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  1. #1
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    Default A couple of questions

    Just a couple of questions :

    1) After 4 HTs of more than 4300 grafts over the years, I'm wondering how much of skin (scalp) I've lost. I mean how many square inches (of skin) would that be in total ?

    2) I want to do a biopsy and wondering how that is done. Is it painful....?


    Any idea ?

    Thanks ?

  2. #2
    Senior Member gillenator's Avatar
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    Default

    Quote Originally Posted by VictimOfDHT View Post
    Just a couple of questions :

    1) After 4 HTs of more than 4300 grafts over the years, I'm wondering how much of skin (scalp) I've lost. I mean how many square inches (of skin) would that be in total ?

    2) I want to do a biopsy and wondering how that is done. Is it painful....?


    Any idea ?

    Thanks ?
    Victim,

    I am asked this question once every blue moon when discussing repair cases. Your question may be better defined if you do not mind my saying as, "the surface area lost" from 4 seperate strip excisions. The fastest most accurate way of finding out would be to simply request this info from your doc(s) by email. Your doc should be able to in a cinch of time (or an employee) simply pull your chart, look inside and see the surgeon's original notes of the size of the strip(s) excised.

    Most of the strips excised are 1.5 cm wide X the length (expressed in centimeters) to accomodate the approximate number of FUs (grafts) to be harvested in that procedure.

    So if you are an average example, you know that at least a total width of 6 cm was taken in 4 procedures. That's 4 X 1.5cm = 6cm in total width. If your surgeon was more aggressive, the width of the strip can be as much as 2 cm. But doubtful you had 4 seperate strips that were 2 cm in width apiece. Why? A person would need alot of scalp laxity to accomodate 8 cm width of their scalp removed. That's 4 X 2cm = 8cm!!! Can you see why it's more realistic to use the 6 cm in total width?

    Now let's get back to the missing piece. The length question of 4 seperate strips. Once your doc equates the overall density of your occipital zone where the strip will be excised, he can then determine how lomg the strip needs to be again as defined in total centimeters. If for example your density was at 96 FUs per cm2, then to harvest 1500 grafts, your strip would have needed to be at least 16 cm square. However wide and long that doctor would decide to make the strip is up to each individual doc. I do not believe there is any stringent guideline (width X length) to go by. I believe more consideration is given to available elasticity (width). The surgeon may very well choose to make the strip at least 1 cm in width for a 1200 - 1500 graft range.

    I do not know how many grafts you had done each session Victim. Nor do I know anything about your density. Donor density will vary in susequent procedures and density can vary throughout one's donor zone.

    But you mentioned 4300 total grafts and if you have any info on your density as I say, then you can somewhat calculate the surface area lost in approximations only. Why only in approximations? Some docs go a little over, some a little under as they make their long incisions. Some end up throwing in some free grafts, as much as 500 per session! I hear about it lots of times. Better to put them in your scalp than throw the leftover strip (grafts) away to waste.

    So if it were me? I would contact my doc(s) who had performed my past four procedures and get the surgical notes from your chart(s). It's much more accurate.

    Hope this helped to answer your question as close as it could be answered in more hypothetical terms of course.
    "Gillenator"
    Independent Patient Advocate
    more.hair@verizon.net

    NOTE: I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice nor are they the opinions of the following endorsing physicians: Dr. Bob True & Dr. Bob Dorin

  3. #3
    Senior Member gillenator's Avatar
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    Victim,

    Sorry, forgot to address your question about biopsies. No they are not painful providing your doc freezes the area first! Some do not feel it is necessary to numb the area, most docs do thank goodness.

    The biopsy is alot like the punch used in FUE. Most biposies are at least 1mm punches, if not a tad bit larger. It all depends how much of a sample they want or need and the types of tests being done.

    It's all good!
    "Gillenator"
    Independent Patient Advocate
    more.hair@verizon.net

    NOTE: I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice nor are they the opinions of the following endorsing physicians: Dr. Bob True & Dr. Bob Dorin

  4. #4
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    Default

    Those are some seriously large strip width numbers you're talking about there. I always thought that we could go for a max extraction area of dimensions length 34/35cm x 3.5/3.75cm width over multiple strips.

  5. #5
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    Thank you very much for taking the time to answer my question and for all the details, gillenator. I appreciate that. Some of my HTs go as far back as '99 and were done by 3 different doctors, well, it's actually four doctors but my very first HT -at Bosley- was only 300 grafts, so I know the strip that was taken out was a very small one. My other HTs were around 800+ grafts each (3 HTs) and another that was 1700. My last two were done by the same doctor so I know he should be able to tell me the area but I don't think the other ones will be able to since it's been a long time since the HT and I doubt if they still have the file.

    Damn, it shocks me when I think about it. I had all that skin taken out of my head. It doesn't look that bad but still, to know that much is taken out....
    Could the total area excised be the same size as a canadian passport for example or maybe a little smaller ? I hope I didn't lose that much.

    BTW, can doctors know which hairs are transplanted and which ones are native (in the recipient area) when they do a biopsy ?

  6. #6
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    Guys,

    How could I forget to comment on this other important fact? I forgot to mention that our scalps do stretch back to some degree so not all is lost. In fact many of you probably remember reading about HT doctors advising their patients to employ scalp stretching excercises to help produce as much laxity as possible before the date of the procedure.

    And at the same time, our scalps only stretch so far. It's not limitless and why some repeat HT patients end up having to stick to FUE because their scalps are too tight after sustaining multiple strip excisions.
    "Gillenator"
    Independent Patient Advocate
    more.hair@verizon.net

    NOTE: I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice nor are they the opinions of the following endorsing physicians: Dr. Bob True & Dr. Bob Dorin

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