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Subject: "Hairline pics-hyperacute angulation- comments plea..." First topic | Last topic
Dr.TriveniFri Nov-05-04 05:23 AM
Member since Aug 23rd 2004
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"Hairline pics-hyperacute angulation- comments please"
Fri Nov-05-04 05:27 AM by Dr.Triveni

  

          

Dear forum readers,
I am posting a few pics of the hairline design on one of our patients.
It is accompanied with the reasoning of the logic behind it.
Your advise and comments are most welcome.
The patient when he came to us initially- 3 years back -was norwood 6 and in his early 20s. That is to say, extensive hairloss at very young age.
One logical course of action would be to advise him to go in for 5000 to 6000 graft session.
However, that was not possible for the patient.
So we planned a multistage process, each session being a stand alone one. That is, the design should allow the patient the freedom to NOT go for further sessions if for any reason he can not.
The first session we planned, and whose pics are attached, was of 2800 grafts. (he has since got more ht performed).
He has a broad forehead with fine to medium thickness hair and a fairly high degree of skin hair contrast.
Dr.Arvind advocates the formation of recipient sites at a much more acute angle for such patients.
(instead of the hair growing at 30 degrees to the scalp, they almost lie flat, i.e.,15-20 degrees).
This makes the hair almost lie on the scalp leading to a greater degree of coverage than would be possible if the hair were ,comparatively, standing up.
(We have noticed that the hyperacute angulation does not interfere with the styling preference of the person).
I think that hyperacute angulation is especially helpful in those with extensive hairloss and a limited donor supply.

Before


After


Graft placement at 7 days post op


Hairline closeup with hair pulled to side


hairline close up under bright light

Regards.

I work for Dr.A's Clinic as Consultant taking care of pre&post op requirements of patients and compiling studies on BHT
www.besthairtransplant.com
www.fusehair.com
dr.triveni@rediffmail.com
poswalarvind@rediffmail.com

  

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Replies to this topic
Subject Author Message Date ID
RE: Hairline pics-hyperacute angulation- comments ...
Nov 05th 2004
1
RE: recipient site angles and transections
Nov 05th 2004
3
      how to determine what angle to use ?
Nov 07th 2004
6
      RE: how to determine what angle to use ?
Nov 09th 2004
8
      RE: recipient site angles and transections
Nov 07th 2004
7
RE: Hairline pics-hyperacute angulation- comments ...
Nov 05th 2004
2
RE: Hairline pics-hyperacute angulation- comments ...
Nov 05th 2004
4
      RE: Hairline pics-hyperacute angulation- comments ...
Nov 07th 2004
5

jtelecomFri Nov-05-04 07:05 AM
Member since Aug 15th 2003
1940 posts
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#1. "RE: Hairline pics-hyperacute angulation- comments please"
In response to Reply # 0
Fri Nov-05-04 07:07 AM by jtelecom

          

I have always wondered about the safety of using such an acute placement angle for the grafts. What happens when you go to place grafts in the vicinity of these "flat" grafts to increase density in the area? Is there not a much greater chance of transection of the (existing) grafts?

  

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Dr. ArvindFri Nov-05-04 12:46 PM
Member since Jun 23rd 2004
1288 posts
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#3. "RE: recipient site angles and transections"
In response to Reply # 1


          

>I have always wondered about the safety of using such an
>acute placement angle for the grafts. What happens when you go
>to place grafts in the vicinity of these "flat" grafts to
>increase density in the area? Is there not a much greater
>chance of transection of the (existing) grafts?

Dear jtelecom,
Whenever placing the grafts in between existing hair or previously placed grafts we trim the hair to about 1-2mm in length,
That way we can visualize the direction of the hair follicle and make the recipient sites parallel to them.
(Of course, it means that if there were pre existing grafts at an angle of say 45 degrees in the recipient area; we can not make the recipient sites hyper acute).
We have to follow the angulation of the pre existing hair follicles to prevent transection of the hair roots.

The angle of the recipient sites per se is not going to contribute to any increase in no. of transections. If the initial sites are at an angle of 15 degrees the new recipient sites are going to mimic that angle.
Regards,
Dr.A

Dr.(Capt) Arvind Poswal
Dr. A's Clinic,
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: poswalarvind@yahoo.co.in
Ph- 91-011-26274368,91-098-101-78062
Timings-10a.m.to 5p.m
Scalp & Body hair transplants.

  

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High Five ClubSun Nov-07-04 05:25 AM
Member since Aug 02nd 2003
506 posts
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#6. "how to determine what angle to use ?"
In response to Reply # 3
Sun Nov-07-04 05:27 AM by High Five Club

          

>(Of course, it means that if there were pre existing grafts at
>an angle of say 45 degrees in the recipient area; we can not
>make the recipient sites hyper acute).
>We have to follow the angulation of the pre existing hair
>follicles to prevent transection of the hair roots.

Dr. A

Can't tell you how much I appreciate your posts.

Say in the absence of pre-existing hair, how does a doctor determine at what angles the grafts should be placed ? Is 30 degrees to 45 degress the norm?

HFC

  

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Dr. ArvindTue Nov-09-04 08:08 AM
Member since Jun 23rd 2004
1288 posts
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#8. "RE: how to determine what angle to use ?"
In response to Reply # 6


          

>Say in the absence of pre-existing hair, how does a doctor
>determine at what angles the grafts should be placed ? Is 30
>degrees to 45 degress the norm?
>
>HFC
I prefer to keep the angles as low as possible especially if the patient has extensive hair loss and limited donor supply.
In a norwood 6 for example we will be looking fwd to replace 25000 FUs at least( which have been lost).
Planning to provide even 30% of the follicles(to get a thinning appearance) would mean 7500 grafts.
Hyperangulation in such cases helps by making each hair follicle provide more coverage.
3000 grafts at 45 degrees would provide less coverage than at more acute angles.
I feel that while determining the factors which may reflect on the final results of a ht, graft angulation should also be kept in mind.

Dr.(Capt) Arvind Poswal
Dr. A's Clinic,
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: poswalarvind@yahoo.co.in
Ph- 91-011-26274368,91-098-101-78062
Timings-10a.m.to 5p.m
Scalp & Body hair transplants.

  

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69stingSun Nov-07-04 07:06 AM
Member since Aug 05th 2003
448 posts
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#7. "RE: recipient site angles and transections"
In response to Reply # 3


  

          

DR. Arvind, thanks for the photo's and great information. I agree with you that the lower the angle you can use, the better the coverage you will get. I have noticed that people who have never had an ht and keep there hair cut short, there hair appears to being laying on there had and people who have had ht and keeps there hair short it tends to stand up and not give good coverage. your advice and knowledge to this forum is greatly appreciated. keep up the great work.

  

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marcoFri Nov-05-04 09:11 AM
Member since Feb 27th 2003
1515 posts
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#2. "RE: Hairline pics-hyperacute angulation- comments please"
In response to Reply # 0


          

so what is the advantage of 30 degree angulation compared with hyperacute?

  

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gillenatorFri Nov-05-04 10:15 PM
Member since Feb 14th 2004
508 posts
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#4. "RE: Hairline pics-hyperacute angulation- comments please"
In response to Reply # 2


  

          

With 30 degree angulation or even higher, the fully matured hair cylinders tend to produce more volume "off the scalp" so to speak. As the degree of angulation is brought down, the eye tends to notice more coverage verses volume.

This is due to two known factors. The first is our eyes will be able to view the caliber better as the cylinders lay closer or flatter to the scalp. For patients with a wider color contrast like the patient previewed, coverage or more accurately put "the appearance of coverage" improves without necessarily increasing the hair count and/or graft count. This technique can bring additional benefit visually speaking especially for those folks in a more advanced class of hairloss. It is also beneficial for those with less than average donor density levels, and those with finer caliber of hair.

The patients with coarse hair get more bang out of their results because it is indeed hair that covers our scalp so the "fatter" the hair cylinder, the more coverage obtained, all other factors being equal.

The second known factor is the reflection of ultra-violet light and its effects on our visualization. Ultra-violet rays refect much more off the scalp for folks with wider color contrasts (dark pigmentation in hair, light in skin), and so the flatter the hair lays, the less light is allowed to the scalp thereby minimizing the reflection effects. This added improvement of technology from Dr. Arvind provides another option for those of us who desire improvement in visual coverage

Visually speaking, I am very impressed with the coverage comparing his before and after pics. And he still has some donor left which will allow him to do any touch-ups that he may desire or even add a little more density

Gillenator

I am not a doctor; all opinions shared are not medical advice but my own views. Contributing Physicians: Dr. Glenn Charles, Dr. Jim DeYarman, Dr. Paul Rose, Dr. Ron Shapiro, Dr. Christian Bisanga, Drs. Bob True & Bob Dorin

  

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johnpSun Nov-07-04 04:20 AM
Member since Oct 27th 2003
560 posts
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#5. "RE: Hairline pics-hyperacute angulation- comments please"
In response to Reply # 4


          

Dr. A,

Thanks for the excellent education. This is the first time I read about the significance of hyper-acute angulation in hair transplant.

Johnp

  

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Top Surgical Hair Transplantation Hair Transplant Open Forum topic #17557First topic | Last topic
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