Procedure detail
This patient is in his mid 50's and wanted 1) thickening of the entire scalp and 2) frontal restoration. He was doing testosterone replacement, which is becoming more common nowadays. Despite my recommendation, he did not initially want to do finasteride. About six months post op, he did decide to start taking it and has had no side effects.We performed FUT of 3,421 grafts (1-749, 2-1,591, 3-856, 4-225; total hairs= 7399 hairs). We put about 2,500 grafts in the frontal scalp and 1,000 in the back. We also performed PRP/ACell to provide some overall thickening. As usual, we did not shave the recipient area, so he could return to work in 7-10 days.
He is shown 10 months post op. Also of note, he had some very low hairs in the front central area, going down to 6cm above the eyebrows. If we had built the hairline off this point, it would have created a very front heavy result, as well as requiring an inordinate number of grafts. What I do is design a hairline as if they were bald, and use electolysis to eradicate hairs below this line. In the op photo, the small red spots can be seen where we did this. After electrolysis, a certain number of hairs will always grow back. He was trimming these (see arrow) but plans to come back for another electolysis session to clean these up.
Bald class
Norwood class 3A
The Norwood Class A patterns are characterized by a predominantly front to back progression of hair loss. These patterns lack the connecting bridge across the top of the scalp and generally have more limited hair loss in the crown, even when advanced.
