https://www.hairrestorationnetwork.com/topic/66545…
Hi,
I would like to share this case with you. This 26 year old male had an FUE hair transplant (not in UK) several years ago. Since then he had further male pattern hair loss and developed a large recessed area between the hairline that had been implanted and his native hairline (which had moved further back, particularly in the frontal temporal areas).
He was quite distressed with the unnatural appearance, he struggled to cover the receding areas and found the new hairline to be unnatural (with poorly directed hairs). After multiple consults he spoke to Dr Arshad on several occasions and options to repair his hairline were discussed in depth. He then underwent punch extraction of the previous hairline and FUE from scalp donor to reconstruct a more natural hairline.
Some points to note about this case are:
the hairline that was previously implanted was too low and into the region of the frontalis muscle, these can be removed through various means, punching out these grafts has certain risks for example scarring, and regrowth of hairs. The patient was keen to punch out all of the previous hairline so these same grafts could be used further back.
the punch extractions was difficult as the hairs were very misdirected
the patient has some regrowth of the punched out grafts which he plucks and trims, he has some scarring and induration in this area
because of the regrowth of some of the previous grafts in the hairline, the options of further punch out extractions was discussed with the patient. But he is worried about further scarring in this area. Also the option of excising this area and raising/advancing a forehead flap was also discussed with the patient, as he is now happy with the density at the front of his new hairline and is on finasteride, therefore after a period of observation (to ensure stability of his male pattern hair loss) such a forehead reduction procedure with Dr Arshad is an option for him in the future.
Graft breakdown:
- Punch outs from previous hairline 395
- Singles - 110, doubles 40, triples 1,139
Total number of grafts implanted = 1684
I hope you enjoy reviewing this case.
Regards
Adam
__________________
PRE OPERATIVE
AFTER EXTRACTION OF PREVIOUS GRAFTS AND IMPLANTATION OF NEW HAIRLINE
AFTER 10 MONTHS