https://www.hairtx.com
Dallas Hair Transplant Surgeon, Dr. Sam Lam, creates this SlideShare on hair transplant recipient-site design and distribution. Recipient sites are the small slits into which hair grafts are inserted. Recipient-site design is fundamental to create natural-appearing hairlines along with other regions of the scalp. In addition, prioritizing areas of the scalp with various recipient-site densities is important to optimally leverage finite grafts in each hair-transplant procedure.
5. However, bad hair transplants today
still exist…
This gentleman’s hairline looks wiry like pubic
hair from trauma, is too straight, and lacks visual
density. He is shown before and after our
hair-transplant correction.
6. This is another example of
a bad transplant we fixed.
Before the correction, you can see that the surgeon
used 3 to 4 hair grafts, which should never be done.
The grafts are also compressed and pitted. The
hairline is too straight and does not match the temples.
7. This is another terrible hair
transplant that we fixed.
These grafts are too large for the hairline and
too vertically positioned. The hairline is too
straight, and there is too much see-through. In
addition, the temples do not match the hairline.
8. Another principle is that a surgeon must
follow the classic Norwood pattern to
ensure a natural-appearing result.
9. Each region of the scalp has hairs
growing in different directions, and it is
vital to mimic how hair grows in each
section.
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10. These illustrations from Dr. Lam’s
textbook show how hairs grow
differently in various parts of the head.
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12. The natural hair angles change
from low to high to low, as seen
from the profile view.
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13. This shows that each recipient site
(which describes a site into which hair
grafts are placed) has a different angle
(front to back), direction (side to side),
and occasionally tilt (oblique angle).
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14. Dr. Lam designed this concept of the
"head like a box" to describe the scalp in
terms of vertical and horizontal planes to
teach students how to understand better
the regions of the scalp.
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16. This is an example of a
recipient-site pattern that
Dr. Lam records for every
hair transplant case. It
shows the creativity of
beautiful hair work. hairtx.com
17. This shows the interlocking and
forward-facing recipient sites for
a typical male hairline.
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18. This shows thethe gentle turning
of the recipient sites in the left
fronto-temporal angle
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19. This shows the pattern for a
clockwise whorl in the crown.
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20. This shows the recipient sites for
a female hairline with a cowlick.
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21. This shows the recipient sites for
a man with a gentle curve to the
right near and at the hairline
following the existing hair angles.
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22. This shows the recipient sites for
the left fronto-temporal angle
with a full temporal point
reconstruction.
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23. This shows the recipient
sites for a left sideburn
reconstruction from a
previous facelift.
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24. These are some needles used
for recipient-site creation
depending on the graft size.
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25. This shows a needle vs. a blade,
both used to make recipient sites.
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26. Recipient-Site Instruments
Size Comparison Chart
Instrument Size Hairs
21G needle 0.8 mm 1-Hair Grafts
20G needle 0.9 mm 1-Hair Grafts
19G needle 1.0 mm 2-Hair Grafts
SP 88 blade 1.0 mm 2-Hair Grafts
SP 89 blade 1.25 mm 3-Hair Grafts
18G needle 1.3 mm 3-Hair Grafts
SP 90 blade 1.5 mm 3-Hair Grafts
SM 61 blade 1.5 mm 3-Hair Grafts
SP 91 blade 2.0 mm 3-Hair Grafts
SM 62 blade 2.0 mm 3-Hair Grafts
27. Graft size must always first be
measured to verify the fit of
the depth and size of a needle
with a few test sites.
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28. DRAWN HAIRLINE
In the following slides, you will
see the sequential recipient-site
creation used to design a
natural-appearing hairline.
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42. A natural hairline must appear like
a coastline, relatively straight from
a distance but progressively less
straight the closer you look at it.
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43. LOW DENSITY MEDIUM DENSITY HIGH DENSITY
15-20 sites/cm2 20-30 sites/cm2 30-40 sites/cm2
Recipient-site density varies
depending on higher-priority and
lower-priority zones of the head,
as shown in the following slide.
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44. 1
1
2 2
34 4
This slide shows the priorities for
graft density with 1 being the most
important.
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45. The next slides show
various recipient-site
design patterns. hairtx.com
46. You can see how
artistic and different
a design can be. hairtx.com
49. Doing great hair transplant requires
technical left-brain thinking and
creative right brain thinking!
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Email info@hairtx.com or call 972-312-8188
Editor's Notes
How do we become passionate about something that my colleagues say is boring?
Two things: Knowledge/Experience Leads to Creativity
TALK ABOUT THE SAN DIEGO CASE.
Example is understanding how hair grows in various regions of the head. This is important when designing a head.
They grow differently. I encourage you to look at person who is not balding but has closely cropped hair. Maybe you can come and look at my head afterward to see how hair grows at different angles on the head. It is important to match these angles as part of the creative exercise when making recipient sites.
I always draw for my staff and record my pattern based on a patient’s hair loss needs.
Here is an example of these recipient sites of a male hairline.
Here are the angles required for the frontotemporal angle.
This is a crown design
This is a female hairline design. We will talk more about these patterns in a moment.
I have followed the miniaturized hairs and the hair is whorling all the way to the hairline
Sagittal plus temporal points
Follow Norwood Pattern
Don’t be too front heavy
Divide lines into quadrants and halves
Leave some so that you can go back and tighten. There are always holes.
Practice on a melon
