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This fellow was in yesterday for a scar check. He has been doing a comb-over for years to hide his hairloss. At his initial consultation, I suggested he preserve his comb-over, do a big frontal case, which would take a week off of work, then he could go back to work with his comb-over and hopefully no one would notice. Then a year later we could do a second case but I felt we’d never cover the crown.
We did a large strip case on him, and excised the usual size (1.7cm wide) strip and had a nice 2 layer closure. In fact, I commented during the strip that #1: he had fantastic density—way more than I expected and #2: that we probably could have gone a little wider given how easy he was to close. I expected us to get 3500+ grafts, pretty typical for a big case at my office.
As the day wound on, my techs’ numbers kept growing and by 3 o’clock, we had 4536 grafts, roughly half singles and half doubles and triples. I’d made fewer single slits than that, so in the far back we added some extra one’s to give more bulk. I’ve described my thoughts on this before, and essentially, back in the middle of the head, I think it’s reasonable to add extra singles like this as you really just want density. I’d never do this up front or at the hairline, as the hairs may grow at a bit of an angle and look noticeable, but way back in the middle; again I just want density and more coverage.
Shown are periop pics, 3 day checkup pics, 1 week and 5 week pictures. His scar is virtually undetectable even at 1 month. Assuming this grows in well, I’m guessing we can get 3000 out of another strip and really almost completely give him good coverage. He has thick wavy hair which solves half the battle.
Dr. Lindsey McLean VA
We did a large strip case on him, and excised the usual size (1.7cm wide) strip and had a nice 2 layer closure. In fact, I commented during the strip that #1: he had fantastic density—way more than I expected and #2: that we probably could have gone a little wider given how easy he was to close. I expected us to get 3500+ grafts, pretty typical for a big case at my office.
As the day wound on, my techs’ numbers kept growing and by 3 o’clock, we had 4536 grafts, roughly half singles and half doubles and triples. I’d made fewer single slits than that, so in the far back we added some extra one’s to give more bulk. I’ve described my thoughts on this before, and essentially, back in the middle of the head, I think it’s reasonable to add extra singles like this as you really just want density. I’d never do this up front or at the hairline, as the hairs may grow at a bit of an angle and look noticeable, but way back in the middle; again I just want density and more coverage.
Shown are periop pics, 3 day checkup pics, 1 week and 5 week pictures. His scar is virtually undetectable even at 1 month. Assuming this grows in well, I’m guessing we can get 3000 out of another strip and really almost completely give him good coverage. He has thick wavy hair which solves half the battle.
Dr. Lindsey McLean VA
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