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Dense Packing Hairlines

  • Thread starter Paul Shapiro MD
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Paul Shapiro MD

Paul Shapiro MD

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#1
Here are few examples of patients in which we believe dense packing in the hairline area is appropriate. We consider planting at densities between 40- 60FU/sqcm as dense packing. There are patients in whom we will plant at densities from 60-80 FU/sqcm, but they are the rare exceptions and need to be perfect candidates for what we would call super dense packing.


In order for us to feel comfortable dense packing the hairline, the following criteria need to be met:
1) The patient must be at least 30 years of age
2) The patent should have a family history that suggests his balding will not progress further then a Norwood type IV.
3) The donor area has to have at least an average density of 80/FU/sqcm
4) The donor area has to have good laxity
5) The hair behind the hairline should have no or little evidence of miniaturization.
6) The crown should have no or little evidence of hair loss or miniaturization.

At SMG, we have a camera which can take close up photographs of a 1 cm2 area of the skin, which allows us to get a measurement of donor density and the density of our incisions. That is how we can get an accurate measurement of density. As you can see, to get an accurate count, the existing hair has to buzzed. We rarely take postoperative density photographs because most post op patients do not want to buzz their new hair. Even if the patient did buzz his hair it is difficult to tell previous existing hair from transplanted hair in post operative photos. That is one of the reasons it is so difficult to do accurate post operative density studies. These cases were both done within the last month so we do not have 6 month results. We will post them when they return for their follow up visits.

Case #1 was placed at a density of 60-80 FU/sq cm. He had all the criteria for a case in which packing at super high densities. He is a 33 year old male with no family history of hair loss more than a Norwood type IV. He has great donor density of greater then 100 FU/sqcm., and no miniaturization or hair loss behind his hair line. He also had no evidence of hair loss or miniaturization in his crown. We do not get many patients like this; he is a good candidate for super dense packing. The photographs show incisions ranged from 60 -80 FU/sq.cm. A total of 2164 FU's were planted.
Below are photographs showing his donor density, the density of incisions, and day of surgery photos:

DONOR DENSITY




INCISION DENSITY



DAY OF SURGERY PHOTOS (before and after for comparision)



Case #2 was packed at densities of 40-50 FU/sqcm. He represents the more typical patients seen for dense packing. He is a 38 year old male with most of the males in his family not progressing to greater than a Norwood type IV, but he did have an uncle who had Norwood type V hair loss. His donor density was not as good as case #1 and there was some evidence of miniaturization in his central core and crown areas.

DONOR DENSITY



INCISION DENSITY




DAY OF SURGERY PHOTOS (before and after for compasion)




 
Bigmac

Bigmac

Administrator
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#2
Thanks Dr Paul for this,its a very interesting and well documented post.

I like your thinking and approach to patients hairloss needs.

bm.
 
bullitnut

bullitnut

4 awesome repairs with SMG
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#3
Yeah i too like this approach, shows great ethics and patient care. The two examples look superb too i hope they keep you updated
 
A

AJKV

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#4
Dear Dr. Paul,

is it possible to see updates from case No. 1? It would be very interesting for me and many other candidates...!

Thank you in advance!
 
janna

janna

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#5
AJKV,

The patient in Case #1 had his surgery in mid August of '09. It's not quite 3 months so there's not much to see. We'll stay on top of it to ask the patient for updates.

Thanks for your interest.


 
A

AJKV

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#7
Oh, I didn't notice that the surgery was only 3 month ago...;;D So I will be patient...