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Top Surgical Hair Transplantation Hair Transplant Open Forum topic #25247
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Subject: "When Hair transplants go wrong" First topic | Last topic
Dr. ArvindMon Jun-13-05 05:34 PM
Member since Jun 23rd 2004
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"When Hair transplants go wrong"


          

Dear Forum readers,
A wrongly performed hair transplant is a very sad sight to see.


I hope that analyzing and discussing the reasons due to which a particular hair transplant turned out to be unsatisfactory, will help forum readers and fellow and future ht doctors,

1. Avoid the mistakes committed in these wrong transplants
2. Learn and improve the repair techniques
3. Demistify the ART and SCIENCE of a correctly performed hair transplant. (That way, the patient knows, to an extent, what to watch out or ask for when planning a hair transplant in conjunction with his HT doctor).

The following case shows that the mistakes committed could easily have been avoided.

We performed the repair in this particular patient using 2000 strip FUHT grafts (the donor area was closed by the CAD closure method).

But for the beginning, allow me to post a few pictures.
I would welcome your opinion on what exactly went wrong in this person’s hair transplant.









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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Replies to this topic
Subject Author Message Date ID
Pictures
Jun 13th 2005
1
RE: Pictures
Jun 13th 2005
2
      RE: Pictures
Jun 13th 2005
3
      Density
Jun 14th 2005
9
      RE: Pictures
Jun 13th 2005
4
           RE: Pictures
Jun 13th 2005
5
           RE: Pictures
Jun 14th 2005
6
           CAD closure
Jun 15th 2005
24
           RE: Pictures
Jun 14th 2005
11
           hairline
Jun 14th 2005
10
RE: When Hair transplants go wrong
Jun 14th 2005
7
RE: When Hair transplants go wrong
Jun 14th 2005
8
the saddest part
Jun 14th 2005
14
      RE: the saddest part
Jun 15th 2005
22
           RE: the saddest part
Jun 15th 2005
23
Age
Jun 14th 2005
13
RE: When Hair transplants go wrong
Jun 14th 2005
12
The patient
Jun 14th 2005
15
His donor
Jun 14th 2005
16
Pics and method of the repair
Jun 14th 2005
17
Recipient area a few days later
Jun 14th 2005
18
Strip
Jun 14th 2005
19
WHAT WENT WRONG - > I KNOW !!!!!
Jun 14th 2005
20
RE: Strip
Jun 15th 2005
21
      RE: Strip
Jun 15th 2005
25
           RE: Strip
Jun 16th 2005
26

Dr. ArvindMon Jun-13-05 06:05 PM
Member since Jun 23rd 2004
1288 posts
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#1. "Pictures"
In response to Reply # 0


          

Following are pics after trimming the previously transplanted hair.







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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Dr. ArvindMon Jun-13-05 06:07 PM
Member since Jun 23rd 2004
1288 posts
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#2. "RE: Pictures"
In response to Reply # 1


          





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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Dens1Mon Jun-13-05 09:59 PM
Member since Oct 03rd 2004
303 posts
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#3. "RE: Pictures"
In response to Reply # 2


  

          

yikes!, I noticed the many triples in the hairline, plus great distance between the grafts and wrong angulation, thatīs even worse than my previous procedures...
one question: what do you reckon is the highest density you can achieve starting from this situation as Iīve read that itīs harder to increase density as because of wrong angulation in this patientīs previous work?
Iīm looking forward to seeing your pice while working on this repair case.

  

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Dr. ArvindTue Jun-14-05 05:31 AM
Member since Jun 23rd 2004
1288 posts
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#9. "Density"
In response to Reply # 3


          

>one question: what do you reckon is the highest density you
>can achieve starting from this situation as Iīve read that
>itīs harder to increase density as because of wrong angulation
>in this patientīs previous work?
>Iīm looking forward to seeing your pice while working on this
>repair case.

The density acheivable in a repair case where the previous grafts are wrongly angulated depends on
1. the nature of the angulations,
2. the distance between the previous grafts.

If the grafts are grossly misdirected (that is 90 degrees or more) than the doctor should discuss whether to remove that graft and reimplant it OR to work around it, taking care to avoid transection of the root OR to place new grafts densely and properly angulated regardless.

The third option is the one that will give the highest density BUT should be followed only if there are very few of the wrongly angled grafts.

In this patient we will be working in between the grafts trying for the minimum root transections.

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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raj paulMon Jun-13-05 10:03 PM
Member since Nov 19th 2004
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#4. "RE: Pictures"
In response to Reply # 2
Mon Jun-13-05 10:04 PM by raj paul

  

          

Dr Arvind,
1.The grafts seem to be grossly misplaced without proper angulation,

2.The hairline has been very thinly packed and

3.Multi-hair FU in the hairline also seems to make his HT look obvious.

Are you planning to lower the hairline or just fill inbetween the existing hairs?

thanks.

  

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DJMon Jun-13-05 10:42 PM
Member since Jun 22nd 2003
396 posts
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#5. "RE: Pictures"
In response to Reply # 4


  

          


Dr A, I enjoy so much your putting these pictures out for all to see. I do believe they help educate. I believe in your madness.

Anyway, Will you be removing them or grafting through them?

What will your approach be for this visit?

There are so many of these cases and the guys have to live with this day in and day out... It's bad, I am sure guys that do not live with this, or have never had to, they just cannot know how it feels to have these sticking out of their forehead for all to see. It's very good he is getting this repaired.

Thanks, dj

  

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parableTue Jun-14-05 03:25 AM
Member since Oct 14th 2003
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#6. "RE: Pictures"
In response to Reply # 5


          

If I may ask Doctor A,

What is the 'CAD' closure method?...

Thanks

  

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Dr. ArvindWed Jun-15-05 06:55 AM
Member since Jun 23rd 2004
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#24. "CAD closure"
In response to Reply # 6


          

>If I may ask Doctor A,
>
>What is the 'CAD' closure method?...
>
>Thanks

Dear Parable,
We will be telling details about the CAD closure method in near future.
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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Dr. ArvindTue Jun-14-05 05:39 AM
Member since Jun 23rd 2004
1288 posts
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#11. "RE: Pictures"
In response to Reply # 5


          

>
>Dr A, I enjoy so much your putting these pictures out for all
>to see. I do believe they help educate. I believe in your
>madness.
>
>Anyway, Will you be removing them or grafting through them?
>
>What will your approach be for this visit?
>
>There are so many of these cases and the guys have to live
>with this day in and day out... It's bad, I am sure guys that
>do not live with this, or have never had to, they just cannot
>know how it feels to have these sticking out of their forehead
>for all to see. It's very good he is getting this repaired.
>
>Thanks, dj

Thanks for beleiving in my madness.
It is a sad thing that I have to point out the faults. These are sometimes so obvious that it makes one wonder why did the transplanting clinic not dealt out more humanity.
Sure it would be common knowledge for them too, as a HT clinic, that hair, in nature, do not grow like this.

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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Dr. ArvindTue Jun-14-05 05:34 AM
Member since Jun 23rd 2004
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#10. "hairline"
In response to Reply # 4


          

>Dr Arvind,
>1.The grafts seem to be grossly misplaced without proper
>angulation,
>
>2.The hairline has been very thinly packed and
>
>3.Multi-hair FU in the hairline also seems to make his HT look
>obvious.
>
>Are you planning to lower the hairline or just fill inbetween
>the existing hairs?
>
>thanks.

We worked in the hairline as well as just in front of it.

Apart from the defects that you have so rightly pointed out, is the fact that the previously transplanted hairline is a single straight line.
Grafts need to be placed to break up that straight line into an irregular zone.

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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JeepGUYTue Jun-14-05 04:00 AM
Member since Jul 15th 2004
253 posts
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#7. "RE: When Hair transplants go wrong"
In response to Reply # 0


          

Apart from the obvious (ie the plugs), this fellow probably had transplants at a very young age. The doctor went a bit too aggressive and did not account for the natural progression of hair loss as the patient grows older.

  

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ETERNAL HOPETue Jun-14-05 04:16 AM
Member since Nov 04th 2003
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#8. "RE: When Hair transplants go wrong"
In response to Reply # 7


  

          


This transplant case likely was performed within the past decade, as there are various constituent grafts placed (2/3/4 and even 5 haired grafts) invariably during the mini/micro stage which remains a staple in a few current clinics. The work is horrendous and painfully obvious. Are the larger "plugs" destined for excision?

Ciao!

  

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Dr. ArvindTue Jun-14-05 05:52 AM
Member since Jun 23rd 2004
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#14. "the saddest part"
In response to Reply # 8


          

>
>This transplant case likely was performed within the past
>decade, as there are various constituent grafts placed (2/3/4
>and even 5 haired grafts) invariably during the mini/micro
>stage which remains a staple in a few current clinics. The
>work is horrendous and painfully obvious. Are the larger
>"plugs" destined for excision?
>
>Ciao!
>
Dear EH,
The saddest part of the HT story here is that the previous hair transplant was performed in Jan 2005.
The patient was given to beleive, by a UK based clinic, that he will be getting 3500 hair follicles (not grafts) in the front area.

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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jtelecomWed Jun-15-05 06:46 AM
Member since Aug 15th 2003
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#22. "RE: the saddest part"
In response to Reply # 14
Wed Jun-15-05 06:47 AM by jtelecom

          

Dr. A:

January 2005???? Five months is a little early to experience regrowth - let alone full regrowth - don't you think? There are numerous posters on this website who did not experience any regrowth for 6 months or more. Don't you think that it is wise to wait at least a year before grafting in those recipient areas of the previous surgery?

Jtelecom

  

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Dr. ArvindWed Jun-15-05 06:52 AM
Member since Jun 23rd 2004
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#23. "RE: the saddest part"
In response to Reply # 22


          

Dear jtelecom,
I agree with you.
We do not advise revisiting an area for atleast 6 months.
Especially when the transplant is of a type where no scarring is visible.
However, in the particular patient the grafts are growing and that too from obvious pitted spots.
That is the reason for taking up the patient at the 6 month mark.
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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Dr. ArvindTue Jun-14-05 05:47 AM
Member since Jun 23rd 2004
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#13. "Age"
In response to Reply # 7


          

>Apart from the obvious (ie the plugs), this fellow probably
>had transplants at a very young age. The doctor went a bit too
>aggressive and did not account for the natural progression of
>hair loss as the patient grows older.
>
>
No, Jeepguy, the patient was in his 40s when he went in for his first hair transplant.

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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bbaTue Jun-14-05 05:45 AM
Member since Dec 17th 2004
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#12. "RE: When Hair transplants go wrong"
In response to Reply # 0


  

          

Natural baldness it much better than unatural hair, someone tried to cover to much with to little with this guy.I just wonder if this was supposed to be the final result for him or did he just not go back to the doctor he begin with.

  

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Dr. ArvindTue Jun-14-05 05:58 AM
Member since Jun 23rd 2004
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#15. "The patient"
In response to Reply # 12


          

> Natural baldness it much better than unatural hair, someone
>tried to cover to much with to little with this guy.I just
>wonder if this was supposed to be the final result for him or
>did he just not go back to the doctor he begin with.

I do not know whether they advised for multiple sittings in the same area.
But, in the patient's words, he found the internet forums just about when he had got his previous hair transplant done. That is the time he understood what had gone amiss.

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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damraakTue Jun-14-05 06:49 AM
Member since May 28th 2005
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#16. "His donor"
In response to Reply # 0
Tue Jun-14-05 06:54 AM by damraak

          

Dr. Arvind, what does his strip scar look like ? I assume he had a strip. Did the other doctor do a good job with his donor scar?

  

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Dr. ArvindTue Jun-14-05 10:53 AM
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#17. "Pics and method of the repair"
In response to Reply # 0
Tue Jun-14-05 10:54 AM by Dr. Arvind

          

Most of the imperfections of the previous HT in the patient have been very aptly pointed out by the forum posters.

1. Grafts placed in too straight a line in the hairline
2. Grafts placed at wrong angulations.
3. Grafts pointing in wrong directions.
4. Grafts placed too far apart.
5. Too few grafts for the area attempted.
6. Too many 3-5 hair grafts , some right in the front hairline.

An attempt at repair involves many choices.

The main aims of the repair are-

1. To draw the attention away fron the too straight hairline by breaking it up.
2. Too many of the grafts are in wrong direction/angulation. So, instead of attempting a massive extraction of the previously transplanted grafts, we attempted to camoflage them in a large number of closely placed grafts.
3. The skin hair color contrast is in favor of the patient. We transplanted the front hairline zone mostly with 1 hair grafts.

Following are the pictures during the present procedure.






We have attempted to keep the surgical intervention, in the recipient area, to a minimum.

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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Dr. ArvindTue Jun-14-05 10:57 AM
Member since Jun 23rd 2004
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#18. "Recipient area a few days later"
In response to Reply # 17


          

These are the pictures of the recipient area 1 and 3 days after the procedure.





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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Mr FrodoTue Jun-14-05 05:45 PM
Member since Nov 23rd 2003
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#19. "Strip"
In response to Reply # 0


  

          

Dr. A,

Is there a reason why you did the repair with a strip? Is strip better suited for this type of repair or it's just the patient's preference to have a strip ? Why not use body hair, fue etc ?

  

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Sunny DeolTue Jun-14-05 07:52 PM
Member since Aug 27th 2003
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#20. "WHAT WENT WRONG - > I KNOW !!!!!"
In response to Reply # 19


  

          

Hello Guys,

What went wrong was that this guy went to a doctor like in BOSLEY instead of coming to Dr. A in the first place ? Poor guy suffered with so much pain.

In response to the question -> "But for the beginning, allow me to post a few pictures.I would welcome your opinion on what exactly went wrong in this person’s hair transplant."

  

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Dr. ArvindWed Jun-15-05 06:05 AM
Member since Jun 23rd 2004
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#21. "RE: Strip"
In response to Reply # 19


          

>Dr. A,
>
>Is there a reason why you did the repair with a strip? Is
>strip better suited for this type of repair or it's just the
>patient's preference to have a strip ? Why not use body hair,
>fue etc ?
>
>
It was the patient's preference to go for a strip procedure.

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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OptimistWed Jun-15-05 09:24 AM
Member since Jul 14th 2003
939 posts
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#25. "RE: Strip"
In response to Reply # 21


          

Dr. A I have read a post regarding Dr. Rose "ledge closure" technique" in closing strip scars. I was wondering if you know about it and what you think of it. Do you think it is a solution to fixing stretched strip scars or is FUE grafting a better solution?

  

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backnatsThu Jun-16-05 07:20 AM
Member since Jul 11th 2004
33 posts
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#26. "RE: Strip"
In response to Reply # 25


          

Good question Optimist.

Want Miracle Gro

  

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