Procedure detail
This patient presented several challenges. He is in his mid 40's and has type IV evolving into a type V hair loss. He did not want to take finasteride despite my recommendations. His donor density was average but the hairs/FU count was below average. Given that future loss will occur, we came up with a conservative plan to give him nice improvement but also buffer the expected future loss. We did FUT 3,205 grafts ( 1-1123, 2-1538, 3-544; 5,831 hairs) and covered the front with medium density and the back with lighter density. Making the hairline lower and putting all the grafts in the front might have looked better in the short term but would have resulted in an unnatural front heavy look as hair loss progressed in the midscalp and crown. Overall, he was very pleased with the outcome, shown at 9 months.
Bald class
Norwood class 4
Characterized by further frontal hair loss and enlargement of vertex, but there is still a solid band of hair across the top (mid-scalp) separating front and vertex.
