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We do pay attention at MY WHTC to patient ‘s comfort and discretion.
Shaving hairs for hair transplant surgery is common and it makes the work easier than not shaving.
Arming ourselves with PATIENCE, DEDICATION, we will work harder and harder to meet our patient’s desires; that are why we do offer not to shave the recipient area in some cases without jeopardizing the results as you can notice in the above examples.

We are presenting results after 6 months for hairline work.
Hairline work is one of the major requests in our field. When rebuilding it, the doctor has to always think about balance of face, naturalness, and density.

To get the face balanced, we should always consider rebuilding or reinforcing temples points, especially when we are lowering hairline

Angulation of hairs from temples pointes to middle frontal hairline will vary from flat (1 to 5 degrees) angle to 35 to 40 degrees. And this will play a big role in naturalness.

Density will give us the impression of fullness and coverage and in our practice, we like to stay between 50 and 60 follicular unit per square cm.

Use of medical therapy is always encouraged and you get fast results from it.

This young woman was disturbed by receding hairs in the fronto-temporal region.
She did not braid her hairs and she used to cut it a lot for styling purpose. One day she just realized hairs were not growing back in that specific region .She couldn’t style her hairs anymore or let it grow longer as it was accentuating and revealing the balding region.
She decided to contact us for hair restoration .Her hair thinning was not extensive and limited to the fronto-temporal region .We diagnosed a Female hair loss pattern and recommended medical therapy ( based on Rogaine foam 5% + Help Hair protein shake  and surgery) .
We performed 1142 grafts FIT shaven in two days.
Now, 8 months after her surgery, she is able to let her hair grow longer and feel more confident about herself.

After using Dr Miracle product to perm her hair, the patient had a burning sensation on the temples points followed by surinfection (presence of pus) .It took 2 weeks to heal and the patient was left with a scar (left temple point).

She also had thinning in fronto temporal region, typical of fronto temporal recession in Female Hair loss pattern.


We opted to graft her with the strip technique.
In frontal hair line , we applied a density of 45FU/cm2 .In Left temple point , the grafting density was 35 Fu/cm2 and on right temple point , 30 Fu/cm2 .

We also injected Acell + ATP + fresh DP cells in recipient area.

During post op, we recommended Help Hair Whey protein + Help Hair vitamins + Rogaine foam.

WE ARE PRESENTING HER RESULTS AT 9 MONTHS POST OP.

                                        





Le patient présenté ci-dessus a 40 ans et il est classé comme Norwood 3 vertex.
Il a pris Propecia pendant 3 ans. Il est venu à notre bureau, après avoir été déçu par une première expérience de chirurgie FUE dans une autre clinique pour corriger ses temples reculés.

Résultat de la première intervention chirurgicale:

1. Mauvais rendement dans les temples avec une faible densité
2. Mauvaise angulation de cheveux ressemblant à des cornes
3. Aspect Pluggy (cheveux de poupée) avec tissu cicatriciel dans les golfes reculés.
4. Points blancs dans la zone donneuse à peine visibles avec une coupe de cheveux courte

Pour réparer ce cas, nous avons recommandé les actions suivantes:

A. Abaisser ligne frontale de cheveux pour déguiser les travaux antérieurs
B. Greffe à une densité de 50 UF/cm2 à la ligne frontale de cheveux et 40 UF/cm2 aux golfes
C. Ajouter stimulateurs d’anagène (protéines et vitamines Help Hair Protein Shake  et Help Hair vitamins), Cap laser ou Rogaine à son traitement anti-DHT actuel.

Nous avons effectué son opération en 2 jours:  1920 greffes avec FIT / rasé. En période post-opératoire immédiate, nous avons exposé le patient à la lumière LED (Triwings) pour stimuler la croissance des cheveux, donner un effet antioxydant et favoriser la circulation sanguine ainsi que le processus anti-inflammatoire (aider à diminuer la douleur et l'œdème en post op). Il a également appliqué « Hair Cycle Biotin Spray » comme hydratant dans les premiers jours post-opératoires et le shampoing « Hair Cycle Shampoo ».

Le patient a remarqué la première croissance autour de 5 mois de croissance post-op et la croissance complète à 7 mois. Nous présentons ses résultats à 9 mois après l'opération :






 

This young patient had a previous surgery in another clinic (3000 grafts by the FUE technique).He walked in our consultation room with pluggy look hairs, low density coverage and unnatural hair angulation in frontal zone. We could also observe some thinning on top and vertex which announces future loss in those areas.
The donor area looked someway thin with some patchy spots of lower density.
His goal was to build his frontal zone.

Our first concern was his donor area .A bad donor area would disqualify him for the surgery .Fortunately he had a density of 100 Fu/cm2 with medium fine, dark brown, slight wavy hairs.
In the Norwood scale, he was at level 3Vertex moving toward a NW5 .He was on finasteride (for the last 9 months) and minoxidil (for the last 6 months).

Our plan was to recreate a new hair line in front of the old one without going to low .We were pleased his existing hair line was at 8.5 cm from the eyebrow which gave us enough room to build a decent, conservative hair line at 7.5 cm.
We grafted the hair line at 40 to 50 Fu/cm2 ( because a high density in the micro scarring area could yield a poor growth ).In the frontal area and central top , we kept a density of 30 Fu/cm2 and in the temples 35 Fu/cm2 .The entire procedure was carried out in 3 consecutive days as outlined below :the pattern we followed ( from back to front and from the center to the sides ) take into account the nerves anatomy to lower any discomfort  in the following days .

The patient sent us his 3 months and 6 months results as illustrated below.

 

We even up the donor look



His hair line looks natural with a decent coverage for 6 months.



We will now present a summary of before and after with dry and wet pictures.
Dry pictures






Wet pictures

Our young patients was a Norwood 2 with receding temples .

His goal was to build back his hair line .

We urge him to commit to medical therapy based on a combo of anti DHT ( propecia) + anagen stimulators ( rogaine + Help Hair protein) .This measure is important due to his young age ( high probability of extensive hair loss in the future) and because it will slow down hair loss progress .



For naturalness and balance of the face , we also decided to graft the temple pointes.

His grafting density in the hair line was around 60 fu/cm2 .


   

[Results]

    This 40 years old patient, NW 3 vertex in hair loss scale came for a repair case:
  He had 3 previous hair transplants by strip technique (3000 grafts).
Results: Wrong hair angle direction,  pluggy look, pitting, a damaged receiving area with bumps (cobblestone), and big scars in the donor.
  His goal was: (1) To look natural, (2) To fill in his back scar, (3) To  lower his frontal hair line and  frame his face  so that he will stop wearing a hat all the time.


     Surgery 1 plan:


•   Remove the plugs (to minimize the scarring, we usually close the punch holes with a suture, nylon 5/0, for 3 to 4 days. In this case, we left it for only one day because we had to graft the area)
•   Lower FHL with hairs above the nape area, build back the temples pointes in harmony with the new hair line (otherwise the result may not look natural).
•   Increase density in frontal zone. This area was fibrotic and whitish because of previous work and had poor blood circulation (poking test, bled after 20 sec or plus).
•   Fill in scars in the back.
    Total graft number: 4025 grafts in 4 days.
    After 9 months
•   Yield was very good in the virgin area (temples pointes, FHL). You will notice a difference in hair strength and pigmentation between his FHL and temples pointes.  Indeed hairs for the FHL originated from lower donor area above the nape hairs.
•   The pluggy look was corrected.
•   Poor growth in the scarring area in frontal zone.
•   Good coverage of the scar in the back (not illustrated in our pictures).


 













  Surgery # 2Plan (9 months after surgery 1):
 
  -We decided with the patient to lower the density in the temples pointes
    by removing the grafts and relocating them in FHL and frontal zone .
  -We completed the FHL with grafts from regular donor area  for a total of 969 grafts .

  Results : Natural look with a low solid hair line  ,
                           in harmony with temples pointes density .

                           No pluggy look .

                           Good growth in frontal zone that was grafted at low density .

Next step : Reinforce some patchy area in the frontal zone to complete the work .

















The patient just sent a last set of pictures that will be added to the post later on this week .

Repair case requires patience and sometimes more than one procedure in order to meet some kind of expectations if possible.

By mywhtc at 2012-06-12