Explanatory Photos

Fig 35.

(a) A patient in his 60s before surgery. The frontal hairline was moderately sparse but still cosmetically adequate. However, the back of the frontal area and the midscalp area were thinning significantly. As the hairline zone sometimes consumes as much as 40 to 50% of the grafts used in the frontal area, it was decided not to treat that zone so those grafts could instead be used to go farther back into the midscalp area. (b) The patient 13 months after 2356 FU at a density of 25-30 FU/cm2. (c) A photo taken at the same time as Fig. (b) with the hair combed forward in the hairline zone showing the untreated frontal hairline and the increase in density in the back portion of the frontal area and the midscalp area. (d) This is how the patient looked a year after surgery with the hair combed as it was normally worn. This approach not only allowed the patient to get farther back into thinning areas but also made the transition from a thinning appearance to a thicker one far more subtle and unrecognized by friends and colleagues. That approach is especially useful in middle aged and older patients for whom a thinning hairline zone is not as problematic as hair loss further back on the head. ("The patient" is Dr. Walter Unger and the surgeon was Dr. Robin Unger.)