This nice fellow is about 9months out from a plug repair procedure. He had had 6 plug and minigraft procedures by relatively well known doctors a few years back and had been turned down for repair due to the significant scarring in his limited donor region.

We planned a 1500 graft attempt, but were fortunate enough to be able to harvest 2100 grafts using a long strip, followed by tension free closure.

As usual in these cases, the staff worked very hard to get good grafts using microscopic dissection, and it paid off.

Dr. Lindsey McLean VA

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William H. Lindsey, MD, FACS
McLean, VA

Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians

This nice fellow is about 9months out from a plug repair procedure. He had had 6 plug and minigraft procedures by relatively well known doctors a few years back and had been turned down for repair due to the significant scarring in his limited donor region.

We planned a 1500 graft attempt, but were fortunate enough to be able to harvest 2100 grafts using a long strip, followed by tension free closure.

As usual in these cases, the staff worked very hard to get good grafts using microscopic dissection, and it paid off.

Dr. Lindsey McLean VA

__________________
William H. Lindsey, MD, FACS
McLean, VA

Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians

Looks great!

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100? 'mini' grapfts by Latham's Hair Clinic - 1991 (Removed 50 plugs by Cooley 3/08.)
2750 FU 3/20/08 by Dr. Cooley

My Hair Loss Website - Hair Transplant with Dr. Cooley

Current regimen:
1.66 mg Proscar M-W-F
Rogaine 5% Foam - every now and then
AndroGel - once daily
Lipitor - 5 mg every other day
Weightlifting - 2x per week
Jogging - 3x per week

It looks better.....but does this patient plan to fill in the rest? Does he even have enough donor to do so?

Cause i would rather shave my head bald than wear it like this. Guys gotta' know when to get over it and move on. A Tuft of hair in the front then completely bald behind looks way worse and more pathetic than any shaved head. Not trying to be a douchebag just my honest opinion

I figure he was probably more bothered by the corn rows in his hairline. Therefore, I'd disagree and would rather have what he got. If he'd never had the prior procedure, then yes I'd agree.

__________________
100? 'mini' grapfts by Latham's Hair Clinic - 1991 (Removed 50 plugs by Cooley 3/08.)
2750 FU 3/20/08 by Dr. Cooley

My Hair Loss Website - Hair Transplant with Dr. Cooley

Current regimen:
1.66 mg Proscar M-W-F
Rogaine 5% Foam - every now and then
AndroGel - once daily
Lipitor - 5 mg every other day
Weightlifting - 2x per week
Jogging - 3x per week

Not sure about this one, maybe this guy should have went with a complete reversal? He could have had the plugs removed and transplanted into his donor scars? With hair only on the frontal third, but nothing behind it, it looks a bit odd. IMHO, he'd look better completely bald on top.

I just read my post again and would really like to stress that i wasn't trying to be mean. If the guy's happier than he was good for him. That's a lot of money for still looking odd tho

Just watched my favorite show "plastic surgery:before and after" where a lady got her breasts completely redone and a tummy tuck for $15,000. Sucks that a lot of guys have to pay that just for a fistful of hair

vincehair,
I'm with you on this one. He is still a bald guy. As someone who is in a similar situation I can tell you that I'd much rather use 2100 grafts to get the sides and back filled in to make the size of the bald area smaller rather than spending all those grafts just in the front and still be the same bald man I was before.

I don't agree with most people who say the frontal third is more important because that's what people see. That's bull. Anyone who says that is just fooling themselves because THEY don't see it. Believe me the same people who see you from the front also see you from the back when they are behind you. You're not fooling them into thinking you're no longer bald.

Guys I am almost 100 % positive that Dr. Lindsey has a plan for this patient.

There are a couple of options on a patient such as this---
#1--go the FUE route to supply density behind the new hairline as far back as possible.

Patient accepts this, is very happy and leaves bald crown.

#2-- FUE/Strip out the rest of the donor, and in conjunction with a hair-piece-- cover his crown.

In either case, he will have a natural hairline to work from--something a hair-piece will not give him.

Another point to consider is that Dr. Lindsey mentioned donor scarring--the patient might be unable to shave down and just removing the old work was not enough.

There are a couple of ways to approach this type of patient but it takes time---Dr. Lindsey is just showing a very difficult patient and the approach.

I am sure he will let us know his long-term treatment plan at some point.

Cheers,
Jason

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Go Cubs!

6721 transplanted grafts
13,906 hairs
Performed by Dr. Ron Shapiro

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

A couple of comments:

1. This fellow is REALLY happy. He went from having poor self-esteem and constant worry about his plugginess, which caused him to wear a hairpiece, to now being able to look folks in the eye and feel confident! He sometimes still wears a piece on the crown, but doesn't have to, and tells me he likes that his scalp can "breathe again".

2. We might be able to get another 1500 grafts out next year, and if we do, we will work our way back and pics will follow.

3. This man is pretty tall. I tell alot of tall guys, who don't have a ton of donor hair, that they should get a hairline first. The WORST mistake, and I have seen this alot from chain hair centers, is that you take a class 6 and put a couple of thousand very thin hair grafts all over the scalp. You wind up with a financially and donor graft poor guy who looks like he grabbed something electric and his thin hair is standing straight up. That is FAR worse than being pluggy, and way far worse than having a good hairline, but being bald in the crown and posterior half of the frontal region. Unless this guy is in church in front of you, or on an overhead surveillence camera, most passersby won't notice that he has as much scalp visible as he does, ....and we may be able to help that, or he can continue to wear a crown piece.

4. I disagree with the plug excision mentioned above. Having done scalp reductions in my fellowship in 1995 (only), having done lots of forehead lifts, and having excised literally more than 600 scalp cysts referred by the local dermatologists--I can speak with some expertise on the stretchability of the scalp. It doesn't stretch much. Once you move from the very stretchable forehead, which is quite forgiving scar-wise, and move onto the previously hair covered areas, the scalp gets tight and scars get worse. See many of my scar posts on this site.

Now that leaves you the option of excising lots of plug scars at once and getting lots of fair to bad scars, or excising a couple at a time, and waiting 6 months for "stress-relaxation and skin-creep" issues to resolve and then doing a few more. An excellent way for the doctor to pay for the new yacht...but I don't like boating, and that would take a long time. Thus, I like to camouflage plugs if possible and rarely, will I excise old plugs. It might work for other docs, but it doesn't work so well for me.

5. Lastly, as long as the patient is happy, I will be at least mostly happy, and in his case; both of us are happy.

6. I appreciate all of your comments and allowing me to explain my philosophy. Whether you agree or disagree, at least you know where I stand.

Thanks

William H Lindsey MD McLean VA

__________________
William H. Lindsey, MD, FACS
McLean, VA

Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians