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4683 FUSE grafts - 9 mth update (TH)


#1

Dear forum readers,
TH revisited our clinic at 9 months since his first HT, for second part of his hair restoration surgery.

Patient particulars
TH is a NW 6 patient of Maori descent.
He has had no other hair restortion surgeries ever.

His 5 month update can be read at
http://hairtransplantcentre.blogspot.com/2007/10/dear-forum-readers-patient-th-sent-his.html

Graft details of 1st HT -
4683 FUSE grafts (of which only 2099 are from the scalp) - 44%.

719 chest, 1533 leg, 206 armpit and 126 abdomen grafts make the rest - 56%.

We shall present the detailed pre operative, intra operative and 9 month post operative pictorial history.
Thereafter, we shall discuss the 2nd time FUSE (scalp + BHT) performed recently.

But first, a quick before and after picture comparison.
Before

After 9 months (we expect further improvement in the first HT’s density in the next 3 months).

Regards,
Dr. A


#2

TH being a Norwood 6 had an extensive area to cover.
In the first stage, the options were to go for a low hairline (almost Norwood 1) or to remain conservatively high.
As the pictures below show

Some closer pictures showing the extent of hairloss.


#3


#4

Pictures of the scalp donor area immediately after extractions. A 26 gauge needle (diameter 0.45mm) is juxtaposed in the picture for comparison.

Recipient area pictures

Day 1 - Scalp and body hair grafts placed in ratio of 1:1. Body hair grafts consisted of chest and leg hair.

Day 2 - Scalp hair and body hair grafts used in a ratio of 1:2.
Body hair consisted of grafts from the chest, armpits, abdomen and the legs.

Day 3 - Scalp hair and body hair grafts placed in a ratio of 4:1 in the front three rows and in ratio of 3:1 thereafter. The body hair grafts for the purpose were extracted from the legs only.

Regards,
Dr. A


#5

O.K you got us all on this one. :slight_smile:


#6

» O.K you got us all on this one. :slight_smile:

Not all of us :wink:


#7

» » O.K you got us all on this one. :slight_smile:
»
» Not all of us :wink:

What got me in that I new he was of Maori discent but my due dilligence suggested that very few Maoris travel to the mambai regeon. Togeter with this a background was taken with a carl zeise 385-UM lense and these are not available in India. Taken together I had to discount Dr. A. If it were not for these issues it was obviousely a mixed BHT scalp FUE of about 4700, probably performed in mambai somewhere near Nehru Place. Is it too late to edit my original conclussions??:stuck_out_tongue:


#8

» O.K you got us all on this one. :slight_smile:

Dear Marco,
The intention was not that.
However, I wanted to see reactions of the readers if they do not know which technique - the strip FUHT or the stitchless FUSE - was used.

When TH visited us this time, I asked my doctor colleagues as well as technicians working since a long time to give me an estimate - based on the hair growth you see, with how many strip grafts would you have been able to acheive similar growth at 1 year?

The estimates ranged from 3500 grafts (my own estimate)to 5000 and 4500(of 2 of my technicians who have worked alongside me for 8 and 5 years respectively).

I am glad many readers considered the result good enough for strip.

Regards,
Dr. A


#9


#10

TH keeps his scalp donor area buzz cut. Something that is possible following the FUSE extractions.
In TH’s first HT, 2099 grafts were extracted.

The following pictures show the scalp donor area after 9 months.


#11

In the second stage of his hair restoration, TH wishes to go for a lower hairline and to fill in the crown areas behind the previous transplant.

The plan -
The final hairline will consist of mostly scalp hair mixed with hair from the thigh and the chest.

The crown will be filled using some scalp hair grafts mixed with grafts from the armpit, pubic, chest and beard areas.
The aim being to focus on the more robust hair, rather than on sheer numbers to provide coverage. That is to say, better coverage value per graft.


#12


#13

» I am glad many readers considered the result good enough for strip.
»
» Regards,
» Dr. A

To be honest Dr.Arvind, I am an intelligent guy. I have no axe to grind and i am getting to the point that I really need to get my first HT. I am also more than able to put evidence together and get to the bottom line. Having read comment and seen the results of a lot of surgeons over the last few years, I remain totally confused as to the right direction to go in; i.e strip BHT FUSE numbers needed one or multi sessions and now whether to include botox in any scar if I go for strip. The comments by the surgeons are clear and decisive and … mostly at odds with each other. It make all of this quite difficult.


#14

» » I am glad many readers considered the result good enough for strip.
» »
» » Regards,
» » Dr. A
»
» To be honest Dr.Arvind, I am an intelligent guy. I have no axe to grind
» and i am getting to the point that I really need to get my first HT. I am
» also more than able to put evidence together and get to the bottom line.
» Having read comment and seen the results of a lot of surgeons over the
» last few years, I remain totally confused as to the right direction to go
» in; i.e strip BHT FUSE numbers needed one or multi sessions and now
» whether to include botox in any scar if I go for strip. The comments by
» the surgeons are clear and decisive and … mostly at odds with each
» other. It make all of this quite difficult.

Marco,

If you feel overwhelmed or confused by this, the best thing is to sit tight and NOT do anything at this point. As a general rule, I think people should be at least 80% comfortable with the idea before taking the plunge.

Where possible, do smaller sessions.


#15

You got me on this one Dr. Arvind. Very natural for body hair, I thought it was strip from HDC. I am curious how many more grafts can you spare from his scalp?


#16

» Where possible, do smaller sessions.

Even that is contentious. Some surgeons will say try not to revisit an area once transplanted (H&W). Many will say do not perform small strip sessions. Others will say do not re-visit an FUE donor area (Feller / BHR). Others will say do not perform FUE as the first call since it may be tapped out (BHR).

so even the single point “do smaller sessions” is contentious!

I do not feel overwhelmed. In truth I am very clear in my conclusion. The advice from HT surgeons is contradictory.


#17

» » Where possible, do smaller sessions.
»
» Even that is contentious. Some surgeons will say try not to revisit an
» area once transplanted (H&W). Many will say do not perform small strip
» sessions. Others will say do not re-visit an FUE donor area (Feller /
» BHR). Others will say do not perform FUE as the first call since it may be
» tapped out (BHR).
»
» so even the single point “do smaller sessions” is contentious!
»
» I do not feel overwhelmed. In truth I am very clear in my conclusion. The
» advice from HT surgeons is contradictory.

I think you are like me. The more I come to these sites the less I feel the urge to get a hair transplant. I still want to get something done but I don’t feel the urgency like I used to a couple years ago. I just want to wait and see right now.


#18

» You got me on this one Dr. Arvind. Very natural for body hair, I thought it
» was strip from HDC. I am curious how many more grafts can you spare from
» his scalp?

It looks good because the hair is cut very short. Less is more, that’s always the key.


#19

Following are some pictures of the facial/beard donor area before any extractions (Jan 2008).


#20

Dear forum readers,
TH has opted for temple closure and a three peaked feathered hairline.
The following pictures explain the hairline design.