This presentation represents a different approach for one with such aggressive loss. This patient is classified as a NW6 however the loss extends further than a typical NW6 but not quite as far as a NW7. In fact, this case is more of a hybrid, or a cross, between the two. The crown loss is typical of a NW6 however the sides are more aggressive that is more similar to a NW7.
After long discussions with this patient he decided that he would rather have a thinner top in order to have improved coverage extended into the crown. The result shown in 1 year post-op.
» This presentation represents a different approach for one with such
» aggressive loss. This patient is classified as a NW6 however the loss
» extends further than a typical NW6 but not quite as far as a NW7. In fact,
» this case is more of a hybrid, or a cross, between the two. The crown loss
» is typical of a NW6 however the sides are more aggressive that is more
» similar to a NW7.
»
»
» After long discussions with this patient he decided that he would rather
» have a thinner top in order to have improved coverage extended into the
» crown. The result shown in 1 year post-op.
»
Hi Joe, for the benefit of others, I am currently talking to H&W / Joe about having an HT with you and also with BHR.
I do not understand why this is regarded as a “different” approach. For a single pass one could not do better than this. This would very much be my preference and I believe from various discussions that it would also be the choice of many type VI. So what is the disadvantage? Generally it is the surgeon that wants to cover one area at a higher density followed by a second session to address another (usually the crown). If two sessions are needed or optimal then either, two areas could be covered, one area in each session or complete coverage with the second session adding density.
Is there a problem adding density to an area already covered in a second session???
although I see this result as pretty much the best that could possibly be achieved in one session, I feel that a small amount of nape hair by “you know what” would soften the hairline a little at this density.
I am not sure if I have seen a better result in one session for this degree of hair loss!!!
» » This presentation represents a different approach for one with such
» » aggressive loss. This patient is classified as a NW6 however the loss
» » extends further than a typical NW6 but not quite as far as a NW7. In
» fact,
» » this case is more of a hybrid, or a cross, between the two. The crown
» loss
» » is typical of a NW6 however the sides are more aggressive that is more
» » similar to a NW7.
» »
» »
» » After long discussions with this patient he decided that he would
» rather
» » have a thinner top in order to have improved coverage extended into the
» » crown. The result shown in 1 year post-op.
» »
»
» Hi Joe, for the benefit of others, I am currently talking to H&W / Joe
» about having an HT with you and also with BHR.
»
» I do not understand why this is regarded as a “different” approach. For a
» single pass one could not do better than this. This would very much be my
» preference and I believe from various discussions that it would also be the
» choice of many type VI. So what is the disadvantage? Generally it is the
» surgeon that wants to cover one area at a higher density followed by a
» second session to address another (usually the crown). If two sessions are
» needed or optimal then either, two areas could be covered, one area in each
» session or complete coverage with the second session adding density.
»
» Is there a problem adding density to an area already covered in a second
» session???
»
» although I see this result as pretty much the best that could possibly be
» achieved in one session, I feel that a small amount of nape hair by “you
» know what” would soften the hairline a little at this density.
»
» I am not sure if I have seen a better result in one session for this
» degree of hair loss!!!
I think it is different because they are giving him a thinner top in order to have coverage extended into the crown, almost like a small combover from front to the back/crown area, they normally don’t do that, I think.
Given the amount of scalp they had to cover I think this is great - it looks like he’s naturally thinning, but he looks a lot better than he did. Nice hairline placement, natural-looking coverage that could stand alone without a second op. The fact that he may have enough for a second procedure is just a nice bonus. He looks better as it is, but I’m sure with some thickeners and concealers this guy can look pretty damn good now.
My only quibble is the graft placement at the hairline. I don’t know what it is (and “pluggy” is way too harsh), but it just looks a little “off” somehow. It could do with softening somehow.
That said, given that this is one surgery on a NW6 I think the approach they took was very wise - as I said before, this could be a standalone procedure if he wanted it to be. Although I’d definitely like to see his results after a second…
Actually, on a second examination I doubt Joe Public would notice anything.
Good result.
(And funnily enough (not HT-related) I think the result would look better if he let his sideboards grow an inch or so instead of shaving them off at glasses-level. It would make the sides less bare-looking and mean you wouldn’t notice the side temple recession so much).
I appreciate your question. This case is different for the same reason that Neveragain mentioned. Normally, in a case like this, we would recommend two sessions with the first being in the front to achieve a one pass result for density then the second being in the crown for light coverage. Because we knew we would not get the “big” numbers of 5000 or more in one session we explained that the result would be quite thin compared to some of our other results on patients with aggressive loss but he was fine with that so we went ahead and spread the grafts out from the new hairline into the crown. This is simply a case of getting the maximum mileage possible with only a few drops of petrol.
As far as the hairline needing nape hairs, this would not work simply because nape hairs rarely survive the process which is why there are so few “results” of nape hair hair lines online. It’s been talked about for years yet few examples exist. In reality, the hairline looks quite good but there is a slight “kink” to the hair that is simply attributed to the immature nature of many hair transplants at this stage. With several more months the hair overall should soften up a bit.
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