Class 7 Restoration - 3,500 FIT/FUE, 1,200 BHT

[Jessica.Mywhtc]

This patient had his surgery 12 months ago. He was a class 7 with broad head, and his donor density was average.  With advanced hair loss and very limited donor reserved, he was classified as “not an i candidate”.  There is no way to cover his entire scalp without a combo of BHT and scalp. 

So we began by treating his frontal zone and midscalp with only scalp hairs: 3500 grafts.  Then we placed 1200 grafts BHT in the crown as a test to see how he will respond to it.  The main goal was to cover the front and top, matching the density of the sides.  This has been accomplished.



Great care must be taken when creating sites and placing grafts in areas of diffuse thinning.  Any damage to surrounding hairs can cause shock loss in the area.





Preservation of the donor is of great importance especially for patients with advanced loss.  The patient had only average density in the donor to begin with and also prefers to wear his hair short in the back.





Now that the 12 month results have grown in, the goal is to treat the crown.  Recently we transplanted the crown with scalp, and used body hairs to reinforce the middle scalp.  If we want to harvest more, FIT Farming will be required.  We used only leg hairs because this is the patient’s only BHT with good caliber.

[Jessica.Mywhtc]

Here is the donor at the begining of day 2


Here is the donor at the end of day 2


A closer pic at end of day 2


Right side of the donor area at end of day 2


Close up shot of the healing after 24 hours


Here is the donor after day 3


A closer pic at end of day 3

[Jessica.Mywhtc]

Placement immediately after surgery

[hairjones]

Hi Jessica. How many grafts can a standard patient receive or a person with not so much hair loss?

[tshinos]

Hairjones,
A standard patient is hard to determine .It is very subjectif.There is a scale you can refer to (the norwood class) and from that you can determine roughly how many grafts a patient in one category needs.
A class 2 with temples recession may need from 500 to 1000 grafts depending on hair line location and density he wants.
A class 3 ,bald in the 1/3 first frontal zone,may need from the same reasons listed above between 1500 to 2500 grafts.Sometimes ,you can eventhough push to 3000.
A standard procedure (in others terms most of the surgery we performed) requires from 2000 to 4000 grafts.
Under 2000,it is a small case and above 4000,it must be an extensive lost.

[MyWHTC]

That is a good question, hairjones. This patient has/had substantial loss and, given the extent of the miniaturization, his donor area is limited. I think most Norwood 5’s and 6’s (this patient is a 7) have a larger donor area. This might mean that more grafts can be harvested for these “lesser Norwoods.” But, as Dr. Mwamba pointed out, every patient is different. So, while this patient has a smaller area to harvest from, another patient might have (for example) lower donor density. Hair transplants are multi-variable. That is why consults are so important. Each case presents a unique set of advantages and challenges!

Anyhow, as previously stated, 3,500 grafts is a fairly large case. Still, many patients have the donor area to do more in a single session. It very much depends of the person’s goals and recipient area demands. 

[Jessica.Mywhtc]

Attached below is a chart of the Norwood Classes.  You can click on the image to see it larger.  What stage of loss are you in?
The total amount that can be harvested from your donor depends on your hair characteristics and density.  A typical donor with conservative harvesting can yield 4000 or more grafts.  The best way to find out how much donor availability you have is to ask Dr. Mwamba in person or through photo consultation at no cost.

The amount of scalp hair that can be transplanted from the donor is limited.  It is impossible to cover the entire balding area of Class 6 loss with scalp hair only.

You can increase your donor hairs by including body hairs.  Hair harvested from the beard, chest, back, and legs can help increase coverage and density, but offer much less coverage than a scalp hair graft.  The extraction sites heal very well in almost all patients.

Another option is FIT farming.  This is when a scalp hair is harvested to be transplanted to the front, and a body hair takes its place in the donor area.  This allows Dr. Mwamba to harvest larger numbers from the scalp donor without thinning the area too much.