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Subject: "Case discussion - 1600 bht + 800 scalp FUSE" First topic | Last topic
Dr. ArvindTue May-02-06 05:21 AM
Member since Jun 23rd 2004
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"Case discussion - 1600 bht + 800 scalp FUSE"


          

Dear forum readers,
Body hair transplants and scalp fue has progressed over a short period of years.
However, the physicians providing these treatments are limited.
As more practitioners join the field, I think they may benefit from the experience and observations of the preceding doctors.

Also true is that with the advent of bht and fue, new choices are open to prospective patients to deal with their hair loss.
Various patients make, and will continue to make choices based on the knowledge available at any particular time. These choices are as important as the techniques and should be discussed.


I, therefore, hope that detailed case discussions of individual results will help the new doctors as well as prospective patients.

As for veteran doctors, I know they have been performing hair transplants for multiple years and some of the points I discuss may have already been observed and assimilated by them in their practice.
I request them to have patience and humor me.

-----------------------------------------------

Case A1
For purpose of patient privacy, allow me to refer to this particular patient as A1.

A1 provides many important insights as well as the choices that may face a person addressing his hair loss.

I will go over a brief history of the patient and will request inputs from forum readers and fellow HT doctors in respect to the choices they would make if in A1's position.

Particulars-

The patient is a male adult Caucasian.
Fitzpatrick skin type 2/3.

A NW 5, with no previous hair restoration surgeries (a virgin scalp).

The chest and pubic hair are slightly thicker in calibre than scalp.
The armpithair almost thesamecalibre as scalp.
The leg hair are finer in calibre.

A1 is going along his hair restoration in multiple steps.

His previous step had included a total of 2400+ grafts being placed in the scalp recipient area. This included 1600 body hair grafts (a major part from the chest) and 800 scalp FUSE/fue grafts.

That had been approximately 7 months earlier.

While it is early to see the full growth in the transplanted hair, the cosmetic difference is still visible. Over the subsequent months, we expect further growth.

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
RE: Case discussion - 1600 bht + 800 scalp FUSE
May 02nd 2006
1
RE: Case discussion - 1600 bht + 800 scalp FUSE
May 02nd 2006
2
      RE: Case discussion - 1600 bht + 800 scalp FUSE
May 02nd 2006
3
           Chest donor - great
May 02nd 2006
4
The chest donor area - before re harvesting
May 02nd 2006
5
A1 - Aims and choices
May 02nd 2006
6
      RE: A1 - Aims and choices
May 02nd 2006
7
      RE: A1 - Aims and choices
May 02nd 2006
8
      Thank you
May 03rd 2006
10
      RE: A1 - Aims and choices
May 03rd 2006
9
      RE: A1 - Aims and choices
May 03rd 2006
11
           RE: A1 - Aims and choices
May 03rd 2006
12
Beard hair - an additional source
May 03rd 2006
13
RE: Beard hair - an additional source
May 03rd 2006
14
      RE: Beard hair - an additional source
May 03rd 2006
15
           RE: Beard hair - an additional source
May 03rd 2006
16

Dr. ArvindTue May-02-06 05:32 AM
Member since Jun 23rd 2004
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#1. "RE: Case discussion - 1600 bht + 800 scalp FUSE"
In response to Reply # 0


          

Following are some close up pictures of the recipient area with the hair parted as well as combed in different directions to give a true idea of the growth.
The previous grafts were all transplated in the front area.
Nothing was transplanted into the crown.
The crown area being addressed this time.

Hair pulled back with the comb


Hair pulled back andto the side


Hair pulled to the side



Pictures with hair parted at various points in the previous recipient 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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SKTue May-02-06 08:14 AM
Member since Oct 27th 2005
287 posts
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#2. "RE: Case discussion - 1600 bht + 800 scalp FUSE"
In response to Reply # 1


  

          

Thanks for posting the photos and relevant details.
My situation is very similar. Good calibre body hair though available, is in short supply.

What does A1's chest donor look like? Healing is a big issue for me when using body hair.

  

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Dr. ArvindTue May-02-06 10:06 AM
Member since Jun 23rd 2004
1288 posts
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#3. "RE: Case discussion - 1600 bht + 800 scalp FUSE"
In response to Reply # 2
Tue May-02-06 10:13 AM by Dr. Arvind

          

Dear SK,
Whether to use the scalp hair or body hair or a mix of both will depend on the characteristics of the hair.
These vary from patient to patient.
If you email the pictures to me or post them on the forum, along with your requirements. I will be able to suggest a course of action.
-----------------------------------------------

Chest donor
Usually, the body donor pictures are shown as before after comparison.
As fate would have it, A1's chest donor pictures have already been posted at the following thread.
I did want to mention it at the time, but other things were being discussed.

http://www.hairsite4.com/dc/dcboard.php?az=show_topic&forum=12&topic_id=37863&mode=full

The pictures showing the fresh extractions being performed from the chest area are actually the extractions being performed from a chest area that has been previously harvested.

To a person not knowing the area had been harvested before, that is what the donor will look like.
Those pictures show the true extent of the healing possible.
The picture is of the chest donor area being re harvested.



I will post more before and after pictures ofthe chest area shortly.

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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righteranyTue May-02-06 10:39 AM
Member since Oct 17th 2005
78 posts
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#4. "Chest donor - great"
In response to Reply # 3


  

          

Wonderful.
I felt compelled to post.
Reading the post detailing your technique who would have thought it was an area being re visited.

Indeed great work.

1st session - 300 FUSE grafts by Dr. A.
Excellent yeild
1500 more grafts placed in my crown - April 06.
http://www.hairsite4.com/dc/dcboard.php?az=show_topic&forum=12&topic_id=29785&mode=full

  

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Dr. ArvindTue May-02-06 04:52 PM
Member since Jun 23rd 2004
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#5. "The chest donor area - before re harvesting"
In response to Reply # 0


          

This is the picture of the chest area as it looks at the start of the second round of extractions.



A close up


A closer picture prior to reharvesting the previously harvested area


An extreme close up during the second round of extractions.

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 May-02-06 05:03 PM
Member since Jun 23rd 2004
1288 posts
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#6. "A1 - Aims and choices"
In response to Reply # 5
Tue May-02-06 05:06 PM by Dr. Arvind

          

A1 wishes to get rid of the hair piece he has been wearing.
However, his hair piece is one that gives the appearance of a very low hairline.
He does not wish the transition from hair piece to his own hair to be apparent.

Limitation of robust, thick calibre body hair is one factor.

He has undergone smaller sessions of bht with us before and has found the hair to grow.
However, we have found that the hair has NOT increased in calibre at the end of 1 year in A1's case. (He has been using minoxidil, though not as frequently as advised).

The good news, of course, is that the transplanted chest hair has not had a reduction in calibre either.

The choice in front of him is to -
1. transplant increasing numbers of non robust as well as robust body hair along with scalp hair,
2. search for additional robust hair to be used in conjunction with the scalp and chest hair,
3. adopt innovative means to affect a full head of hair with the limited number of robust grafts available.

We would love to hear your opinions regarding any extra choices that are possible and that you would make in your own case.

While giving choices and reasons for the same, please also consider that he is a NW5 and further progression of hair loss is possible and we will need to retain a quantum of donor hair (body or scalp) for that eventuality.

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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newtTue May-02-06 05:18 PM
Member since Mar 04th 2006
31 posts
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#7. "RE: A1 - Aims and choices"
In response to Reply # 6


          

My opinion- why not just go for lots of scalp donor hair?
Add the chest hair to the equation and you can get a sufficient nymber.With using the hair with best characteristics, he gets good coverage even with lesser number of grafts.

As for future hairloss, who knows. He may not lose more. Even if he does, HM may burst forth on the screen to help by that time.

  

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bennstuTue May-02-06 05:31 PM
Member since Feb 01st 2006
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#8. "RE: A1 - Aims and choices"
In response to Reply # 6
Tue May-02-06 05:32 PM by bennstu

  

          

Dr. A,
You are a breath of fresh air as usual.
Those pictures of the chest donor had me floored.
I went over the thread detailing the techniques over again.
I couldn't believe it.
Demonstrating the technique on a previously harvested donor area without telling it was so, is the litmus test in my opinion. Kudos where its deserved.

As for A1, why not use pubic and armpit hair too. With your skills, I know those donors do not pose any problems.
I think A1 should consider those additional donor areas too.

Even if they add up to 1000 more grafts, they will be the best and the thickest hair and provide greatest coverage.
He should also use more scalp donor than he has till now. 800 is too small a number to extract from the scalp. Surely, he can go for 3000 scalp grafts at least.

  

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Dr. ArvindWed May-03-06 03:44 AM
Member since Jun 23rd 2004
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#10. "Thank you"
In response to Reply # 8


          

Newt and bennstu both have given suggestions that have been employed in the patient A1.

Pubic, armpit as well as more scalp hair were combined and used with the remaining body hair for transplanting.

The patient does not want to trim too much of the scalp donor at one time.
Therefore, the extractions were performed from 1-2 cm wide trimmed strips of scalp donor.
That way A1 can return to work earlier and the trimmed strips of scalp donor can be covered by the remaining hair.

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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KamranWed May-03-06 03:12 AM
Member since Apr 10th 2006
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#9. "RE: A1 - Aims and choices"
In response to Reply # 6
Wed May-03-06 03:12 AM by Kamran

          

Dr. A,
Thanks for affording us an oppurtunity to see the advances as they evolve.

I can speak from my own experience that the donor sites are very minute and they heal within a few days. It doesnt even feel like a surgery.
I am glad for this patient's case. There are not many patients where body hair have been shown to grow on a virgen scalp. The growth on a virgen scalp really proves the success of body hair transplant. Maybe next time, I will go for some body hair myself too.

50 FUSE grafts - 2004. Testing waters.
906 FUSE grafts - Jan 2005. Confident but cautious.
914 grafts - April 2006. Planning my hair transplant in stages.

  

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Dr NarayanWed May-03-06 04:12 AM
Member since Dec 10th 2005
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#11. "RE: A1 - Aims and choices"
In response to Reply # 6
Wed May-03-06 04:12 AM by Dr Narayan

          

Interesting.
If I was in A1's position what will I do..,

Lets see. I could use the less is more phenomenon. Placing the good body hair along with scalp hair, in the recipient at a moderate density, and then doing a crew cut. Or even a buzz cut.

Since A1 does not have any strip scars to worry about, that could be a good way out. I do not think taking out 3000 or so fue from scalp should create any problems.

Later, if he loses more hair, the scalp donor could be re harvested and the donor sites filled with the less robust body hair acting as DEM grafts.

  

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Dr. ArvindWed May-03-06 05:47 AM
Member since Jun 23rd 2004
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#12. "RE: A1 - Aims and choices"
In response to Reply # 11


          

Dear Dr. Narayan,
Your advised strategy was indeed discussed with A1 while talking about all the choices available to him.

With the hair buzz cut the norwood area looks fuller even for lesser number of hair.

Finallyfree's pictures when he had buzz cut his scalp prior to his last HT, are a testament to the benefits of that approach.

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. ArvindWed May-03-06 05:57 AM
Member since Jun 23rd 2004
1288 posts
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#13. "Beard hair - an additional source"
In response to Reply # 0


          

As forum readers are aware, we had performed a test 100+ grafts procedure for forum poster fueoptions.

A1 too decided to go for a test session using the hair in that area.

He decided to use beard hair grafts as a test session.

This is the picture of the area before performing the extractions.



And this is the picture just after the extraction.
A beard hair graft is juxtaposed for comparison.

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. ArvindWed May-03-06 06:10 AM
Member since Jun 23rd 2004
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#14. "RE: Beard hair - an additional source"
In response to Reply # 13
Wed May-03-06 06:11 AM by Dr. Arvind

          

At the end of the day, a few hours later, these are what the extraction sites looked like.




The extraction sites were examined and pictured again the next day.
Following is the picture.
I believe that there are differences in the mechanism of healing in this area as compared to most body areas. More about that later though.




A1 felt, the next day, that the healing had progressed very encouragingly and he wanted to have a few more grafts extracted from other beard areas.

We will try to keep forum readers apprised of the healing in the beard 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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Dr. ArvindWed May-03-06 07:17 AM
Member since Jun 23rd 2004
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#15. "RE: Beard hair - an additional source"
In response to Reply # 14


          

Here are some additional pictures of the beard donor areas.

The donor area prior to extractions




The donor sites just after extractions


The donor sites with 24 gauge needle juxtaposed for comparison


Thedonor sites with the extracted grafts and the needle


The donor sites a few hours later

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 May-03-06 04:45 PM
Member since Jul 14th 2003
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#16. "RE: Beard hair - an additional source"
In response to Reply # 15


          

Well it is good news to hear that things have improved so much so as to make extraction of facial hair possible. If so this will be a very exciting evolvement and proof that improvements in present day protocols have advanced tremendously. I believe that facial hair can be very useful for many people that are weak on BH. The only thing I would worry about is the coarsness of beard hair on the scalp. In some cases having such thick hairs could be uncomfortable on the scalp. But it is definetely worth experimenting with.

  

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Top Surgical Hair Transplantation Hair Transplant Open Forum topic #38120First topic | Last topic
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