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Old 04-04-2008, 06:14 PM
THINinHOUSTON's Avatar
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I have some hair in the front of my head and if I were to get some graphs in the front is it necessary to shave the area?

I see most photos with the recipient area shaved. But if I could keep the hair I can conceal the area.

Does shaving provide a better chance for survival? make it easier for the Dr. to operate?
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Old 04-04-2008, 06:14 PM
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I have some hair in the front of my head and if I were to get some graphs in the front is it necessary to shave the area?

I see most photos with the recipient area shaved. But if I could keep the hair I can conceal the area.

Does shaving provide a better chance for survival? make it easier for the Dr. to operate?
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Old 04-04-2008, 07:39 PM
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NO, some docs do and some don't.

In fact, there is an excellent debate between two doctors in a thread giving the pros of each side.

I'll summarize, but maybe someone can link it. Some Drs. think it's imperative to shave the recipient area as it makes the ht faster, therefore allowing them to get the donor hairs back into the head at a faster rate. Also, they believe it affects native hairs less.

The Dr. who doesn't shave believed there is minimal value in shaving it; and that value isn't worth the embarassment the patient would go through if he couldn't take the time off.

I brought it up to my doc, and he didn't suggest or require it so it's a personal choice I think as top docs are on both sides of this issue.
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Old 04-04-2008, 11:48 PM
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Many top clinics feel it beneficial - Think long term gain for short term inconvenience.
IMO the Doc's wouldn't do it if they didn't feel there were definite benefits. They do not want to inconvenience you - only want you to have the BEST result possible

Post by Dr Hassan on the subject:
---------------
There are multiple technical factors that come into play during the creation of recipient sites and the subsequent graft placement. These include:

1.) When thinning areas are shaved down the "thinning process" takes on a different meaning. With the use of magnification it will be seen that some follicular bundles are absent (and there are wider spaces between remaining bundles) and that some bundles are significantly miniaturized. It will then be possible to place new recipient sites in the place of absent bundles and alongside miniaturized bundles to recreate the density. This can also be done in a uniform manner so that if the pre-existing hair eventually disappears, due to progression of hairloss, the transplant can still look reasonably natural. If the recipient site is not shaved the surgeon must part through the hair again and again looking for any empty spaces and trying to fill the spaces as best as possible. This is not really as exact a process but much more hit or miss.

2.) The hair exits the scalp at an exact angle. The only way to precisely match that angle is to buzz the recipient hair down (in a way similar to how ALL doctors need to shave the donor hair when taking out the donor strip).

3.) Transection of existing hair below the skin surface is possible if the incisions are not made exactly parallel to the surrounding bundles. We often see this as a "halo" type effect when performing repair procedures.

4.) When inserting grafts the technicians can easily identify the recipient sites and ensure that all sites are filled. This can be achieved with no trauma to the pre-existing hair.

5.) When hair is buzzed no manipulation of the pre-existing hair is required at all. When the hair is not shaved it needs to be combed through (hundreds of times) by the physician who makes the recipients sites and again by the technician who places the grafts into the sites. This repetitive trauma of combing through the hair again and again will result in "hair shock", a shedding of the existing hair. When this hair falls out in 2 to 3 weeks there will be a 2 to 3 month wait before it returns. Whereas if the hair were buzzed it would grow from day one 1 and keep growing. A number 3 buzz cut often will look good at 10 to 14 days post operatively and blend in with the recipient site well.

All these factors are relatively unimportant if you are trying to place to 2 or 3 hundred grafts into recipient sites however if you wish to have the utmost of refined results the difference is night and day.

-----------------
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Old 04-05-2008, 02:24 AM
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Houston,

The subject of shaving can and will go on for ever.

Take a look at the results of Dr.Shapiro for example.(By the way he's not the Doc I used).
He IS one of the top docs.
His work is showcased on the forum on a daily basis.
His results are top notch...I'm sure everyone would agree.
He doesn't require shaving.

Everyone has an opinion...even the docs.

Do your homework...and after that...do your homework.


MH
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Old 04-05-2008, 02:42 AM
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When i had my HT i wasnt required to shave. 2 days after the surgery i started shedding like crazy. I decided to shave down to a #1 and the shock loss completly stopped. it seems like a stick for a lack of a better word. the longer the stick the easier it is to break, but the shorter it is the stronger it is. hope the analogy works for you guys. LOL
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Old 04-05-2008, 04:04 AM
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I can only agree 100% with spex.
Patient pay a lot of money for a lifelong result. They want the best possible result and by shaving the recipient area they give the doc and his team the best possible field of view.

Shave it !
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Old 04-05-2008, 07:11 AM
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Just to add to the discussion....

Though I feel that shaving the recipient area creates an optimal work environment for the physician, in my opinion, it isn't always necessary.

Where shaving appears to be most helpful is when hair is being transplanted in between and around a lot of existing native hair. Around sparse native hair, shaving is most likely not going to be as much of an issue.

The type of recipient incision made also may be a factor here. Whereas cases can be made for both perpendicular (coronal/lateral) and paralel (sagital) incisions depending on the patient, I have heard many physicians argue that sagital incisions do a much better job of sliding in and around existing hairs to avoid transection then coronals do. This certainly makes a strong case for physicians who do not require shaving of the recipient area.

At the same time however, those who don't typically require shaving admit that surgery can take much longer when transplanting in between and around existing native hair which could then potentially make larger hair transplant megasessions exceeding 4000 grafts near impossible to perform in a single day.

Bill
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Old 04-05-2008, 03:22 PM
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thanks for all the advice. After reading some articles I think I will shave it to about an inch. Should make it easy for the surgeon because you dont have to "comb" it out of the way and the doc can see the angles.
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