Paciente que consulta por primera vez en 2011, con 38 años, presenta alopecia avanzada, MPB NW V, sin tratamiento médico. Donante con valores de cobertura aceptables, se medica con finasteride y se plantea estrategia a 2 cirugías y una tercera para aumentar cobertura. Se realiza una primera intervención de 3333 grtafts para restaurar frontal (7716 pelos; 2,31 pelos/graft; 0.8 mm punch; grafts: I-397; II-1697; III-1169; IV-102; V-2).
A los 5 meses se realiza nueva intervención de 2101 Grafts para restaurar la coronilla (4639 pelos; 2,2 pelos/grafts; 0.85 mm punch; Grafts: I-250; II-1200; III-615; IV-36).
A los 18 meses volvemos a intervenir nuevamente al paciente para aumentar cobertura general, extrayendo 1601 grafts (3841 pelos; 2,39 pelos/grafts, 0.8 mm punch; Grafts: I-156; II-733; III-632; IV-77; V-3). Buena cobertura general a los 11 meses por lo que se da por finalizada la restauración.
El paciente concurre nuevamente a los 5 años, con 45 años, sigue estable por medicación, finasteride, y con la misma cobertura general. Nos solicita si podemos aumentar la cobertura. Evaluamos su zona donante y decidimos realizar una cuarta cirugía para reforzar la densidad general. Donante en este momento:
· Temporal. 55 micras de pelo; 52 UF/cm2; 95 pelos/cm2; 1,83 pelos/UF; CV de 5,22
· Parietal: 57 micras; 53 UF/cm2; 113 pelos/cm2; 2,13 pelos/UF; CV de 6,44
· Occipital: 58 micras; 95 UF/cm2; 148 pelos/cm2; 2,08 pelos/UF; CV de 8,58
TDA (area donante total) de 267 cm2 y TDC (capacidad donante total) de 3386 grafts (a 2,10 pelos/graft, TDHC de 6821 pelos).
En esta última cirugía se extraen 2101 grafts (5220 pelos) para 55 cm2 de frontal y 59 cm2 de coronilla (14 a 22 grafts/cm2) a 2, 48 pelos/grafts (140 singles, 985 dobles, 798 triples; 174 cuadruples; 4 quíntuples).
El video muestra la zona rasurada antes de su cuarta cirugía y el resultado a 5 meses tras esta última intervención. Se evolucionará su resultado a los 10 meses.
The first time we saw this patient was in 2011 with 38 year-old: he had an advanced alopecia, MPB NW V, and no medical treatment. Donor with acceptable coverage values, we prescribed finasteride and sugested a 2 step strategy and the possibility of a third one to increase the coverage.
In the first procedure we extracted 3333 grafts to restore the frontal area (7716 hairs; 2.31 hairs/graft; 0.8 mm punch; Grafts: I-397; II-1697; III-1169; IV-102; V-2).
At 5 months, a new procedure was carried out with 2101 Grafts, to restore the crown (4639 hairs; 2.2 hairs/grafts; 0.85 mm punch; Grafts: I-250; II-1200; III-615; IV-36).
After 18 months we decided to do the 3rd surgery to augment the overall coverage, extracting 1601 grafts (3841 hairs; 2.39 hairs / grafts, 0.8 mm punch; Grafts: I-156; II-733; III-632; IV-77 ; V-3). Good general coverage at 11 months, so we consider that we could discharged the patient.
The patient comes again after 5 years, with 45 year-old, hair-loss stable due to med's (finasteride), and roughly with the same general coverage. He asked if we could increase the density. We assessed his donor area and decided to perform a fourth surgery to reinforce all the areas. Currently donor area:
· Temporal. 55 microns of hair; 52 FU/cm2; 95 hairs/cm2; 1,83 hairs/FU; CV of 5,22
· Parietal: 57 microns; 53 FU/cm2; 113 hairs/cm2; 2,13 hairs/FU; CV of 6,44
· Occipital: 58 microns; 95 FU/cm2; 148 hairs/cm2; 2,08 hairs/FU; CV of 8,58
TDA (total donor area) of 267 cm2 and TDC (total donor capacity) of 3386 grafts (at 2,10 hairs/graft, TDHC of 6821 hairs).
In this last surgery we extracted 2101 grafts (5220 hairs) for 55 cm2 in the frontal area and 59 cm2 at crown (14 to 22 grafts/cm2) at 2,48 hairs/grafts (140 singles, 985 doubles, 798 triples; 174 cuadruples; 4 quintuples).
The video shows the donor and recipient area shaved before his 4th surgery and the 5 months outcome after this last procedure. We will show the 10 month result soon.
Dr. José Lorenzo. www.injertocapilar.com. Madrid. Spain.
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