Dr. James DeYarman

I would appy the Rogaine before using a moisturing cream as it could prevent the absorption of Rogaine into the scalp.

In theory the scalp pores are opened up the most after a hot shower but you still have to massage the Rogaine into the scalp. I would still wipe off the excess Rogaine after the massage.

Rogaine is a scalp treatment not a hair treatment. Apply the Rogaine to the scalp and massage the product into the scalp. After massage take a towel and wipe off the Rogaine from your hair. Leaving the Rogaine on your hair can cause more damage to the hair as it has a lot of alcohol. I don't agree with the manufactor on leaving the product on the hair.

These after photos are at only 4 months. I wanted to show the results with PRP. I am amazed how much quicker patients grow in when given PRP at the time surgery. I also used Acell in the donor bed and was unable to show any scar with photo. I will continue to update his progress. He is very happy with the results.

This 46 year old man had one procedure of 3507 follicular units via strip method. He is on no meds and is very pleased with the result.

Thanks. His donor hair was very thick which gave him excellent coverage.

Matt

Thank you for the kind words. I will pass this on to the patient.

This 46 year man had one session of 3500 grafts from front to back. He got excellent results and is on no meds.

This is a 45 year old Asian male that had 4000 grafts transplanted in one session. These results are after two years. He is on only Rogaine and did not get PRP. Patient is very happy with the result.

This 45 year old man had 3523 follicular units transplanted in the front and crown. I have included a close-up of the hairline. The patient is very pleased with the result.

This 50 year old man had 4728 follicular units transplanted in one session. The donor site was closed with Acell in the donor bed. PRP was injected in the receptant area plus Acell in PPP into the receptant area. The patient got an excellent result and the after photos are at 8 months.

I inject the PRP after making the sites. I inject .1cc every centimeter intra-dermal. Following the injection I massage the area for at least 2 minutes. The process takes less than 5 minutes.

The principle makes sense as when the body heals it will increase platelets to the area of trauma. With PRP you are able to get an increase in platelets to the area which should aid in the healing process. I feel anything that will improve the outcome should be done and because there are no side effects then I feel you are helping the patient.

I have observed that all of my patients that are having a second procedure where they did not get PRP the first time claim they have a better post-op course and the redness seems to clear up faster. I have seen patients start to grow in the second month but I am careful not to tell this to the patient as they could be disappointed if they don’t.

These results are from one procedure. I have attached his post-op photos.

This 21 year old man was one of my first patients to get PRP with the transplants. We transplanted the front one third and I have included photos at 10 days, 3 months, and 11 months. Note how fast he healed and the amount of growth at 3 months. These are the benefits I am seeing with PRP.

This young man is in the military and requested full restoration from front too back. He was transplanted with 4996 follicular units placed in lateral slits. These photos are at one year after the transplant and the patient is very pleased with the result.

Future_HT_Doc

Thanks for the great questions.

First in requards to the staple over sutures. I have found that staples give a better scar. Sutures will strangulate hair folliciles and cause hair loss along the scar line. Staples are more uncomfortable for the patient but willl give the best result for the scar.

The second question was a good pick-up on your part in seeing the PPP instead of the PRP. When you create PRP the centrifudge goes through two speeds. The first cycle the blood cells are seperated from the Plasma and the second cycle the platelets are contrated in the plasma. When you draw off the plasma it is referred to as platelett poor plasma and has some platelets and grow factors in the plasma. I have used this as a holding solutions for the grafts. I feel this is better then normal saline.

In reguards to Acell and PRP. I was first introduced to Acell by Dr Jerry Cooley. He recommended an Acell strip of 2mm in width placed in the donor bed prior to closing. This will promote healing and repair of hair follicles in the area. The scar line might be red post-op but it will clear up to give a nice result.

I think PRP should be used on every hair transplant procedure. I inject .1cc every square centimeter in the area transplanted. All patients that I transplant that are having a second procedure where they did not get PRP the first time are amazed how fast they heal and the reddness clears up faster. I have seen patients where the hair will start to grow back in the second month. Since there is no side affects and safe why not do this to help the outcome of the transplant.

Introduction for Dr James DeYarman

I would like to introduce myself, my staff and my methods to the hair transplant network. I have over 30 years of experience in hair restoration and my staff has a combined experience of over 40 years. We perform FUT and FUE transplantation. I will go over my method.

I start the planning of the procedure by examining the donor area with a video microscope and keep on file a photo of the patient’s donor density. After discussion of the hair line design I photograph the area and use photo shop to add hair to the photo to give the patient an idea on what we will be trying to achieve. I like to use a grid over the transplanted area for graft distribution and hair line design.

The strip is removed with a single blade and prior to closing an Acell strip is placed in the donor bed. Trichophytic closure is performed with staples.

The tissue is dissected with microscopes and I have a photo of the grafts we create.

The recipient sites are created as lateral slits by creating the blades with a custom cutter device matching the blade size to the size of the grafts. The techs insert the grafts and I have them use holding cups on their finger with PPP in the cup as the holding solution. If we do not do PRP then I use hypersol as the holding solution.

After the sites are created I inject .1cc of PRP every square centimeter over the transplanted area.

If I am doing FUE I like to inject Acell solution in the donor area and PRP in the recipient area.

The patient leaves the office and is instructed in post-op care on how to prevent swelling and returns to the office in 10 days for staple removal.

Video photo of patients donor area.bmp

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Your orginal question had to do when can you do temple point restoration.

I feel that temple restoration will reverse the signs of aging. I have attached a photo of James Dean. He was only 21 when he made this movie and to make him appear older they grayed his hair and created deep temple recessions.

Lateral slits have made it possible to restore the temples. Therefore if a patient show signs of temple recession and loss of temporal peaks they can be restored at any age.

As far as any reply to question on Jotronic's hair transplants I am talking about design.

I feel that temple restoration is the most important area to transplant. It wasn't until the use of the lateral slit were we able to tranplant this area. Temple recessions will age a person more then crown loss. When someone argues that you will run out of hair it should be noted that you will not lose the hair on the sides completely. It is much easier to maintain the hair in this area then on top. I can always tell if a person has had a tranplant if their hairline is restored withount temple restoration.

Even Jotronic's profile shows sign of restoration because of the acute angle. If Jotronic gives me permission I will add hair to his photo to show what I mean.