Dr. Paul Shapiro—2311 FUT grafts on Class IIIA Patient. One Year post op

[Paul Shapiro MD]

This 30 year old male has medium caliber, dark brown hair. He had an average donor density of about 85FU/sq.cm and an average scalp laxity. Our plan was to cover only the front 1/3 of scalp with 2,000 to 2,500 FU. Because he was only 30 with a strong family history of hair loss we were trying to get good coverage with a density of 30-35 FU/sq./cm. He is not a candidate for denser packing because he does have the potential for more hair loss and may become a Norwood type 6 by family history. I also kept the hairline above the wispy widow peak he had. He wanted a more rounded hairline and he most likely will lose that hair in the future. Also, if I lowered the hairline and he progressed to a Norwood type 6, he may not have enough donor to cover the front two thirds of his scalp in the future. He started propecia at the time of the transplant. He responded well to propecia and you can see the increase density behind where I did the transplant. His hair count was as follows:



· 512 one hair FU

· 1405 two hair FU

· 393 three hair FU

· 1 four hair FU

Total FU-2311, Total hairs- 4595




I have included a 1 day post op photo to show the area transplanted and the pattern.

 

[jonzi]

What a result! Could use an updated camerasystem though. I would like to see this artistry in razorsharp quality.

 

[mars]

Dr paul great result..one question for you it seemed this patient had a small case of retrograde alopecia in the before pics above his ears right one more than left,did propecia halp thicken that hair or is it just the hair is a bit longer in the after pics?

 

[karmenelec]

Dr. Paul, is your clinic utilizing Acell in any way shape of form? Autocloning and scar reduction applications aside, by now I hope you'd agree that there is overwhelming evidence from Dr. Cooley that Acell at the very least increases graft survivability. Seems to me that every HT clinic should be at least soaking their grafts in Acell prior to implantation.

 

[Paul Shapiro MD]

I think what you are seeing is just his hair is a bit longer on the sides in the post op photo. Usually propecia does not thicken hair there.

Dr. Paul

 

[Paul Shapiro MD]

Karmelec:

We do offer Acell and have used it on a few patients. Also, I am going to visit Dr. Cooley in a few weeks to observe his process. There is some good evidence that Acell is helpful in graft survival. But it is too early to agree with you when you say "overwhelming evidence from Dr. Cooley that Acell at the very least increases graft survivability". To scientifically determine if something is increasing graft survivability we need to do controlled studies, preferable double blind control studies. These are difficult to do. We also need to see results one and two years out post op. Dr. Cooley €™s work is very interesting and promising, and I hope to learn more when I visit him. As I said we do offer Acell if patients are interested in using it. And I do hope it will help graft survivability.

Dr. Paul

 

[karmenelec]

Dr. Paul, that's great news! I'm glad your clinic continues to stay at the forefront of advances in your field. Perhaps I used a bit of hyperbole, but I do think you'll see when you meet with Dr. Cooley that his results have been consistent and rather incredible. I am most impressed with his plucking results. I have it on good authority that he recently completed a 5000 graft transplant done solely with plucking and Acell. I would hazard to guess that the good doc would not have agreed to do such a procedure (and likely charge upwards of $25K) if he was not absolutely confident of the results based on what he's seen so far. 5000 grafts without any donor depletion - now that's something worth looking into.