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fannullone83.
User deleted
Ciao a tutti.
Volevo sapere qualè la massima altezza di una strip? Sapevo 1,5 cm, ma io provando a pizzicare i lembi dello scalpo, riesco e sentire le unghia a 2cm di distanza. Vuol dire che potrei anche avere una strip da 2cm?? Io andrò da tesauro a breve. Per caso sapere se può fare strip di tale misura, o nn supera 1,5 cm? Grazie. -
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In caso di ottima lassità la losanga prelevata può essere anche più alta di 2 cm in alcun punti il chirurgo dovrà essere bravo a variare l'altezza per mantenere a "tensione zero" i due lembi da suturare. Nel mio caso per esempio il Dr.Wong ha rimosso una strip alta 2.1 cm grazie al fatto che mi ero ammazzato di esercizi per la lassità per rimuovere l'italica mostruosa cicatrice.
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fannullone83.
User deleted
quando sono andato a fare la visita pre-operazione, mi ha detto tesauro che ho una buona elasticità..
non so cosa vorrà dire..
ma il mio calcolo "artigianale" può aver senso??
oppure non è minimamente logico..?
ovviamente devo spingere un pochino, però ci passano due dita tra i due estremi che riesco a comprimere con le unghia..
non è che riesco a pizzicare tranquillmanete.. devo premere un pò dal basso e dall'alto per far formare la "cumetta"..
tu cosa dici? riuscivi a prendere il pezzetto senza problemi con due sole dita, o ti aiutavi anche tu premendo un pò con due mani prima??. -
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Dalla descrizione che hai fatto sembri avere una buona elasticità di base che puoi incrementare con gli appositi esercizi;
https://bellicapelli.forumfree.it/?t=37382873. -
Gianluke.
User deleted
Vedendo questo video mi è venuta la paura di avere una scarsa lassità dello scalpo. Quello che si vede nel video non riesco minimamente a farlo. Come posso verificare con certezza la lassità attuale? Non vorrei arrivare a una strip e non poter prendere più di 2500-3000 uf e rimanere fregato !!
www.youtube.com/watch?v=hl5R_WhNCyc&feature=related. -
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Beh il soggetto ha una lassità molto alta di norma se riesci già a pizzicare un po di pelle è un buon segnale . -
Gianluke.
User deleted
Come avevo già detto ai lati di più, al centro pochissimo. Ma più che altro vedo che un soggetto tipo quello della foto ha molto grasso sottocutaneo, come se avesse diciamo parecchia carne tra la pelle e le ossa del cranio. A me la pelle pare veramente attaccata alle ossa. . -
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Ma la conformazione del cranio può influire sull elasticità del cuio capelluto? Per esempio se si ha un cranio leggermente piu curvo nella parte inferiore . -
Gianluke.
User deleted
Visto che la cosa pare interessare qualcun altro...segnalo degli articoli che mi ha dato il dott. Tesauro, il quale mi ha rassicurato sul mio prelievo trattandosi di uno scalpo vergine e molto denso.
Interessante la differenziazione fatta tra Lassità ed elasticità.
SCALP LAXITY
Scalp "laxity" and elasticity are not synonymous although these terms are frequently misused in that fashion. Gerard Seery has described, "scalp laxity" as being composed of two distinct components. His description of these and their implications are worthwhile quoting:
"The first component of scalp laxity is the ability of the scalp to slide or glide on the underlying pericranium. This is possible because the loose fibroareolar tissue in the subgaleal compartment allows the scalp to be moved on the cranium. This has nothing to do with the stretching or the elastin content of the skin and is simply a mechanical movement of the scalp on the pericranium. In a scalp with a high capacity to slide/glide, an excision of 4 cm or more (if made parallel to Langer’s lines) may be possible and closure easily effected. Operations that take advantage of the scalp’s capacity to glide, rather than stretch, are virtually complication-free and result in negligible topographical distortion of tissues. (The analogy of pulling a carpet over a polished floor comes to mind. The carpet and the furniture are moved but their topographical relationships to each other are not changed nor are the physical components of the carpet altered). Scalp surgery that utilizes the scalps facility to glide is highly effective and minimally traumatic to tissues. The relatively restricted width of donor strip excision in the temporal area is the result of the lateral extremity of the subgaleal space not extending that far laterally i.e. the galea blends with the temporalis fascia and results in only three layers of tissue being present in the temporal area.
The second property of scalp laxity is its extensibility or ability to stretch. It is reiterated that this is independent of the sliding phenomena. Some scalps are highly elasticized and reasonably wide strips can be removed by undermining and stretching but this is relatively much more detrimental to tissue viability, and often the formation of fine scars, than sliding.
The net consequence of the above is that notably wider horizontal strips can be taken from the superior donor area (because the subgaleal fibroareolar layer allows the gliding described above) than in the lower area. As much as a 2 cm width or more may be taken in the higher regions of the occipital scalp and closure effected without difficulty. In the inferior donor area, where there is no subgaleal fibroareolar layer, the width of the strip taken is determined by the skin extensibility (loosely termed elasticity) and subcutaneous tissue. Here a horizontal strip as narrow as 1 cm may result in difficulty with closure. It must also be remembered that some scalps have relatively poorly developed fibroareolar layers i.e. are "tight scalps" in which the gliding phenomenon is minimal. This is easily determined by simply placing the pulps of the examining fingers on the scalp and moving them on the underlying pericranium. The orientation of the lines of minimum tension (Langer’s lines) also play a part in determining the width of the strip that can be taken.*
At the midscalp, crown and going down into the scalp’s upper donor area, Langer’s lines are largely vertical and allow generous excision of tissue taken in a vertical axis. Conversely, there is an associated relative limitation in excision widths in the horizontal axis (because here Langer’s lines proceed are cross-cut), but this is more than compensated by the tissue laxity provided by the fibroareolar layer in the upper donor region. As Langer’s lines proceed inferiorly into the mid donor area, they increasingly assume a too horizontal orientation and in the inferior part of the donor area are entirely horizontal. This facilitates a relatively wider donor strip excision in the inferior donor area than would otherwise be the case but this does not nearly compensate for the absence of the "gliding" subgaleal fibroareolar layer present in the upper donor area.
Bosley outlined a method of objectively assessing scalp laxity for AR. He quantified the decrease in distance between two dots on either side of the alopecic area following manual compression between both thumbs and index fingers. * Norwood proposed a somewhat similar means of evaluating scalp laxity. He counted the number of folds created on the alopecic scalp as a result of manually compressing the temporal regions of the scalp toward one another*.
Scalp laxity of the donor area, unfortunately, still remains entirely subjective. One can estimate scalp laxity at that site by manually compressing two anatomically different regions toward one another, or the skin can be moved up and down to get a sense of laxity, but a standard and objective method of assessing laxity in the donor area is still required. Until one has evolved, we can, at least, suggest grading scalp laxity as "tight, moderately tight, slightly tight, average, slightly loose, moderately loose, or loose".
In general, a tight scalp requires a longer, narrower incision to move a given amount of hair than a loose one because the donor wound should ideally be closed with minimum tension. Limitations in the width of donor area excisions are reduced further with multiple excisions in the same donor region as part of subsequent sessions (see below). Failure to recognize a tighter than average scalp may compromise the surgeon’s ability to close the donor area without significant tension. If the excision width exceeds the combined laxity and elasticity of the donor region, it may even be impossible to approximate the margins of the wound. Such instances may require undermining of one or both wound flaps and/or the use of mechanical creep by approximating the wound edges as closely as possible with towel clips or staples, for 30 to 60 minutes or longer, before attempting final closure. In the worst scenario, even with undermining and the use of mechanical creep, it may not be possible to approximate the margins with reasonable tension. Galeal sutures or "deep plane fixation" described by Seery, at the end of this chapter, should then be used. If necessary, the edges must be left with a slight gap at one or more points along the course of the wound closure. The gap(s) will fill in by secondary intention and the resulting scar(s) may be cosmetically improved at a later time. It is, of course, wise to err on the side of a conservative assessment of what is a reasonable maximum width for the donor strip and to avoid such situations.
It follows from the preceding, that a tight donor scalp limits the amount of donor area, which may safely be moved to the recipient region during each session. In a patient with a greater degree of hair loss, it may not be possible to achieve the coverage both the patient and physician desire or it may require unacceptable numbers of sessions. In patients with more severe degrees of MPB, it may be possible to produce the coverage objectives, but not without multiple smaller than usual sessions. Thus, it is imperative that the patient and physician understand the consequences of limited scalp laxity prior to beginning hair restoration surgery, in order to prevent unrealistic expectations. Scalp laxity nearly always varies from area to area, and frequently is greater on one side of the head than the other. Thus, the maximum width of any donor strip can be greater or smaller at various points along its length. Most commonly, from a scalp laxity point of view, it can be wider in the temporal and occipital areas. However, because the "permanent" donor hair zone in the occipital and temporal areas are not as wide as in the parietal area (Fig. #10), you may not want to excise maximum widths at those sites, despite adequate laxity to do so. One of the disadvantages of the elliptical donor strips used by many hair replacement surgeons is that it is typically widest in the occipital area, where the "permanent" rim hair is approximately 10 mm narrower than in the parietal area. Most of the parietal area is usually lax enough for quite wide donor strips, however, the post-auricular areas nearly always are the least lax and donor strips should accordingly be narrowed – sometimes substantially – in that region. Taking into account both scalp laxity and the varying widths of the "safe donor area": a) if elliptical donor strips are employed, it would seem wisest to use ellipses whose widest points are in the mid-parietal region and narrow as they approach the post-auricular and occipital areas, with the tapered ends overlapping each other in the midline (Fig. #), b11) if the strip extends from ear to ear, a single bladed knife can be used to excise the strip in an undulating pattern that is wider at some points than others. Alternately, two-bladed knives of various widths (according to scalp laxity) can be used along the length of the donor area, with gaps of intact skin between them. The gaps can then be incised with a single-bladed knife to join the sections (Fig. #12). This approach is discussed later in the chapter.
Inoltre qui, per la valutazione del prelievo
http://ushairrestoration.com/laxometer-str...transplants.php.
Massima altezza x striscia strip |
