William Reed, MD
06-30-2011, 06:43 PM
This case is 1608 grafts with a small number of DFUs from one procedure in a 24 yo with a 5 year followup. The patient who is now 29 years old has continued with finasteride throughout this period so it is hard to know how much is its contribution to the overall result. This case raises the issue of whether there is an age required to be considered a transplant candidate or whether, which is my opinion, it is more a question of where it is safe to place grafts in a person under his mid 30s. Briefly, I think it important to avoid placing very much density in the crown and to use most of the grafts in a frontal forelock that is connected at the hairline to the permanent hair on the side of the head as was done in this case. Of course the hairline cannot be too low. It is also important to see how much the donor area may thin over time. We can be less certain of this the younger the patient is. All we have to go on is whether there is evidence of miniaturizing hairs in the donor and whether the patient's family has members who have thinned in their donor areas.