8969Grafts. NW VI.Crazy repair after changing strategy. Pre-op 6th HT. Below TDC.Beard BHT.2684/2021

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47 años, NW VI sin tratamiento médico y antecedentes de 2 cirugías por FUT en 2001 (Svenson) y 2006 (Vila-Rovira) con resultado nulo. El paciente se cansó de buscar solución y abandonó finasteride. Nos consulta en 2021 para disimular cicatriz y llevar el pelo corto.
Tras ver resultado, nos pregunta por la posibilidad reparar receptora (180 cm2 siendo conservadores).
Se prescribe finasteride 5 mg/semana y a los 7 meses en quirófano:
- Temporal: 45 μm ; 67 UF/cm2; 155 pelos/cm2; 2,31 p/UF; CV: 6,97.
- Parietal: 48 μm ; 73 UF/cm2; 160 p/cm2; 2,19 p/UF; CV: 7,68.
- Occipital: 50 μm ; 65 UF/cm2; 149 p/cm2; 2,29 p/UF; CV: 7,45.
TDA: 206 cm².
TDC: 3594 grafts (a 2,27 p/graft).
TDHC: 8143 pelos.
·2ºHT: 2501 grafts: 2201scalp + 300 BHT (5140 pelos + 381 BHT), a 2,34 p/grafts, para 62 cm2 de frontal (38-40 g/cm2). Punch: 0.8mm.
Grafts: I-297; II-996; III-785; IV-119; V-4.
BHT: I-219; II-82
A los 4 meses, 2ª HT::
- T: 59 UF/cm2; 130 pelos/cm2; 2,20 p/UF; CV: 5,85.
- P: 55 UF/cm2; 120 p/cm2; 2,18 p/UF; CV: 5,76.
- O: 60 UF/cm2; 131 p/cm2; 2,18 p/UF; CV de 6,55.
TDC: 1398 grafts (a 2,19 p/graft).
TDHC: 3061 pelos.
·3ºHT: 2501 grafts: 2201scalp + 300 BHT (5162 pelos + 352 BHT), a 2,35 p/grafts, para 67 cm2 zona media (37-38 g/cm2). Punch: 0.8 mm.
Grafts: I-173; II-1147; III-830; IV-50; V-1.
BHT: I-248; II-52
6 meses después, 3ª cirugía:
- T: 48 UF/cm2; 99 pelos/cm2; 2,06 p/UF; CV: 4,46.
- P: 53 UF/cm2; 111 p/cm2; 2,09 p/UF; CV: 5,33.
- O: 40 UF/cm2; 84 p/cm2; 2,10 p/UF; CV: 4,20.
TDC: 0 grafts (a 2,09 p/g).
TDHC: 0 pelos.
·4ºHT: 1601 grafts: 1100scalp + 501 BHT (2573 pelos + 576 BHT), a 2,34 p/grafts, para 45 cm2 de coronila (35 g/cm2). Punch: 0.8 mm.
Grafts: I-117; II-519; III-439; IV-25.
BHT: I-426; II-75.
A los 7 meses, quirófano:
- T: 43 UF/cm2; 89 pelos/cm2; 2,02 p/UF; CV: 4,18.
- P: 53 UF/cm2; 109 p/cm2; 2,06 p/UF; CV: 5,23.
- O: 44 UF/cm2; 96 p/cm2; 2,18 p/UF; CV: 4,80.
TDC: 0 grafts (a 2,09 p/g).
TDHC: 0 pelos.
·5ºHT: 2014 grafts: 1001 scalp + 1000 BHT y 13 frontal (2174 pelos + 1148 BHT + 20 Frontal), a 2,17 p/g, para frontal (11-15 g/cm2) y coronilla (13-16 g/cm2). Punch: 0.8 mm.
Grafts: I-182; II-484; III-316; IV-19.
BHT: I-852; II-148.
Frontal : I-6; II-7
Buen resultado nuevamente a los 10 meses, nos atrevemos con la 6ª operación (2001grafts: 801scalp + 1200BHT). Se muestra prequirúrgico como habitualmente hacemos.
This 47-year-old patient, NW VI without medical treatment, has a history of 2 FUT surgeries in 2001 (Svenson) and 2006 (Vila-Rovira) with no results. The patient got tired and stopped using finasteride. He consulted us in 2021 to hide the scar and keep his hair short.
After seeing the result, asked for the possibility to improve his recipient (180 cm2 being conservative). We prescibed finasteride 5 mg/week and at 7 months, in the OR:
- Temporal: 45 μm ; 67 FU/cm2; 155 hairs/cm2; 2.31 h/FU; CV: 6.97.
- Parietal: 48 μm; 73 FU/cm2; 160 h/cm2; 2.19 h/FU; CV: 7.68.
- Occipital: 50 μm; 65 FU/cm2; 149 h/cm2; 2.29 h/FU; CV: 7.45.
TDA: 206 cm².
TDC: 3,594grafts (at 2.27 h/graft).
TDHC: 8,143 hairs.
·2ndHT: 2,501 grafts: 2201scalp + 300 BHT (5,140hairs + 381 BHT) for 62 cm2 in front area (38-40 g/cm2) at 2.34 h/graft. Punch: 0,8 mm.
Graft: I-297; II-996; III-785; IV-119; V-4.
BHT: I-219; II-82
At 4 months, 2nd HT:
- T: 59 FU/cm2; 130 hairs/cm2; 2.20 h/FU; CV: 5.85.
- P: 55 FU/cm2; 120 h/cm2; 2.18 h/FU; CV: 5.76.
- O: 60 FU/cm2; 131 h/cm2; 2.18 h/FU; CV: 6.55.
TDC: 1,398 grafts (at 2.19 h/graft).
TDHC: 3,061 hairs.
·3rdHT: 2,501 grafts: 2201scalp + 300 BHT (5,162hairs + 352 BHT) for 67 cm2 in mid area (37-38 g/cm2) at 2.35 h/graft. Punch: 0,8 mm.
Graft: I-173; II-1147; III-830; IV-50; V-1.
BHT: I-248; II-52
6 months later, 3rd HT:
- T: 48 FU/cm2; 99 hairs/cm2; 2.06 h/FU; CV: 4.46.
- P: 53 FU/cm2; 111 h/cm2; 2.09 h/FU; CV: 5.33.
- O: 40 FU/cm2; 84 h/cm2; 2.10 h/FU; CV: 4.20.
TDC: 0 grafts (at 2.09 h/graft).
TDHC: 0 hairs.
·4thHT: 1601 grafts: 1100scalp + 501 BHT (2573 hairs + 576 BHT) for 45 cm2 in the crown (35 g/cm2) at 2.34 h/graft. Punch: 0,8 mm.
Grafts: I-117; II-519; III-439; IV-25.
BHT: I-426; II-75.
At 7 months, OR:
- T: 43 FU/cm2; 89 hairs/cm2; 2.02 h/FU; CV: 4.18.
- P: 53 FU/cm2; 109 h/cm2; 2.06 h/FU; CV: 5.23.
- O: 44 FU/cm2; 96 h/cm2; 2.18 h/FU; CV: 4.80.
TDC: 0 grafts (at 2.09 h/graft).
TDHC: 0 hairs.
·5thHT: 2014 grafts: 1001 scalp + 1000 BHT & 13 front (2174 hairs + 1148 BHT + 20 Front) in the front area (11-15 g/cm2) and crown (13-16 g/cm2)
at 2.17 h/graft. Punch: 0,8 mm.
Grafts: I-182; II-484; III-316; IV-19.
BHT: I-852; II-148.
Frontal : I-6; II-7
Good result again at 10mths, we dare to do his 6th HT (2001grafts: 801scalp + 1200BHT). The pre-op is shown as we usually do.
Dr. Jose Lorenzo. www.injertocapilar.com. Madrid Spain