinic, I have often felt that the hairline
» » design is a little unimaginative. I have wondered if this is the due to
» » the natural ethnic variation in hairline of Indian patients and whether
» » caucasians have more complex angulation or you may simply disagree with
» » this observation.
» »
» » There are a few other comments but the one question jumps out at me.
» Why
» » did you not do all 5000 in one go?
» »
» » Great improvement from your clinic as usual
»
» Hi Marco,
» Just saw your post and was reminded of what Balloonman said on another
» site.
» This is not FUSE/fue. Its FUHT. Strip.
»
» Its also not Indian v/s other styles. We just follow the patient’s own
» hair directions. Thats what we did in this case.
» I am glad you like the result. The patient did too.
»
» Let me know if you have any further queries.

Oh, damn, damn, damn. I am waiting for you to perform a large FUSE session sinse the promise by Dr. A and others is that it can acheive as many or more than can be done with strip…but it never happens. Well there’s the odd case but as we say in the U.K, one swallow (a bird that migrates over here in the spring time) doesn’t make a summer.

Regarding the Indian variant. You mention style. This is not what I meant. I wondered whether the natural direction of the hailine of indian patients was less complex than the direction of caucasions. If you look at armanis work, there is a complex directionality about his hairline pattern design in many of his patient. Your is more often at a fixed angle which could reflect a more simple directionality of your patients hairlines or it could be a choice on your part. Maybe I am making something out of nothing but I think there is a point here.


#10

It looks pluggy:-|


#11

» It looks pluggy:-|

oh please give us a break, it looks great


#12

» » It looks pluggy:-|
»
» oh please give us a break, it looks great

Seriously i think that behind the natural growing hairs on the hairline, you can clearly see pluggy looking grafts. just saying what i see!


#13

» » » It looks pluggy:-|
» »
» » oh please give us a break, it looks great
»
» Seriously i think that behind the natural growing hairs on the hairline,
» you can clearly see pluggy looking grafts. just saying what i see!

I can’t work out what you are seeing. I can’t see how it could look pluggy since all the grafts are FU not plugs and I can’t see how FUs could look like plugs. Maybe you mean something else.

I also think it looks great.


#14

» » » » It looks pluggy:-|
» » »
» » » oh please give us a break, it looks great
» »
» » Seriously i think that behind the natural growing hairs on the
» hairline,
» » you can clearly see pluggy looking grafts. just saying what i see!
»
»
» I can’t work out what you are seeing. I can’t see how it could look pluggy
» since all the grafts are FU not plugs and I can’t see how FUs could look
» like plugs. Maybe you mean something else.
»
» I also think it looks great.

what would scare me if i was in that situation is using up 3500 grafts in the front, and then lets say 4500 more to fill in the crown, so ur pretty much tapped out at that poiont, and this guys is balding fast and may go to a NW7 later and his part would just head down his sides and back of the head and he would really have no donor scalp hair left at that point, pretty much

so he would be forced to use body hair, I dont know the whole future hairline thing just unnerves me, if you knew where it would stop it would be totally another situation but you dont


#15

» » » » » It looks pluggy:-|
» » » »
» » » » oh please give us a break, it looks great
» » »
» » » Seriously i think that behind the natural growing hairs on the
» » hairline,
» » » you can clearly see pluggy looking grafts. just saying what i see!
» »
» »
» » I can’t work out what you are seeing. I can’t see how it could look
» pluggy
» » since all the grafts are FU not plugs and I can’t see how FUs could
» look
» » like plugs. Maybe you mean something else.
» »
» » I also think it looks great.
»
» what would scare me if i was in that situation is using up 3500 grafts in
» the front, and then lets say 4500 more to fill in the crown, so ur pretty
» much tapped out at that poiont, and this guys is balding fast and may go
» to a NW7 later and his part would just head down his sides and back of the
» head and he would really have no donor scalp hair left at that point,
» pretty much
»
» so he would be forced to use body hair, I dont know the whole future
» hairline thing just unnerves me, if you knew where it would stop it would
» be totally another situation but you dont

I respect that view but by that logic no one is truely safe with a transplant. I do take the point that this particular patient may be heading for more loss. You know sometimes I wonder, if the transplant is done well and the extra loss results in an island then a full horse shoe shaped scalp lift could be an answer.

I think if you go in for an HT then you go in with your eyes open regarding that issue.


#16

» » » » » » It looks pluggy:-|
» » » » »
» » » » » oh please give us a break, it looks great
» » » »
» » » » Seriously i think that behind the natural growing hairs on the
» » » hairline,
» » » » you can clearly see pluggy looking grafts. just saying what i see!
» » »
» » »
» » » I can’t work out what you are seeing. I can’t see how it could look
» » pluggy
» » » since all the grafts are FU not plugs and I can’t see how FUs could
» » look
» » » like plugs. Maybe you mean something else.
» » »
» » » I also think it looks great.
» »
» » what would scare me if i was in that situation is using up 3500 grafts
» in
» » the front, and then lets say 4500 more to fill in the crown, so ur
» pretty
» » much tapped out at that poiont, and this guys is balding fast and may
» go
» » to a NW7 later and his part would just head down his sides and back of
» the
» » head and he would really have no donor scalp hair left at that point,
» » pretty much
» »
» » so he would be forced to use body hair, I dont know the whole future
» » hairline thing just unnerves me, if you knew where it would stop it
» would
» » be totally another situation but you dont
»
»
» I respect that view but by that logic no one is truely safe with a
» transplant. I do take the point that this particular patient may be
» heading for more loss. You know sometimes I wonder, if the transplant is
» done well and the extra loss results in an island then a full horse shoe
» shaped scalp lift could be an answer.
»
» I think if you go in for an HT then you go in with your eyes open
» regarding that issue.

scalp lift? you are joking right?

first of all his side donor area would be tight and tapped out laxity wise also, so

I thought scalp lifts were right there along side going to Bosley


#17

» »
» » I respect that view but by that logic no one is truely safe with a
» » transplant. I do take the point that this particular patient may be
» » heading for more loss. You know sometimes I wonder, if the transplant
» is
» » done well and the extra loss results in an island then a full horse
» shoe
» » shaped scalp lift could be an answer.
» »
» » I think if you go in for an HT then you go in with your eyes open
» » regarding that issue.
»
» scalp lift? you are joking right?
»
» first of all his side donor area would be tight and tapped out laxity wise
» also, so
»
» I thought scalp lifts were right there along side going to Bosley

How dare you disagree with me.:angry::slight_smile:


#18

» I can’t work out what you are seeing. I can’t see how it could look pluggy
» since all the grafts are FU not plugs and I can’t see how FUs could look
» like plugs. Maybe you mean something else.
»
» I also think it looks great.

maybe its because of the contrast of the very dark hair against the scalp, but it looks better than my hairline atm!


#19

» » I can’t work out what you are seeing. I can’t see how it could look
» pluggy
» » since all the grafts are FU not plugs and I can’t see how FUs could
» look
» » like plugs. Maybe you mean something else.
» »
» » I also think it looks great.
»
» maybe its because of the contrast of the very dark hair against the scalp,
» but it looks better than my hairline atm!

Oh yeh, I see what you mean, the hair forming those layers as it sort of sticks together. Theres a name for it but I can’t remember what it is. I think its just an illusion /grooming /hair style / oil issue


#20

» Regarding the Indian variant. You mention style. This is not what I meant.
» I wondered whether the natural direction of the hailine of indian patients
» was less complex than the direction of caucasions. If you look at armanis
» work, there is a complex directionality about his hairline pattern design
» in many of his patient. Your is more often at a fixed angle which could
» reflect a more simple directionality of your patients hairlines or it
» could be a choice on your part. Maybe I am making something out of nothing
» but I think there is a point here.

Marco,
I will like to understand your point of view. If you could explain in detail, it will be great. Feedback and suggestions is always good.

Meantime, to explain my point, I will post some links to earlier threads.
You may find differences based on the patient’s own hair directions as well as the requirements.

This thread shows 2 entirely different hairline results.
http://www.hairsite4.com/dc/dcboard.php?az=show_topic&forum=12&topic_id=48950&mode=full#49273

Caucasian patient

Indian patient

The Indian patient had hair growing in a wide variety of different angles, while the Caucasian patient’s hair were much simpler and straightforward.

Not to say that its always so. Its a person to person variation and we follow what the patient’s own hair directions were.

The patient being discussed on this thread had hair growtyh in front of the recipient area that he lost over the period of the past year.
The final hairline that will be created eventually will, likely include a feathered zone of scalp + body hair.