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Old 08-06-2010, 10:26 PM
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Default 12 months - 2,348 grafts - Dr. Paul Shapiro

It has been almost 12 months since I’ve had my transplant of 2,348 grafts/4,258 hairs with Dr. Paul Shapiro at SMG. This procedure was somewhat of a repair job as I had a below average transplant one year prior and was left with cobblestone-like bumps and 2/3 haired grafts in the hairline. It was only passable when I caked on the dermmatch and combed my hair forward to cover the hairline. Fortunately, constructing hairlines with concealers is a thing of the past as I am very pleased with the results. I’ll will attempt to describe my situation in detail.

Hairline
My hairline is far more natural now. As you can see in the immediate post-ops, Dr. Paul punched out a few 2/3 haired grafts from my hairline. Now I only have 1 hair grafts in the hairline which gives it a much softer appearance. The new hairs from this transplant do not have the bumps (cobblestoning, pitting, hyperactive oil glands?) that I got with my previous surgeon. The hairs exiting the scalp look very natural. SMG is well known for their hairline work and I can see why.

Density
The density is much improved overall as you can clearly see from my top down shots. I do not have to apply any concealers in the frontal third anymore, which is a HUGE relief. Once in awhile I’ll dab some Nanogen in the front but only for important occasions (weddings, nights out, etc). The appearance of density depends a bit on lighting. The comments I’ve gotten range from “you have a full head of hair” to “your hair looks a little thin”. Funny thing is they are both kind of right! I still keep out an eye for fluorescent lights and the sun on a clear day. My frontal tuft holds up very well in extreme lighting but the temples not as much. This will be addressed in my next surgery.

Donor
With my first procedure by another surgeon, the donor was taken pretty high, probably outside the safe zone. Dr. Paul took a much lower strip out for my second procedure. It has healed to my liking. I could shave down to a 5 guard and no one would notice it. Dr. Paul feels that the scar is a little too wide and he was a perplexed as my trichophytic closure was normal. I did fight off an infection in the first couple weeks of recovery but this could just boil down my physiology. I still have scars from hernia surgeries I had from years ago (10 years and 20 years), so I just might be the scarring type. Either way, the donor scar doesn’t bother me now one bit and doesn’t really affect the way I cut my hair.

Future
Dr. Paul and I discussed the strategy for my next procedure in June 2011. He will aim for 2,000 grafts, transplanting the temple region going behind the frontal tuft (sort of a U shape), and also the crown. I do use a lot of dermmatch and nanogen for the crown right now and it is somewhat of a flat spot.

Dr. Paul said I have approximately 4,000 grafts left for strip procedures and that I still have good donor laxity. We might do a double-layer closure next time around instead of a trichophytic closure to see if it heals better. Unfortunately, my scar situation is a little complex because of my poor first procedure. We could try to take out one of my scars with the next procedure but then my graft total would be limited. Janna did mention that we could shoot for a larger graft total and then do a scar revision if I need it down the road.

With all of the knowns and unknowns of hair transplantation, it sure is a good feeling to be connected with a clinic that I completely trust. They are straight shooters at SMG and that’s why I appreciate them. Of course, great results don’t hurt either.
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Last edited by aaron1234; 08-06-2010 at 10:43 PM.
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Old 08-07-2010, 12:03 AM
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Very nice results Dr. Paul Shapiro. This patients new hairline is natural and should still look appropriate as the patients ages. Two layer closures are often a good idea in patients who have had prior procedures. It does reduce the tension at the wound margins which can often be the cause of wider scars.
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Old 08-07-2010, 12:04 AM
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I think you have a great looking mature hairline and personally if I were you I'd wait probably 10 years and just consider doing the crown if you lost a lot more there. I wouldn't touch the top or front anymore, but that's just me.

The more I study people's blogs and the more I look at my own progress I think I'm coming to understand what transplanted hair looks like. It seems as though it's always going to be a bit see-through under different lighting conditions.
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Old 08-07-2010, 01:52 AM
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aaron1234,

Wow! I think your hair looks fantastic as is. Thanks for posting a detailed account of your excellent experience with world class hair restoration physician and Coalition member Dr. Paul Shapiro.

Best of luck!
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I am not a medical professional. All opinions are my own and my advice should not constitute as medical advice.

My hair restoration journey:

1833 grafts on April 26, 2010 by Dr. Scott Alexander - Follicular unit strip surgery (FUSS)
2516 grafts on January 2, 2009 by Dr. Scott Alexander - Follicular unit strip surgery (FUSS)

View my Hair Loss Website
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Old 08-07-2010, 10:28 AM
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Thanks Dr. Charles, Megatron, Plunge! I am indeed excited about where I sit now from one year ago.

Megatron, you are right about HT hair changing under different lighting. I have also noticed this with people's native hair as well. If you stuck a flashlight over a person with a full head of hair you would probably still see scalp. It really all depends on the texture of your hair. If you have thin and straight hair like me then harsh lighting will effect you more than if you have coarse and curly hair. It's just the nature of the business, everyone is different.

Plunge! Thanks co-moderator! Thanks to Dr. Paul and SMG my hair does look great as is! .... just one more...
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Old 08-07-2010, 12:42 PM
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You look great, aaron! Congratulations. You should be very pleased with that result. I know I would!
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Old 08-08-2010, 01:40 AM
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Quote:
Originally Posted by aaron1234 View Post
Megatron, you are right about HT hair changing under different lighting. I have also noticed this with people's native hair as well. If you stuck a flashlight over a person with a full head of hair you would probably still see scalp. It really all depends on the texture of your hair. If you have thin and straight hair like me then harsh lighting will effect you more than if you have coarse and curly hair. It's just the nature of the business, everyone is different.
ya, but I think there's a difference between HT hair and native hair in that the HT hair is uniformly thick, but not dense where as native hair is more dense and has a lot of miniturization. don't get me wrong, I still much prefer HT hair then no hair, but I don't think it can ever match the look of guys that are fortunate enough to not have the MPB gene.
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Old 08-12-2010, 07:05 AM
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looks great
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Old 08-22-2010, 05:19 PM
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Hey Aaron...glad to see your results my man!!! Wow you look great!! What a change right?

Anyway, hope things are going well...give me a ring anytime.

Jason
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Old 08-22-2010, 09:15 PM
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Thanks Jason! Hard to believe it's been a year, right? Huge difference. Dr. Paul really did well for me and I'm more than happy to go back next year. Really appreciate your help. Will talk soon.
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