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An interesting case (Doc 1)


#1

Dear forum readers,
We recently operated on a patient (refer with nickname Doc 1).

He had some previous surgeies and presented some unique challenges.

His previous HT work is an instructive study for aspiring HT patients.

Patient particulars

The patient is almost 30 and would have been a advanced NW 4/ early NW 5 if he had not got any HT.

Previous 2 strip HT surgeries were performed by a famous N. American HT surgeon.
The first HT was for 3500 grafts in the frontal area.
It was followed 4 months later by an 1100 grafts strip surgery, the grafts being placed in the crown area.

In both instances, surgical staples were used for closure of the strip wound.


#2

The following is a videoclip of Doc 1 before he went for a procedure at our clinic.
Doc 1 feels he got <50% growth. However, its not fair for me to comment because I do not have access to Doc1’s before HT pictures.

The only area I can talk about is the crown where I do not understand what the aim of the surgeon was. The grafts are placed in the centre of the crown with bald patch around.

12_file9.wmv


#3

The following are pictures taken when Doc 1 visited us, before we operated.

The areas on both sides of the donor are unusually thinned out.

The following picture shows the thinning (more noticeable on the right side as outlined in yellow).


#4

This picture shows the exit points of the staples.


#5

Dear forum readers,
Doc 1 has

  1. a thinned out scalp donor,
  2. straight hair, and,
  3. a high skin - hair color contrast.

He is in a difficult situation because he has limited scalp donor and has an island of transplanted hair on the crown.

Therefore, additional donor resources need to be used.

We plan to create a swirl and to fill the areas around the central island to connect it to the hair on the sides. For these areas, facial and scalp donor hair will be used.
Additionally, left side temple was transplanted at a very low density.
We plan to fill that using the scalp donor hair.

Regards,
Dr. A


#6

Dear forum readers,
A total of 1025 grafts were transplanted.
Of these, 504 were from the scalp donor area and 521 from the beard donor area.

(8 beard hair grafts were transplanted in a localised identifiable part of the strip scar to help patient assess its use for filling in the strip scar).

Comparative pictures of the different types of donor hair.
The thick calibre hair on the left is the beard donor hair, while the remaining are scalp donor hair.

Doc 1 visited us 1 day after his procedure.

The following pictures show the beard donor area 1 day after extraction.

Some videos
video of the beard donor area (1 day after)

12_file10.wmv

Video of the scalp 1 day after
12_file11.wmv

Regards,
Dr. A


#7

» Dear forum readers,
» A total of 1025 grafts were transplanted.
» Of these, 504 were from the scalp donor area and 521 from the beard donor
» area.
»
» (8 beard hair grafts were transplanted in a localised identifiable part of
» the strip scar to help patient assess its use for filling in the strip
» scar).
»
» Comparative pictures of the different types of donor hair.
» The thick calibre hair on the left is the beard donor hair, while the
» remaining are scalp donor hair.
»


»
»
»
» Doc 1 visited us 1 day after his procedure.
»
» The following pictures show the beard donor area 1 day after extraction.
»
»
»
»
»
»
»
»
»
» Some videos
» video of the beard donor area (1 day after)
»
» 12_file10.wmv
»
»
»
» Video of the scalp 1 day after
» 12_file11.wmv
»
» Regards,
» Dr. A

That is a weird scar, ive never seen one thats straight and angular like that.