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Results
The procedure produced natural-looking in just 1 or 2 sessions, with undetectable scarring (Figures 6-9). Most patient’s older than 50 years were satisfied after a single session. Younger patient’s were more demanding and often requiring a second session before being entirely satisfied with the results. Most of these younger patient’s had always planned to undergo a second procedure.
The following complications occurred in this series of 453 consecutive cases. In 2 patient’s (1 African-American and 1 of Mediterranean origin), keloid scarring developed at the donor site. Two patients experienced poor hair growth. Both cases occurred early in the series, when my assistants were learning to dissect grafts, and these patients were satisfied with their results after a second session. At the time of this writing, we achieve about 95% hair growth from each individual graft. Two cases of alopecia at the donor-site closure developed as a result of ischmia caused by overly tight closures. This complication was revised by excision, grafting, or both.
Discussion
Aesthetic hair restoration cannot restore the hair density patient’s had when they were younger. It can only redistribute the patient’s existing hair in a more strategic way to provide better scalp coverage with a natural-looking hairline. To ensure patient satisfaction, careful selection of patients with an appropriate donor-hair supply and realistic expectations is necessary.
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