Q:

I am a previous hair transplant patient who has class VI hair loss. I had previous procedures done to get some thin hair in the front and top.  I am keeping my hair very short on the back and my primary goal was to camouflage the scar in the back of my head from previous hair transplants. So far, I have achieved this by simply growing my hair longer, and covered the rest of my scalp with Toppik-like products.

Cosmetically, the hair restoration was successful, but constant usage of this kind of product is a bit messy and annoying. Because of this, I have completely shaved my head and decided to try a different route. With the help of tattooing, I was going to go for a shaved head look. Unfortunately though, the scar is a show-stopper and I need to consider all of my options.

What I would consider to be a successful result is: short hair completely covering my head (even if only relatively light density) combined with tattooing and a self-tanner to reduce contrast. I am not “greedy” about the sides at the front, and will accept a 3 or 3A pattern. Is this possible in my case, though?

A:

It is good to hear that you are not striving for high density and that you are realistic about the final appearance of your hair.  Being a class VI with limited donor hair, should leave options open to create light density in your large balding area, but obtaining more density would be extremely difficult if not impossible due to your insufficient donor hair. You should know your priorities and how many surgeries you are committed to have in order to achieve your desired look.

• If you only need to revise the scar and have trichophytic closure done to minimize the visibility of your scar, one surgery is adequate.  Double edged trichophytic closure is a new technique that can improve the appearance of the scar tremendosly.
• If you are attempting to achieve higher density as well as scar revision, you may need several hair transplant procedures (depending on your donor amount available).

Your donor hair can be easily evaluated and options can be given to you for about what to be expected through attending a consultation with an experienced hair transplant doctor.

Hair Restoration surgery is evolving rapidly and we are consistently refining our approach on a regular basis to improve the quality of transplanted hair while at the same time minimizing the possibility of complications. Double edged trichophytic closure is a new approach to donor wound closure that has been put into practice by Dr. Mohebi and US Hair Restoration.

Double edged or two sided trichotomy can help to minimize complications of trichophytic closure (based on the width of epithelium that is being removed and inability of some the hair follicles or oil glands to find their way out to the skin surface). This practice of double edged closure helps us to minimize the width of the top skin layer (epithelium) that is removed from each edge of the donor wound. By making these changes, double edged trichophytic closure allows hair to grow into the wound from both edges and thus minimize the contrast between a patient’s scar (with no hair) and surrounding scalp (with 100% hair density).

By employing the double edged trichophytic closure in our pratice, we constantly have results of less detectable donor scars. In addition to less detectable scarring, we are also able to minimize the risk of folliculitis or ingrown hairs in the donor area, which are the two of the most common complications of traditional trichotomy.