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This patient, I have to say, was an extreme pleasure to have visit with us. He was here for 5 days of surgery. He received 2739 FIT scalp grafts and 1020 body hair grafts from the upper back for a total of 3759 grafts. The pictures speak for themselves, but I will add a few comments.
The pictures show that we treated the frontal hairline and frontal third. We also added some detail with recreating and reinforcing the temple points. Temple points can make a subtle but big difference because they frame the face. Temple points are often neglected. When a patient has a frontal third transplant, but is recessed in the temples, the overall look can sometimes look a little strange even if the work is very natural. This is because it does not often occur in nature for the temple points to be recessed but the frontal hairline remain intact. Dr. Cole mimics nature as closely as possible when planning his surgical reconstructions. It doesn’t take a lot of hair to reinforce the temples, but those few hairs must be placed exactly and strategically.
The close-up pictures show the crown and frontal third work. There is less density placed in the crown. Because this patient has restricted donor reserves (as do most patients with loss greater than NW Class 2), Dr. Cole made sure that he got the most value for his money. Crown work can require several thousands of grafts to achieve full density. A light coverage, however, can give a youthful yet mature look. A larger percentage of the donor hairs were used for the front and frontal hairline to give the most cosmetic difference with the least amount of grafts. The patient also took advantage of his body hairs to extend his donor reserves. This extra boost in donor numbers can help to create extra thickness that will grow in and mature at a later date than the scalp hairs. The effect will be that the scalp hairs will grow in and thicken, followed by a more gradual extra thickening contributed by the slower growing body hair grafts.
Last, but definitely not least, here are some pictures of the donor areas. Notice that in the before picture, the patient has an area of lower density in the back of his head. This area was not harvested due to this individual characteristic. Overall, the areas of less density are less harvested to afford the patient enough post-op coverage no matter how his density ranges in different areas of the donor. The patterns and scatterings of the donor extractions are carefully thought out and planned before and during the surgery to create the most donor preservation while still meeting the patients needs as much as possible. The body hair extraction sites are already healing. The difference between the body hairs taken on day two and the body hairs extracted on day five are easily apparent. |
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