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Miles - 3000fuht (15 mth result) interesting case for young pts


#1

Dear forum readers,
Patient nicknamed Miles, presented an interesting situation. Not that it happened the first time, but I think this is one that has not been discussed previously.

Apart from the facts that the patient is comparatively young (in his mid 20s), and wants a vitruvian design hairline and temple point recreation, he has an additional facet - he has a cowlick and a swirl in the frontal area.

The following pictures depict the situation


In such a case, the doctor has to, in my opinion, make the patient aware of the situation, and make a decision on the hair directions based on mutual understanding of future possibilities.

Possibility 1 - To follow the natural hair directions and recreate the cowlick and the swirl.
Possibility 2 - To disregard the previous cowlick and swirl and to transplant hair in a forward direction.

Disadvantages of possibility 2 are -

  1. Till the pre existent hair in the swirl and cowlick eventually succumb to MPB, they will present a grooming difficulty to the transplanted hair.
  2. Possible damage to the miniaturising pre existent hair in the recipient area while creating the recipient slits.

If you have a similar hair situation, I would love to hear your choice when you decide to go for an HT.
It would be interesting aspect to consider.

Hints - It would be advisable to consider the history of extent of hairloss in family members as well as the current speed of hairloss (rapid, moderate or slow).

I look forward to hearing your thoughts.
Regards,
Dr. A


#2

I have a cowlick and have mentioned this when I have talked to clinics. My hairloss follows the pattern of very gradual overall miniaturization rather than recession. So I am going from NW1 straight to NW6. The positive about this is that concealers with short hair works well for a long time.

roughly 70% of clinics seem to want to ignore the cowlick whereas some have said they would have no problem with it. I can mention Dr. Cole because he has written about his approach to this on his website. Dr. Bisanga also is happy to follow the pattern.

Clearly any clinic dealing with this by following the pattern must have a good comprehension of the changes in direction but MUST also be able to finely control angulation of the grafts. Personally I would like to keep it because it is what I am used to as well as the reasons that you have mentioned. I also feel that there is often changes in direction within the native hairline even if there is not a cowlick.

By the way you did not mention the downside of option one!

Regards,
marco.


#3

I think downside of option 1 would be that it would require a greater level of expertise and an eye for detial,something an unexperienced surgeon will have difficulty with!!


#4

»
» By the way you did not mention the downside of option one!
»
» Regards,
» marco.

Dear Marco,
The “downside” of Option 1 is that sometimes people do not like the swirl and cowlick and would rather be happy that the new transplant does not put them in a similar old hair pattern.
More a matter of personal choice, I would say. Some like them, others would rather not have them.

This also reminds me of Zayden’s case. In Zayden, the manmade flaps led to a sort of swirl and with hair going in some pretty unnatural directions. In his case we, however, did follow the existing directions, incorporating them in the transplant.

In case of Miles, on the other hand, the patient’s preference was to not recreate the swirl and cowlick.

Regards,
Dr. A


#5

Pictures in patient’s preffered hairstyle



Pictures (close up) with hair combed back





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#9

Great result. I’ve seen three great hairlines in the last few, weeks looks like people with. I kind of get a feeling like there is increased awareness for hairtranplants in India…


#10

» Great result. I’ve seen three great hairlines in the last few, weeks looks
» like people with. I kind of get a feeling like there is increased awareness
» for hairtranplants in India…

Hi arvin,
read your procedure went well:)
Now its time to lay back and wait.
i personally got very anxious during this waiting peroid but everything eventually pans out as told by the doctor.
good luck,

regards,
hairlove


#11

» » Great result. I’ve seen three great hairlines in the last few, weeks
» looks
» » like people with. I kind of get a feeling like there is increased
» awareness
» » for hairtranplants in India…
»
» Hi arvin,
» read your procedure went well:)
» Now its time to lay back and wait.
» i personally got very anxious during this waiting peroid but everything
» eventually pans out as told by the doctor.
» good luck,
»
» regards,
» hairlove
The waiting period is going to be nerve wracking. I do appreciate your supporting words Hairlove!
Thanks,
Arvin