Dr. Thomas Nakatsui

Hi Everyone, This is a 11 month follow-up from a FUT surgery where the patient wanted to lower his hairline and fill in some of the balded area behind the mid scalp. We decided to lower his hairline and fill in his temple points slightly to make it look balanced. He also had some balding in the lateral humps behind the mid scalp where he had maintained hair. If we left this and only did his hairline, this would have started to leave the pattern unbalanced. We therefore filled the lateral humps with with single hairs to give him coverage in this area to make it blend with the surrounding hair. There is also a photo of the stripline scar. While not invisible, it is still thin and for a patient who does not plan to ever cut his hair short, this works very well. We transplanted 942 single grafts, 1107 double grafts, and 219 three hair grafts, for a total count of 2268 grafts. He naturally had a lot of single hair follicular units, which is not usually ideal as it provides less density per follicular unit. In this case, it worked well for us as we didn't need high density in the lateral humps. He may eventually want to thicken the hair that he has between the areas we transplanted but this works very well for him and he is very happy with the results so far. Dr. Nakatsui https://drnakatsui.com

This is a follow up to a thread I posted last November 2019. Prior to seeing me, he had received a transplant from another clinic several years ago who told the patient he had received 2500 grafts. Last year, we transplanted 697 single grafts, 1332 double grafts, and 281 three hair grafts, for a total count of 2309 grafts to fill in the previously transplanted areas. We transplanted the frontal scalp for him last year, although we chose to not put any grafts into his frontal forelock at the time as he needed the grafts more urgently elsewhere. [url=https://flic.kr/p/2jMU5Pq][img]https://live.staticflickr.com/65535/50402518718_d23483109f_k.jpg[/img][/url][url=https://flic.kr/p/2jMU5Pq]11[/url] by [url=https://www.flickr.com/photos/28308587@N07/]t_nakatsui[/url], on Flickr

Thanks to everyone who commented on this patient's FUE results!! Dr. Nakatsui

As there seemed to be a lot of interest with the last patient I posted, I thought I would put up another temple fill-in. This is a patient who came in two weeks ago to my office for follow-up. When he first came to us about two years ago, he really didn't like the deep recession of his temples. He didn't want to lower his hairline but he did want to fill in the balded temple areas that he really didn't like having exposed. We transplanted 361 single grafts, 629 double grafts, and 110 three hair grafts, for a total of 1100 grafts. He is very happy with the improvement. Dr. Nakatsui https://drnakatsui.com

This is a patient who came in for follow-up for an FUE procedure back in 2018. He had wanted to fill in his temples. We transplanted 67 single grafts, 489 double grafts, and 160 big grafts, for a total count of 716 grafts. He is very happy with the improvement to this temples and cannot detect any of the FUE extraction sites. Dr. Nakatsui https://drnakatsui.com

This is a patient who first came to see me in 2015 and who wanted to thicken up his frontal scalp. He was very happy with his results but over the next four years felt that his hair was continuing to thin, particularly in the mid scalp area and in 2019, we did a smaller procedure to fill in the mid scalp. In 2016, he received 784 single grafts, 1183 double grafts, and 324 three-hair grafts, for a total count of 2291 grafts to the frontal scalp via FUT. In 2019, he received 652 single grafts, 845 double grafts, and 117 three hair grafts, for a total count of 1618 grafts to the mid scalp via FUT. The post op photos were taken one year after the second surgery to the mid scalp. He is very happy with the increased density of the transplanted areas. The pre op photos are from 2015 and the post op photos are from 2020. Dr. Nakatsui https://drnakatsui.com

This is a patient who came in recently and had previously received a hair transplant to his hairline years ago. Since that time, he experienced thinning of the area behind the transplant, as well as lateral to the transplant, and in the vertex. He wanted to thick up these areas again so we transplanted these areas last year. We used 737 single grafts, 1843 double grafts, and 933 three hair grafts, for a total count of 3513 grafts. The patient is about 11 months out and is very happy with the results so far. Dr. Nakatsui https://drnakatsui.com

This is a patient who wanted his frontal scalp to look thicker and wanted his hairline to be lowered. He wanted to maintain a natural look but didn't want to use a lot of grafts. We only used 455 single grafts, 1090 two-hair grafts, and 705 three-hair grafts, for a total count of 2250 grafts to thicken up the frontal scalp. He came in about 11 months post op and he is very happy with the results. He is happy that it has changed his hairline and areas of significant thinning dramatically while still appearing very natural. In the after photos, he has a bit of product in his hair, obscuring the results a little bit as a result of the hair clumping together on the right side in particular. He may return in the future to thicken up his hair but he is very happy for the time being. Dr. Nakatsui https://drnakatsui.com BEFORE PHOTOS AFTER PHOTOS

Melvin and Mycroft, Thank you for your replies. I am also looking forward to the results. This was an FUT procedure and I believe it was a mini-micrograft procedure or multi-follicular graft procedure. Thanks again.

This is a patient who came in for his procedure recently. His story is interesting in that he had received one prior hair transplant procedure from another clinic about two years ago. He believes he was told he had received approximately 2500 grafts. Luckily, he had a photo of his recipient area following his first procedure so we could ascertain if this was possibly the case . Based on this photo, I think it more likely he received 2500 follicles/hairs as opposed to 2500 grafts as the density does not seem high enough to reconcile a 2500 graft count. I do encounter patients who were told they had received X number of grafts but actually received X number of hairs/follicles. As a result, I would always advise patients when they are consulting with a surgeon they may not be entirely familiar with to find out the type and number of grafts they are receiving and the projected number of hairs this might come out to. This would at least give the patient some idea of what they are going to be receiving. On the other hand, if you have researched the surgeon and are familiar with his or her work, then of course this would not be necessary. At this point, I only have photos of the immediate post-op from his first procedure and the post-op photos from his most recent procedure, as well as the results from his first procedure. I will add the results of his recent procedure in a year or so once the grafts have a chance to grow in. Dr. Nakatsui https://drnakatsui.com

This is a patient who came in a few weeks ago for follow-up He first came in about 5 years ago and wanted to fill in his frontal scalp. In the frontal scalp, we transplanted 684 single hair grafts, 1380 two-hair grafts, and 337 single hair grafts for a total of 2410 grafts. He is very happy with the results. Dr. Nakatsui https://drnakatsui.com

CosmoKramer and Melvin, Thank you for your comments! Dr. N

This is a patient who wanted to thicken up his frontal scalp as he felt that his hair was thinning out of control and his hairs were becoming so fine. We decided to transplant the frontal scalp and we used 2186 grafts consisting of 643 single hair grafts, 1176 two-hair grafts, and 367 three-hair grafts. His after photos were taken 13 months after his transplant. He came in a few weeks ago and is extremely happy with the thickening. Dr. Nakatsui https://drnakatsui.com

Melvin, thanks for the comments! Gasthoerer, thank you for your comments also. I see that I forgot to put the postop front view photo. I will attach the front view before and after here. Dr. Nakatsui https://drnakatsui.com

This is a patient who came in for follow-up a few weeks ago. One year ago, we did a FUE transplant to his temples. We transplanted 177 single grafts, 503 double grafts, and 153 3-hair grafts for a total of 833 grafts. The patient is very happy with his improvement. Of note, he had a strong cowlick on the right side that we had to follow in terms of hair direction. Dr. Nakatsui https://drnakatsui.com

Phi36fromaus, vinzaf19, Thanks for your comments! I really appreciate them. jj51702 and vinzaf19 both asked if the patient is on any other medications as well. I checked his chart and his is currently taking Propecia 1 mg daily. Thanks again for all the comments. Dr. Nakatsui https://drnakatsui.com https://nakatsuiderm.com

CosmoKramer, jj51702, paddyirishman, and forgotpassword, Thank you for your comments! I appreciate them. He is definitely happy with the rejuvenation of his hairline. Even though it is not a low hairline, it has turned the clock back considerably and sometimes that is exactly what the patient wants. As for what other treatments he is on, I will have to check his chart and get back to you. Thanks again for the comments. Dr, N https://drnakatsui.com https://nakatsuiderm.com

This patient came in recently for follow-up and he is now about 6 years out from his surgery. Just wanted to show how well transplants can be sustained over the years. He initially came in unhappy with the significant thinning he had experienced and wanted to rejuvenate his hair. He did not want a low hairline and wanted to keep some temple recession. However, he really wanted to thicken up the appearance of his frontal scalp. We used 566 single grafts, 1236 double grafts, and 918 three-hair grafts, for a total count of 2720 grafts. He is very happy with the results of his transplant. Dr. Nakatsui https://drnakatsui.com

This is a patient who came In a few weeks ago for follow-up. She had always felt self-conscious about her high hairline all her life and had really wanted to lower it. We transplanted 386 single grafts, 856 double-hair grafts, and 375 three-hair grafts for a total of 1617 grafts. We did this five years ago and she tells us this was an amazing transformation for her. She was extremely happy with the change. Dr, Nakatsui https://nakatsuiderm.com/treatments/hair-transplant-edmonton/ https://drnakatsui.com

This is a patient who we transplanted several years ago and came in recently for follow-up. We only transplanted the frontal scalp and transplanted 825 single grafts, 1611 double grafts, and 797 three-hair grafts, for a total count of 3233 grafts. He is very happy with the results. Dr. Nakatsui drnakatsui.com | nakatsuiderm.com

Thanks for the comment! Dr. N

This is a patient with very fine hair who wanted to restore his frontal hairline. As most of you will know, it is more difficult to generate a dense result in a patient with fine donor hair as the hair volume is so much less than in a patient with coarse hair. This patient underwent a strip procedure in 2016 and received 578 single grafts, 847 double grafts, and 393 three hair grafts, for a total count of 1818 grafts. His scarline is very thin. He is very happy with his results. Dr. N Nakatsui Hair Transplant Surgery

We see more and more women who are troubled by their androgenetic alopecia. This patient came in recently for follow-up and I have attached her pre-op and 1 year photos. She had thinning of frontal forelock area, as well as some thinning of the right temple. We did a small transplant of 1427 grafts (683 single hair grafts, 710 double hair grafts, and 34 three hair grafts). Dr. Nakatsui https://drnakatsui.com

Thanks for the great question. As you imply, there are many types of scarring alopecia, ranging from trauma to inflammatory processes such as lichen planopilaris, discoid lupus, and folliculitis decalvans. In this particular case, I do not recall the cause of the alopecia but I believe it was from trauma and therefore, I expect this result to be longstanding. The only problem that might arise would be if his other hair were to recede past the transplanted areas, then the transplanted areas would appear as islands of persistent hair. Over the years, I have transplanted various types of inflammatory scarring alopecias as well. In some cases, the results have been great with longstanding benefit. In some cases, there has been reignition of the inflammatory process with loss of some (but not all) of the transplanted hairs. In all cases, I wait until the disease is quiescent before even considering transplantation. Thanks for the great question! Dr. Nakatsui Nakatsui Hair Transplant Surgery

This is a patient who came in recently for follow-up. He had several small areas of scarring alopecia that he wanted to fill in and wanted to get FUE so that there would be no visible linear scar. We are often asked about the viability of grafts into scar tissue. In my experience, follicular unit grafts grow very well in scar tissue although I do wonder if the percentage of growth is sometimes less than in "virgin" scalp. This patient received 91 single grafts, 291 double grafts, and 25 three-hair grafts for a total of 407 FUE grafts. The areas of scarring alopecia are now undetectable and his donor area looks fantastic. Dr. Nakatsui https://drnakatsui.com