Case Study: Plug Patient 1 (1400 grafts)

Transplanted 1400 FUSE grafts from scalp donor.  No grafts taken from the body donor areas. 

Click here to discuss.

Case Study: Plug Patient 2

Sometimes repair operations require a compromise between the doctor and patient.  This case study illustrates such a compromise.

Challenges
Patient had plug grafts from another clinic prior to visiting Dr. A's Clinic in April 2004.  He was against permanently excising any plugs for fear of scarring. Moreover, he did not want a low hairline to camoflage all the grafts. Finally, he wanted us to fill in above the second row of plugs on the left side of his hairline, leaving the first row visible.   

Solutions
Due to the patient's requests...We were limited in treatment options.  Our doctors created a repair plan that included thinning out grafts in the front rows by taking out plug hair roots via FUSE technique.  The remaining areas were filled with grafts from donor supply to camoflage the plugs. 

Click on photo for slideshow. Click here to discuss.

Case Study: Poorly performed hair transplants
All Hair transplants are not equal. Moreover, lack of proper regulation ensures any doctor can claim to be able to perform hair transplants. Often, with disastrous results.
Following is a patient who underwent a supposed "fue" transplant. Clearly, the clinic that performed the procedure had no knowledge nor experience in the field.
Discuss this patient's pictures of surgery here
Discuss this patient's 5 month result pictures here

 
 Case Study: Plug patient 3 (2100 FUHT grafts)

Another victim of hair plugs by another clinic. 

Challenges 

1. Many plugs had very little to no growth
2. Patient did not want any previous hair plugs removed
3. Limited donor scalp and body hair supply
4. Hair loss existed in the donor region (from nape of neck stretching to mid-point of ears)

Solutions

1. Camoflage plugs with a flood of grafts taken from donor scalp area (2100 strip grafts)
   
2. One plug in temple region was too far out of place.  We excised the plug and dissected for transplant elsewhere. 
3. Focus on front half of scalp which was the most cosmetically embarrasing area for the patient 
   
4. Use an improved closure method which has given us good results (no external sutures or staples)

Click on photo for slideshow.  Click here to discuss.

Case Study: Plug Patient 4 (7500+ grafts)

Patient Background
1990: Patient received his first hair transplant at the age of 22.  Hairline in temporal area was receeding.  Another clinic transplanted 100 plug grafts into the temple areas. Plugs were extracted via "shotgun" method.  After surgery, patient realized the plugs were placed too low and incorrectly. 

1994: Patient went to another doctor to attempt plug removal and fill in hairline.  That doctor performed a strip transplant.   

1995-2003: The patient had four additional strip surgeries.  All strip surgeries were performed at a well known hair transplant chain located in Beverly Hills, California.  These strips removed most of the scars from the previous "shotgun" plug method.  In total, 3000 grafts were transplanted from all four procedures (averaging 700+ grafts per visit).

Challenges: Previous clinics made the following mistakes

1. Graft direction varied significantly.  Since these grafts criss-crossed each other, this made it challenging to place new grafts without transecting existing grafts.  We took extra precaution to ensure the new grafts had significant clearance. 
2. Excessive graft angulation.  Most of the patient’s grafts had 60-degree angulation.  Some grafts had 90-degree angulation (perpendicular to the scalp!)  This resulted in a very unnatural look.  Hair does not normally not grow straight up. 
3. Three-hair grafts placed at the very front of the hairline.  Considering the patient’s skin tone, one-hair grafts would have looked more natural.     

Solutions

1. Use body hair grafts to compensate for limited donor scalp hair supply
2. Fill in scars with body hair grafts 
   

Although challenging, Dr. A’s Clinic successfully treated this patient.

Click here for slideshow.  Click here to discuss. 

Case Study: Plug Patient 5 (2100 grafts)

Patient background
Internet name is "Youngman".  Patient received two transplants at different clinics in the United States before coming to Dr. A’s Clinic.  The previous hair transplants resulted in an unnatural pluggy appearance.  

First surgery: Previous clinic placed grafts in a straight line running from temple to temple.  Patient removed these grafts via laser.  Very few grafts remained visible.  

Second surgery: Previous clinic placed grafts with excessive angulation to scalp.  Some grafts angled 90 degrees to scalp (perpendicular and standing straight up).  This lead to a scenario where, although hair grew in the recipient zone, the scalp was still visible.  These grafts do not provide the coverage they would if they were LYING on the scalp.    

Challenges

1. Donor scar was too low in back (below the nuchal ridge)
2. Instead of harvesting the strip via a concentric line, the previous clinic chose to follow the donor area’s contour.  This lead to scar widening in the area just behind the ear.  
3. Unnatural 2-3 hair grafts in the hairline and 4-6 hair plug grafts in crown

Solutions

1. For scar in back, we excised a strip containing both the scar and the additional donor supply to perform the hair transplant.  We closed the strip in two layers to ensure minimum tension in the area.
2. Placed 1500 grafts in frontal area and 600 grafts in back.  Patient understands thinning hairs in center of scalp will require work later.

Click here for slideshow.  Click here to discuss.

Case Study: Traction Alopecia in Temple Region (200+ grafts)

Patient Background
Patient is a Sikh gentleman who wore a turban for many years.  As a result, he developed traction alopecia, a form of hair loss caused from constant pulling of the turban.  This traction alopecia started from his temples and extended to the back of the ears. 

In addition, patient had minor hairloss in the hairline region. 

Patient previously went to another clinic for help.  He received mini-grafts (5-8 hairs/graft) and plugs (10 hairs/graft) in the hairline and temple regions.  Dismayed at the results, he convinced the original doctor to excise plugs in the hairline.  The doctor excised the plugs by cutting a strip in the hairline (not recommended).  As a result, patient had a visible scar in the hairline.  Temple area minigrafts were not removed.   

Challenges

1. Plugs and mini grafts were “sticking out” (pointing outward instead of matching the underlying scalp angle)
2. Noticeable stitch scar in the hairline area
3. Some unnaturally placed hairs in the hairline area which the patient regularly shaved to conceal 

Solutions

1. Use 200+ scalp and 20 chest hair FUSE grafts in temple area
2. Extract unnatural hairline grafts via FUSE technique
3. Per patient request...The hairline stitch scar was left alone

Click here for slideshow.  Click here to discuss.

Case study: Plug patient 6 (1500 FUHT grafts)
This patient Phil, plans to go for his repair HT is stages.
 Discuss Phil's pictures and result of first stage repair here 

Read real patient stories