Rex - 2600 FUHT grafts (repair HT) 1 year update - video + pix

Dear forum readers,
Patient - Rex
Age - 40’s
Race - West Asia
Norwood stage - 6 (if patient had no transplants ever).

The patient nicknamed Rex visited us last year, 2007, with a situation, we find increasingly too often in repair patients.

Before visiting us, he underwent a strip Follicular unit hair transplant at another centre 3 years ago.

Even though follicular unit grafts were transplanted, the results and HT planning left a lot to be desired.

I shall discuss the things that were done incorrectly, in Rex’s HT 3 years ago. I hope reading about them will educate upcoming clinics/doctors as to what they should not do.

But first, some pictures and video

Please doubleclick on the video screen to view in full screen more.

From now on, we shall have a soundtrack along with the videos.
The current video has background commentary briefly explaining about the procedure. I hope the viewers will find that helpful.

Please let me know if you have any suggestions to further improve the result presentations.

Dr. A

I know Rex’s hairstyle is a bit unconventional. However, it seems that this hair style suits his purposes well for the present.

Dear forum readers,
I thought I will make a different additional approach.

These are some pictures taken under bright “office” lighting. The sort of light conditions that people are seen most of the time.

FYI, there are 4 flourescent tubelights right above Rex when these following pictures were taken.

Dr. A

» I know Rex’s hairstyle is a bit unconventional. However, it seems that this
» hair style suits his purposes well for the present.

Personally, I do not like the choice of transplant termination at the crown. For me, even in the first HT the transplant should not finish before the point that the highest point of the vertex. Also the perifery of the bald area at the crown need to be dealt with or the result looks unatural and transplanted. I have seen this in several “first time rounders” from your clinic. I know everything is a compromise but I feel it makes sense to sacrifice density for coverage in there regions and then add more density in subsequent rounds to avoid the unatural look.

Dear Marco,

Rex’s case is an interesting study to the choice between density and coverage.

Rex’s fist HT was carried out at some other clinic 3 years ago.
One of the things that physician dis was spread out the grafts all over the bald areas at a low density.
The result was not pleasing and Rex was dissatisfied with that HT.

I personally feel that grafts should be transplanted densely in an area, so that there is no need to subject the same area to repeated surgical load.

Given that, I agree, if the graft numbers permit, it is ideal to cover all the bald areas at one go.

The picture below shows the crown area of Rex, where the earlier clinic had transplanted grafts at a low density.

Dr. A

As hair restoration becomes more accepted, many doctors enter the field with minimal/no training.

One of the common mistake they do is shown in the picture above.
The strip was excised by the plastic surgeon who did this HT. It was taken from “in between the two ears”.
Instead of the plane extending from “top of one ear to the top of the other ear”

This makes the repair HT more difficult. The strip scar in the incorrect plane means that

  1. the entire scar can not be included in the next strip,
  2. the unexcised scar tissue from the previous HT puts a stretch on the subsequent strip wound at the point of divergence. As a result that point will widen.

I hope more new doctors keep this in mind when brandishing the knife.
Better, of course, that they take proper and rigorous training.

Dr. A