nConclusion: Hair Transplant and Nanofat Procedure of Mr.

Zahid Iqbal was done and the

surgery was without any complications. Pt. already had vesiclopapular lesions in FUT area in
the pre-op assessment and were prescribed additional medications Due to many risk factors
(Old age, Diabetes, HTN & No dietary restriction) But due to non-compliance, what pt. is
experiencing sporadic discharge on pressure points containing pus mixed with blood from its
pre-existing vesiclopapular lesions that were clearly identified well before surgery.

Patient profile:
Mr Zahid Iqbal 62 years old male resident of sahiwal booked for hair transplant on 7-7-23 for
hybrid session 3000 including trichophytic closure and PRP with Dr Nasir. The patient was
diabetic and hypertensive. He was already taking tab. metformin 500mg 2 tablets twice a day,
tab AVSAR 10/160 mg once a day and tablet Biscard 5mg once a day.
Lab values:Pre-op assessment:
In his pre-op assessment, his hair were extra fine having thin texture, having reversing thinning,
alopecia spots and vesiclopapular lesions above the marked FUT area.The patient had
previous history of COVID twice and he got vaccinated. The surgery was performed on 24-7-23.
Surgery day: The patient was vitally stable, inj. Oxidil 500mg was given after test dose. Inj. B12
and D3 was given. On 9th day of suture removal, scar was health with no visible ooze, skin
colour changes and scar was healthy.

Follicular Unit Transplant (FUT):

1. Preparation: The patient's scalp was cleaned and sterilized. The 15cm central donor
area at the back of the head was marked and anesthetized to numb the area.

2. Donor Strip Removal: A thin 15 x 1.4 cm strip of scalp tissue was carefully removed
from marked the donor area using a scalpel. The incision was then closed with
trichophytic closure technique and removable sutures The removed strip was handed
over to the surgical team for dissection.

3. Dissection of Grafts The strip of donor tissue was dissected under a magnifier into
individual follicular units, each containing 1-4 hair follicles and 1320 grafts with couples
were obtained. These grafts were then categorized based on their size and quality.

4. Recipient Site Creation: Total 1750 sitings were done with 0.9 and 1 mm siting blades in
the recipient area (bald or thinning area).The angle and direction of the incisions were
crucial to ensure natural-looking hair growth.

5. Graft Placement: The individual follicular units were carefully inserted into the
recipient sites by the surgical team. The placement followed a specific pattern to mimic
the natural growth of hair.
6. Healing and Recovery: The surgical area was cleaned, and a bandage was applied.
The patient was given post-operative instructions with medicines prescription for care
and was allowed to go home on the same day.

Follicular Unit Extraction (FUE):

1. Preparation: The patient's scalp was cleaned, and the donor area was marked. Local
anesthesia was administered to numb the area.

2. Extraction of Follicular Units: Using a micro-punch tool, individual follicular units

were extracted one by one from the donor area. The surgeon made 500 small circular
incisions around each follicular unit, which was then carefully extracted.

3. Graft Collection and Sorting:The extracted grafts were handed over to the surgical
team for sorting and preparation. Technicians cleaned and prepared the grafts for
transplantation.

4. Graft Placement: The individual follicular units were delicately placed into the
recipient sites by the surgical team. The surgeon used forceps or specialized tools to
ensure precise placement.

5. Healing and Recovery: After the procedure, the patient's scalp was cleaned, and
small bandages or dressings were applied.

Nano-fat: After anesthesia of abdomen around umbilicus 80 ml fat was extracted

and converted to Nanofat and injected along PRP into the Scalp area.

Next day head wash was planned. On head wash, wound was healthy with no visible ooze
and scar colour changes & vesiclopapular lesions were noticed above FUT Scar area.
Polyfax ointment was applied with pain killer injection. The patient was told about sutures
removal on 9th day.

Suture removal day:

On 9th day of suture removal , scar was healthy with no visible ooze, skin colour changes &
vesiclopapular lesions were noticed above FUT Scar area and medications were prescribed,
sutures were removed.