Limmer Hair Transplant: 2010

Tuesday, October 12, 2010

STAY COMMITTED TO MEDICAL THERAPY

The case presented today has had just under 5000 grafts from two sessions, one in 2006 and the other in 2008. He came in yesterday and has had an additional 2600 grafts to primarily chase after loss in his mid scalp/vertex resulting from the discontinuation of medical therapy. Patient opted to D/C medical treatment for unclear reasons (had no adverse side effect), but now understand its importance and hopefully will remain dedicated to both finasteride and minoxidil. Presented today are his preop photos from 2006, his final growth photos taken preoperatively yesterday after having had ~5000 grafts (~1700 grafts in 2006 and ~3300 grafts in 2008) and an immediate post op photo taken today after an additional 2600 grafts were placed in his crown and mid-scalp.

Take home message for those who see this…
If you are going to move forward with transplant surgery you need to stay committed to medical therapy as long as you are not having adverse side effects.

Brad Limmer, MD/jac

Monday, May 3, 2010

HOW OLD IS TOO OLD FOR A HAIR TRANSPLANT?

The answer to the above question is probably, you are never too old as long as you are in good health and your goals can be met. The oldest man I have ever transplanted was 86 and the oldest woman was his wife at 78. The case presented today was 76 yrs old on his initial transplant in 2008 and returned 7 months ago, primarily to expand his area of coverage.

This case illustrates some of the aspects a lot of older patients struggle with when trying to decide if transplantation makes sense at an older age. He originally presented for consult in 2002 at the age of 69. While he wanted to have it done he struggled with the vanity issue…felt he was too old, what would his friends/co workers think and most of all, his kids thought it was silly for him to have done.

So he put it off. Six years later, 2008, he came back knowing he absolutely wanted to have a transplant and finally address something he had struggled with for the better part of 50 years. He still struggled with the vanity issue/what would his kids think, but decided if we could keep the price reasonable he would move forward.

In September of 2008 he moved forward with transplantation. As a full blown Norwood pattern 6 and only wanting to spend $4500 we had to design a transplant that would produce a very natural cosmetic result with only ~1300 grafts to work with. We placed his mid-frontal hairline at ~10 cm above the brow and kept deep temporal recessions to help minimize the surface area we were to cover.

His post op was uneventful and within the first 6 months he was already enjoying the cosmetic improvement transplants can provide. His natural result, cosmetic improvement and easy recovery not only made him a believer, but helped him get past his vanity issue he had related to doing this so late in life. While he still remained conservative, he did move forward in September of 2009 with an additional 1100 grafts to work through the mid-bridge region and augmentation of mid-frontal tuft.

I think his case/photos presented show that if you are in good health you are never too old to enjoy the positive change that can be made through transplantation. Obviously, none of know how long we are going to live, but this patient sure wishes he had gotten past some of the things holding him back from doing transplantation in 2002 as he could have enjoyed the results even more. But in the end, we all need to move forward when we are truly ready, have a plan and fully understand what we are committing to…no matter what your age.

Brad Limmer, MD/jac

Monday, February 22, 2010

a transplanted hairline never changes...

BEFORE PHOTOS:

The case presented is that of a young man who came in at age 25. During his original consult it was noted that he was already committed to a regiment of propecia/rogaine since age 14. Being so young is always a concern. But his commitment to medical management and his understanding the implications of moving forward with transplantation has, we were able to devise a plan/design a hairline that would work well for him now and look appropriate as he aged. He also understood that if he lost hair behind his newly transplanted hairline he would have to come back and at least transplant the frontal/mid scalp.
On the day of his surgery we mapped out our plan. We harvested 18 sq cm of donor at a fu density of 86, producing just over 1500 grafts and planted at a density of just over 50 grafts/ sq cm. His case proceeded very easily without any bleeding and no popping of grafts. Shortly after lunch we opted to harvest an additional 300 grafts so we could maintain our tight packing, but also plant a little further back creating a nice transition.
While we kept in touch, he finally was able to be seen in follow up this past Friday. He has excellent results which are only helped by his good hair color-skin match. He remains committed to medical therapy and desires to slightly thicken his hairline while he uses the majority of his planned upcoming procedure to reinforce his frontal 1/3 of scalp behind his new hairline.
Presented are his before and after photos. He has excellent density from his single pass grafting session and a hairline design that works well now and for his lifetime. Something young men always need to understand…years will come and go, but a transplanted hairline never changes. So be cognizant of that and design something that looks appropriate for your entire life.

Brad Limmer, MD/jac

AFTER PHOTOS