Results at 9 months and 14 months

1's 500
2's 1632
3's 853
4's 130
Total Grafts 3115 = 6843 Hairs

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I'm employed as the lead medical tech and surgical manager for the Shapiro Medical Group. Feel free to ask me any questions.

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Dr. Ron Shapiro and Dr. Paul Shapiro are members of the Coalition of Independent Hair Restoration Physicians.

janna...i like this result...looks like dr. shapiro used the patients thinning area as a template, which grown in has allowed him to maintain his current look with obviously a thicker healthier head of hair....did the patient request a particular hairline/design? he looks like a great candidate for medical therapy as well.....good stuff*

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Patient Services Director for True & Dorin Medical Group

Dr. True and Dr. Dorin are members of the Coalition of Independent Hair Restoration Physicians

This truly shows that after 9-months there is still maturation occurring with the newly transplanted hairs.

Very natural result...looks good!

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My initial HT thread:
done and done!! Check it out...

janna,a very pleasing result with relatively few grafts(considering the area covered)
i also like the fact along with orange, that the existing "template" of hair was used.
is he considering another to the crown/temple points?

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2381 fut Dr Bessam Farjo
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My Hair Loss Website - Hair Transplant with Dr. Bessam Farjo

challenge the unchallenged.

Echoing Eman, the change between 9 and 14 months is astounding. This shows a a lot of thickening and maturation.

Great work on this lad!

This patient is coming back for a second pass in a month or two.
I'd like to present a pic of his hairline, which we did not take so I'm keen to get more photos of his first result.

The patient came into it knowing he'll have 2 or 3 transplants.

Thank you all for your kind comments!

__________________
I'm employed as the lead medical tech and surgical manager for the Shapiro Medical Group. Feel free to ask me any questions.

YouTube: Shapiro Medical Group's Videos

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Dr. Ron Shapiro and Dr. Paul Shapiro are members of the Coalition of Independent Hair Restoration Physicians.

Janna,
Looks great so far.

Mick

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Patient coordinator for Drs. Bessam and Nilofer of the Farjo Clinic in England

I dont think hell need 3 because the growth looks excellent.
One for the crown with the rest spread out could do it for him
Nice job

It sure is reassuring that the clinic did in fact give the patient the heads up though. [on future surguries] Aleast he know's what to expect from his surgery...

Orange hair and balody

One thing Janna did not mention in her post is the patient's age. He is 28 now and was 27 at the time of surgery.
Looking at his pre-surgery balding pattern, one notices that he is Norwood type 5- 6 with diffuse thinning on top. At his age it is quite possible he can become a type 7 and he is surely on the road to becoming a complete type 6. Medical treatment with propecia and rogaine, hopefully will slow his thinning. Even if the medications do help, over time the medications will lose their efficacy and balding will progress.
When I see a patient like this one, I design my pattern as if he will become a type 7. I also believe that a megasession of 3,000 to 3,500 is the maximum case one should do as a first case in this type of patient. A lot of patients with extensive hair loss before age 30 do not have great donor supply. I estimate that if this patient becomes a type 7 his donor supply may be limited to only 6,000 or 7,000 FU. After educating the patient about his situation, we decided it was best to use the 3,000 to 3,5000 FU to cover the front 2/3 of his scalp, see how it looks. Then he would decide if he wanted a second transplant to cover the crown and/or create more density if needed in the transplanted area.
I did not do any temporal work because he already has a temporal point, be it a weak one, and he may lose that point completely. Temporal point recession is classified as N = Normal, T = Thinning, P = Parallel to Anterior Sideburn Line, or R = Reversal of the Temporal Angle. See photo below. http://i288.photobucket.com/al...s/Classification.jpg
Since this patient has a weak temporal point I believe it is important to wait and see what happens to his temporal points over time. I have drawn in a line for where he is now, a line for where he would be if he has Class P temporal recession (the yellow line) and where he would be if he has Class R temporal recession (the red line). See diagram below: http://i288.photobucket.com/al...l%20Peaks/Slide3.jpg
It would be risky to build up his temporal point at this time. If he becomes a type R then we are committed to filling in the whole temporal area and there may not be enough donor left to do that. Thus we may paint ourselves into a corner and may even have to remove some of the hair that we transplanted.
Another point about the limited donor to remember is that if he does become a type R, then any of the hair in front of the Red line is not safe donor hair. That hair will fall out no matter where it is on the scalp. You can see how this limits the safe donor area.
This is just another example of how it is very important to take into consideration possible future hair loss in a young patient.
I hope this answers your questions about how I decided on the area to be transplanted, and why I did not transplant into the temporal point.
Dr. Paul Shapiro.
Shapiro Medical Group