Donor Scars In The Strip Harvest Procedure

Greetings,

In this blog entry I will discuss my approach to harvesting the donor strip in the strip harvest procedure. Firstly I always try and limit the width of my donor strip to no more than 15mm and this is usually in the area of the scalp with the most laxity. In areas of the scalp where there is less laxity I routinely taper the strip with even less width. The length of the strip is determined by the amount of follicles we are looking to harvest in the session. I only use sutures to close the donor strip. I believe the donor region heals much better with sutures rather than staples and a fine thread suture is definitely more comfortable to sleep on than a row of bulky metal staples on the back of the head. I routinely employ a tricophytic closure when closing the donor region. The involves shaving less than a mm off the lower edge of the donor closure. This transects the follicles on the skin edge thus causing hair to grow through the donor scar and making it even more invisible. In cases when I know the patient is coming back to see me in the near future for a repeat procedure I will not perform a trichophytic closure as you can permanently damage some donor follicles by performing this procedure, so in the interest of maintaining the maximum amount of donor follicles for future procedures I like to wait until the patient is close to the end of his treatment before I employ this technique. When patients present for a second or third procedure I always try to include the old donor scar within my new incision so that the patient is left with only a single linear scar as opposed to “train tracks” running through the back of their scalp. I have included some photos of typical donor scars on my patients.

All the best,

Marc Dauer, MD

Transplanting hair via FUE into mustache scar

Greetings,

Today I will discuss a very interesting case I just performed. This patient presented with a skin graft in his mustache region from a previous accident that required extensive Plastic Surgery. He was left with a large scar  and no ability to cover the scar as it would only grow a scant amount of hair. The patient prefers to wear a goatee but it is very unnatural with only one side growing hair. In this case I performed follicular unit extraction otherwise know as FUE by harvesting the hairs from his beard on the neck individually with a .8mm punch. I harvested the neck hairs as these will most closely resemble the beard hairs we are meant to recreate. After I harvested all the beard hairs via FUE we placed the grafts individually to recreate a mustache.The angles and orientation of the grafts placed in the mustache were made to mimic the angles of the hairs on the unaffected part of the mustache. Typically there is a slightly lower growth rate of grafts transplanted into scar tissue, but these patients usually have excellent cosmetic results. Below you can see the pre operative photo and the post operative photo and the immediate difference that is seen with the transplanted grafts present over the scar.

All the best,

Marc Dauer, M.D.

Tags: Dr. Dauer, facial hair transplant, follicular unit extraction, FUE, Hair Loss after Plastic Surgery, Hair loss after surgical procedures, Hair restoration, Hair Transplant, Hair Transplantation, Hair Transplantation Hair Restoration in Younger Patien, Hair Transplants

Lowering the hairline in a female patient

Greetings,

Today I would like to discuss lowering the hairline in female patients. This is a procedure that has become more common recently with advances in Hair Restoration techniques and the ability to create density that was previously unattainable. In these cases patients report having a high hairline that has been present for their entire lives. In some cases there is thinning behind the hairline, but more often than not, the high hairline is the only issue. With the ability to transplant single hairs into recipient sites that measure .6mm-.8mm we can create cosmetic density in the hairline that rivals a completely normal hairline. Care is also taken to angle the hairs in the exact angle and orientation of the pre existing hairs so that one should not be able to identify any difference between pre existing native hair and the new transplanted hairs. In the case I am highlighting today, this patient has some thinning in her frontal scalp, which I addressed by transplanting hairs into the thinned out region. However her primary concern was her high hairline that had been present for her entire life. I lowered her hairline by just over a centimeter and kept the same design as her original hairline with the peak in the middle. Notice this patient had a very specific angle to her hair growth in the hairline which I maintained with the new transplanted hair grafts. Below you can see the pre operative photo and the immediate post operative photo that show the grafts placed in the new hairline. I hope this discussion provides some insight into this concept.

All the best,

Marc Dauer, M.D.

Tags: Dr. Dauer, Hair Loss, Hair restoration, Hair Transplant, Hair Transplantation, Hair Transplants