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When we treat patients we must analyze their hair loss but also project future loss and design the recipient area accordingly.
The patient in the photos is a younger gentleman. He has a Norwood 3 pattern but we expect him to lose more hair, particularly in the frontal area. Some of the miniaturization appears as clear, wispy, cosmetically insignificant hair. Other miniaturization is subtler as it is in its early stages.
If we were limited to strip technology, I suspect this patient would not be a candidate. Many times we cannot justify committing a patient to linear donor scar if we do not need to harvest a large amount of hair. In some patients we can treat the frontal 1/3 nicely with 2500-3000 grafts. Concerns about shock loss ruled out this size procedure. Given the patient’s age and the desired amount of grafts, a strip harvest was not justified.
The approach here was simple. Firstly, we employed Follicular Isolation Technique. Second, we avoided grafting areas of subtle miniaturization. By completely avoiding areas of cosmetically significant hair, we completely avoid cosmetically significant shock loss. All other areas in the frontal aspect were either bald or very lightly haired. These are the areas that Dr. Cole and crew grafted using 1000 total FITs. We hope to achieve a maximal cosmetic benefit with a relatively small amount of grafts. |
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