Dr. Thomas Nakatsui

Blake, Thanks for the comments and sorry for the late reply. Dr N

David, Sorry for the late reply. As you can see, I am not the best at online participation as it takes me weeks (or months) to reply. As for ongoing medical therapy, I am not certain. He had been on Propecia in 2004 when we did the transplant, but I have never personally given him a prescription for it. At his recent visit, I unfortunately did not elicit this information from him. It is very possible that he continues to be on Propecia but if he returns any time soon, I will be sure to ask. Dr. N

This is a patient who had a transplant 7 years ago and he came in the other day to check out a few things. He is still extremely happy and I thought I would post some results from many years ago. In 2004, he received 549 single grafts, 1355 double grafts, and 874 big grafts, for a total count of 2778 grafts in one session. He tells me this is the best thing he could have done and he has absolutely no regrets. I have some posted some pre-op photos and some 7 year post op photos. Dr. N Dr Nakatsui -- Hair Transplant at the Groot DermaSurgery Centre in Edmonton

This is patient who wanted to lower his hairline and fill in the crown a bit. He had his transplant about 10 months ago and now returns as he wants to thicken up some areas behind the transplanted area. He is very pleased with his results 10 months out and his hair will continue to improve over the next 4 months. He received 537 single grafts, 1483 double grafts, and 585 big grafts, for a total count of 2569 grafts. Happy New Year! Dr. N PREOPERATIVE PHOTOS PLAN AND IMMEDIATE POST OP 10 MONTHS POST-OP

Just wanted to show a patient who came in yesterday 5 years after his transplant to the frontal hairline. The hair transplant is holding up very well but the rest of his hair is continuing to slowly thin behind it. At this point, it is not very noticeable unless viewed from the top under harsh lighting as in my office but if it progresses further, he will return for another surgery. Interestingly, the photo makes the hair loss behind the transplant look worse than it appears to the naked eye. He has not been on finasteride but has now decided to start it. I have included photos from 8 months post op for comparison as well. You can see in the top view that even at that time, there is some thinning behind the hairline under harsh lighting conditions. This case shows that the transplanted hair continues to grow well several years after the transplant but that continuing hair loss can mean another surgery down the road. Dr N PRE-OP IMMEDIATE POST OP 8 MONTHS POST OP 5 YEARS POST OP

This patient came in last week and it has been 3 years since his hair transplant. I thought I would post his results to show how the hair looks several years after transplant. I think the results are undetectable at the hairline even with close inspection. He received 1110 single grafts, 1254 double grafts, and 310 big grafts, for a total count of 2674 grafts to the frontal scalp. As usual, Asians tend to have a disproportionate amount of singles. Dr N

This is a man who had a hair transplant about 3 years ago and returned for follow-up last week. He had received 937 single grafts, 1565 double grafts, and 131 big grafts, for a total count of 2633 grafts to the frontal hairline. He is very happy with the results and I thought I would post his photographs. Dr N

This is a patient that was done in 2004. Unfortunately, at that time we were only using Polaroids (anyone remember those?) and I can only find one photo so far. I have asked my staff to look for his old chart that has been archived in the dungeon to look for the rest of the photos and I will post those when we find them. In any case, he received 1836 grafts done (532 single grafts, 786 two-hair grafts, and 518 three- and four-hair grafts). Although he has tinted his hair, it is in fact the same person. His vertex has thickened up nicely and I will look for the pre-op photos of the front. Dr N http://www.drnakatsui.com

This is a patient that was done in 2004. Unfortunately, at that time we were only using Polaroids (anyone remember those?) and I can only find one photo so far. I have asked my staff to look for his old chart that has been archived in the dungeon to look for the rest of the photos and I will post those when we find them. In any case, he received 1836 grafts done (532 single grafts, 786 two-hair grafts, and 518 three- and four-hair grafts). Although he has tinted his hair, it is in fact the same person. His vertex has thickened up nicely and I will look for the pre-op photos of the front. Dr N

I have never posted an eyebrow transplant before so I thought I would submit one as this woman returned to my office the other day and she was about 4 months out from her transplant. Prior to the transplant, she had very fine eyebrows and was interested in thickening them. I went through the risks of procedure, including the need for constant trimming of the hair and the increased coarseness of the transplanted hairs. I am always surprised at how many women are completely willing to undertake the constant maintenance this procedure entails. Not one complains about the maintenance--they are just so happy that their eyebrows are thicker. Personally, I have trouble watering the trees around my yard even once a week/month. In any case, she is about 4 months out and I would expect things to continue to improve. The blue markings in the pre-operative photos are just ink showing where we were going to insert the grafts. Dr Nakatsui

This is a man who is about 12 months out from his transplant. He wanted to fill in his temples and thicken the frontal forelock area. He didn't want a really low hairline but he did want a mature but relatively full look. He received 535 single grafts, 1105 double grafts, and 526 big grafts, for a total count of 2166 grafts. Dr N

This is a patient we did a few weeks ago. We decided to fill in the frontal 2/3 of the scalp for the time being. In the future, we may go back and fill the crown. We used 434 single grafts, 1811 double grafts, and 1089 three hair grafts, for a total count of 3334 grafts I usually embed my photos but this time I will attach the photos instead as this may make things easier for me. Thanks, Dr N

This is a man who had several prior transplants using minigrafts (multi-follicular unit grafts) and micrografts, but was not yet content with the result. He had a reasonably tight scalp but we were able to get 654 single grafts, 876 double grafts, and 503 big grafts, for a total count of 2043 grafts. It was difficult to completely disguise some of the larger multi-unit grafts near the hairline. Here are some before and after photos. Dr N

Dewayne, Future_HT_Doc, Thanks for the comments. I appreciate them. Dr N

This is a patient who wanted to thicken up his frontal hairline. We used 1658 grafts (337 single grafts, 728 double grafts, and 593 big grafts) These are his results after 8 months. He will probably thicken more with several more months of growth. I will try to get him in again in a few more months for final photographs. Thomas Nakatsui MD FRCPC

This is a patient who wanted to fill in his frontal scalp and temples, and thicken his vertex. We didn't touch the mid scalp. He stopped by recently and we took these photos. He received 703 single grafts, 1687 double grafts, and 810 big grafts, for a total count of 3200 grafts. As this is only 7 months out, this will continue to thicken over the next 5-7 months. He is very happy so far. Thomas Nakatsui, MD FRCPC

dakota3, orangehair, mick, Bill Thanks for the comments. The patient was definitely very pleased, especially when he saw the pre-operative photos. It had been two years since the surgery and he had completely forgotten how little hair he had prior to the surgery. I would say he was actually a little stunned to see the preoperative photos. Dr N

This is a patient who wanted to restore his crown to a natural appearance. Our goal was to generate moderate density in one transplant that was completely natural for his age and be essentially undetectable as a hair transplant. As many of you already know, the crown is one area where it is difficult to generate full thickness with one pass in individuals with no preexisting hair as all of the hair swirls away from the centre. There is thus little "shingling effect". Patients with coarse or wavy hair generally appear thicker. Combing long hair carefully so it shingles over can also generate a thicker appearance (which is often seen in some laser restoration after photos). This patient was actually quite amazed when he saw the pre-operative pictures as he had totally forgotten that he was virtually bald prior to the transplant. I don't have his graft counts in front of me, but he received over 2800 grafts to the crown. In one of the preop photos, you can see where I had mapped out his hair direction. Thomas Nakatsui MD FRCPC

This is a patient who wanted some thickening of his hairline and some filling of his temple points. About 9 months ago, he had a transplant consisting of 459 single grafts, 981 double grafts, and 334 big grafts, for a total count of 1774 grafts. These are his initial results. He is very happy with his results already and may consider lowering his hairline more. Thanks. Dr N

This patient wanted to thicken up his frontal scalp. We transplanted the front with 552 single grafts, 1067 double grafts, and 492 big grafts, for a total count of 2111 grafts. Here are his pre-op photos and 1 yr follow-up photos. Thomas Nakatsui, MD FRCPC

Bill, Thanks for the comments. He is very happy with the results and he tells me it looks even better when his hair is a bit shorter. Our plan is to now fill in the vertex at some point in the near future, so we will touch up the small area in the front at that time. I look forward to showing the after photos once everything has been completed. Dr N.

This was a patient who received 4312 grafts to the frontal 2/3 of his scalp about 1.5 years ago. I have attached photos from 5 months out and at the 1.5 yr point. He received 1349 single grafts, 2485 double grafts, and 478 big grafts, for a total count of 4312 grafts. He had great growth, except for one small area in the frontal scalp that didn't grow very well for some unknown reason. The area of involvement looks fine with no evidence of scar or inflammation. This will require no more than about 100 grafts, which we will fill in at no charge of course. He told me he has previously posted on here and I found his blog here: Patient blog For some reason, I cannot find his original photo files. Luckily, I had a few photos in backup, so here they are. Thomas Nakatsui MD FRCPC

This is a patient who wanted to lower and more importantly thicken his hairline and fill in his temples. You can see the plan of attack in the pre op photos where I have penned in the areas to be filled. We used 310 single grafts, 791 double grafts, and 547 big grafts, for a total count of 1648 grafts for his hairline. Thomas Nakatsui, MD FRCPC

Sorry for the late replies. As you may be able to tell, I only visit once in a blue moon. lost my swagger, Thanks for the comments, I will attach a photo of the immediate post op for you at the end of this reply. He is likely returning for another procedure. The number of grafts will depend upon his goals (e.g. thick vs. thin result). I would guess I would put another 1500-1800 grafts into the crown. TC17, Thanks for the positive comments. I do perform FUE for patients interested in this approach. Thomas Nakatsui, MD FRCPC immediate post op

This patient had extensive thinning and a very tight scalp. We decided to fill in the frontal 2/3 of the scalp and consider doing the back IF he had sufficient laxity in the future. We were able to get 2714 grafts from him although the closure was very tight. We were able to get 1015 single grafts, 1517 double grafts, and 283 big grafts. It was interesting that he had so few 3 and 4 hair grafts and so many singles, but we took what we could get. I have posted some before and after shots for you. Sorry his hair is so messy in the photos. Thomas Nakatsui