Doc1 - 1025 FUSE grafts (504 scalp + 521 beard)/ 4.5 month update

[Dr_Arvind]

Dear forum readers,
Doc1 is the nickname ascribed for the patient whose first stage repair HT was discussed at
http://www.hairsite.com/hair-loss/board_entry-id-12324.html

Previous relevant details

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.

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

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.
The grafts are placed in the centre of the crown with bald patch around.

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

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.

Regards,
Dr. A

[Dr_Arvind]

Dear david,
This thread has been posted in the wrong section.
Please transfer it to the hair transplant forum.

Regards,
Dr. A

[Dr_Arvind]

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).

[Dr_Arvind]

Many patients ask about the viability of beard hair growth in scar tissue.
Doc1 is another patient documentation in this respect.

Of the 8 grafts transplanted in an identifiable area of the strip scar, at 4.5 months, we saw 7 growing.

Following are some pictures of the beard hair grafts growing in the strip scar.

A closer look

Wet hair picture

Regards,
Dr. A

[Dr_Arvind]

The crown area was transplanted using a mix of beard and scalp donor hair.

I ask all beard hair to scalp transplant patients the following questions.

1. Can you “feel” the difference in texture of the transplanted beard hair? And if yes, is that an issue that would discourage you from further use of the beard hair as donor?

2. Has any person not aware of the transplant been able to make out the beard hair?

At 4.5 months, Doc1 can feel the difference in texture, (if he tries too), as the transplanted beard hair has a thicker calibre, but does not consider that an issue. Even though family members know that he has gone for a repair hair transplant, they are not able to distinguish the beard hair in daily life.

---

Following his positive experience in the September 2007 hair transplant, Doc1 has undergone the next stage of his hair transplant repair in March 2008.
This time the focus has been on the frontal areas, where hair density needs to be build up.
Due to the limited scalp donor resources, this has been accomplished with a mix of scalp and beard donor hair.

The front 5 rows of the hairline have only scalp donor hair. Behind that, a mix of scalp and beard donor hair have been used.

Regards,
Dr. A

[marco]

Hi Dr. A,

Some years ago (about 2000 I think) just as the FU approach was being introduced some clinics began to use single hairs rather than FU. For a short period there was a move to split single hairs (I do not know what plane but longitudinal as I remember). The reports were that this could be done and the hair gave about 1.5 hairs per split. The hair was finer and it was suggested that it could be used for the hairlne. Obviously it fell out of favour but I wonder whether this would be of interest in beard hair transplantation. It would present a benign experiment.

[tembo]

Dr. A,

I seem to notice that most guys who have ear hair tend to go bald. It happened to my father after he approached turned 55 (when he first started getting ear hair and losing scalp hair), and it is happening to me before the age of 30! Have you noticed that trend in your patients? This patient clearly has some ear hair, which he might have trimmed too. I also notice the same correlation with back and chest hair versus scalp hair loss.

Your opinions?

[Mr_Frodo]

» Hi Dr. A,
»
» Some years ago (about 2000 I think) just as the FU approach was being
» introduced some clinics began to use single hairs rather than FU. For a
» short period there was a move to split single hairs (I do not know what
» plane but longitudinal as I remember). The reports were that this could be
» done and the hair gave about 1.5 hairs per split. The hair was finer and it
» was suggested that it could be used for the hairlne. Obviously it fell out
» of favour but I wonder whether this would be of interest in beard hair
» transplantation. It would present a benign experiment.

not a bad idea, the beard hair is almost twice as thick as scalp hair according to pic

[stitchmeup]

Dr. Arvind, his scar is not too bad, mine is just a tad wider than his. How many beard hairs do you think Doc1 needs in order to fix his strip scar?

[Dr_Arvind]

» Dr. Arvind, his scar is not too bad, mine is just a tad wider than his. How
» many beard hairs do you think Doc1 needs in order to fix his strip scar?

Dear stitchmeup,
Doc1’s first priority is the front and top areas. The strip scar he wishes to address last.

However, given a similar situation, there are various options.
He could go for just 500 grafts (mix of beard and chest/pubic hair) to break the scar. The grafts can be transplanted at the two ends of the strip scar as well as the centre.
This way the linear strip scar can be camoflaged even with less number of grafts.
He can have all the strip scar transplanted into. 1000 to 1200 robust facial and chest/pubic hair grafts can be used in that choice.

Regards,
Dr. A

[Dr_Arvind]

» Dr. A,
»
» I seem to notice that most guys who have ear hair tend to go bald. It
» happened to my father after he approached turned 55 (when he first started
» getting ear hair and losing scalp hair), and it is happening to me before
» the age of 30! Have you noticed that trend in your patients? This
» patient clearly has some ear hair, which he might have trimmed too. I
» also notice the same correlation with back and chest hair versus scalp
» hair loss.
»
» Your opinions?

Dear tembo,
Over the years I have also seen,

• Nonbalding people with ear hair, e.g. India’s Railway minister, Lalu Prasad Yadav.
  
  http://www.pressmart.net/blog/2007_02_01_archive.html

• Balding people with no/minimal ear hair.

I do not think there is a direct coorelation between extensive baldness and ear hair growth.

Regards,
Dr. A

[arun]

Dr. Arvind,
First let me thank you for opening a new donor in form of usable beard hair.
You seem to have lots of experience using this type of hair in different areas.
For a person like me, who is already a NW 5 going to 6, at which stage or session should I contemplate using the coarser beard hair. I will probably need 3 sessions and I want to follow the option aniother of your patient chose. Starting from the hairline and moving back. http://www.hairsite.com/hair-loss/board_entry-id-22928-page-0-category-2-order-last_answer-descasc-DESC.html

Should I start using some beard hair from the first session itself, so as to make the scalp donor last over a larger area?

[stitchmeup]

» » Dr. Arvind, his scar is not too bad, mine is just a tad wider than his.
» How
» » many beard hairs do you think Doc1 needs in order to fix his strip
» scar?
»
» Dear stitchmeup,
» Doc1’s first priority is the front and top areas. The strip scar he wishes
» to address last.
»
» However, given a similar situation, there are various options.
» He could go for just 500 grafts (mix of beard and chest/pubic hair) to
» break the scar. The grafts can be transplanted at the two ends of the
» strip scar as well as the centre.
» This way the linear strip scar can be camoflaged even with less number of
» grafts.
» He can have all the strip scar transplanted into. 1000 to 1200 robust
» facial and chest/pubic hair grafts can be used in that choice.
»
» Regards,
» Dr. A

Thank you. This will give me an idea how many I need, mine is just a little bit wider than his.

[Dr_Arvind]

» Dr. Arvind,
» First let me thank you for opening a new donor in form of usable beard
» hair.
» You seem to have lots of experience using this type of hair in different
» areas.
» For a person like me, who is already a NW 5 going to 6, at which stage or
» session should I contemplate using the coarser beard hair. I will probably
» need 3 sessions and I want to follow the option aniother of your patient
» chose. Starting from the hairline and moving back.
» http://www.hairsite.com/hair-loss/board_entry-id-22928-page-0-category-2-order-last_answer-descasc-DESC.html
»
» Should I start using some beard hair from the first session itself, so as
» to make the scalp donor last over a larger area?

Dear Arun,
Whenever possible, its best to plan all the sessions at the start.

If you wish to use a combination of scalp, facial and robust body hair, it will be judicious to

1. Start with a mix of the different types in the first HT itself. That way the overall finished result wil look more natural (than if scalp hair were used for 1 area and only body and facial hair for the other).

2. I do not recommend using thick calibre facial hair for the hairline. They are best used in progressively increasing %age as one goes in and to the back.

Regards,
Dr. A

[Dr_Arvind]

12_file28.wmv

Please see it in conjunction with the pictures posted before.