SURGEON: Dr. Nicolò Cirabisi, MD

DATE OF THE FIRST VISIT (10-11-2022): The patient’s expressed need and expectations were to redefine the front line and cover the vertex region.

DATE OF INTERVENTION (10-02-2023 / excision of 3325 u.f.): Graft excision performed with a 0.9 mm diameter motorized punch and graft repositioning performed with 8 x 1.0 mm diameter Incuram pen implanters.

DECORATION OF THE DONOR ZONE DURING EXTRACTION: After placing the patient in prone position, truncal anesthesia of the greater occipital and lesser occipital nerves was performed by infiltration of local anesthetic (Lidocaine). Subsequently, local anesthesia of the occipito-parietal region was performed with an anesthetic solution composed of Lidocaine, Adrenaline and NaCl 0.9% and the grafts were removed. The surface of the donor area was in good condition: physiological and treatable skin for the purpose of the intervention. Hemorrhage was abundant but within the limits of operability. The grafts were robust and regular with good capillary density (3 bulbs per FU).

RECEPTOR ZONE DECORATION DURING INJECTION: The recipient zone (first line and apex) was in good condition, suitable for surgical treatment. Graft placement was performed without complications. Absence of popping and normal bleeding. The patient was treated in supine decubitus for the entire duration of the graft and slept through most of the surgical procedure.

CASE DESCRIPTION: This 31 year old patient wished to redefine his frontal hairline in a natural way without major demands in terms of density, but he intended to achieve a restoration of the vertex region, which represented a major problem for him in terms of safety in social relationships. The patient’s objectives were realistic and sized in projection of achievable results; for this reason he fully trusted Dr. Cirabisi’s criteria in terms of surgical planning and after accepting the re-population project, the date was set for the intervention, which was performed on an outpatient basis, under local anesthesia and conscious sedation thanks to the presence of the anesthesiologist in the team.

DESCRIPTION OF THE RESULT OBTAINED: The postoperative evolution of the patient was more than optimal, with minimal appearance of the classic post-transplant symptoms (slight swelling in the donor area and absence of frontal edema), all documented by controls at 7, 14 and 30 days after the operation and subsequently at 6 and 12 months, during which he did not complain of any problem related to the postoperative evolution, which shows how excellent and rapid was the recovery and the reestablishment of the physiological state of the donor area. The scabs fell off within 15 days (by the seventh day after the operation they had completely disappeared) and hair regrowth in the operated areas was regular and constant, without the patient noticing any hair loss during the first months. By the fifth month after the operation, the patient was already showing more than satisfactory hair coverage, proof of which was his high degree of satisfaction 6 months after the operation.

At the final check up, 12 months after the procedure, the patient confirmed his enthusiasm and joy at being completely covered in the vertex region and his full satisfaction (mixed with amazement) with his new hairline which, as he himself stated: “is better than I imagined”.

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SURGERY

AT 1 YEAR