you have noticed that this patient is a class 6 in the Norwood scale , moving naturally to a class 7.In those cases, we always advise patients to focus their work in FRONT AND TOP and to avoid the crown because with the natural or existing donor supply it is impossible to finish all the work(I mean to give them a full coverage from front to back).
Saying that, we encourages patient to start with a procedure of 2500 to 3500 grafts in frontal zone because usually that is the more expose area when you meet somebody.After 1 year,we will go back with around 2000 grafts to increase the density.Then we will start to think to give them at least a thin look in the crown with fewer grafts (depending on the availability of the donor supply).
Body hairs have been used to increased the density in the crown or somewhere else if we are out of donor supply.Body hairs grows but we are still waiting on news data to evaluate the yield,the behavior of bodyhairs characteristics,...Some theories suggest body hairs will acquire scalp hairs characteristics.We don't push people to use them in front or hair line until we will be sure about the outcomes.We are comfortable to use them in the crown and top to improve the density.
This patient wanted to reserve all his scalp donor for the frontal work.As we were discouraging to do any work in the crown (wisdom of donor supply preservation) and that all the study are talking about using body hairs in the crown,he choosed to start with those 2 plans.
Using scalps hairs for the front(saving donor supply) and body hairs in the crown (which is really what we will end up proposing in 2 years from now). I found myself that approach very interesting .We can assess the yield between scalp hairs and body hairs ,grafted in the same conditions,at the same time , and one beside the others.Good perspectives for the future.