Steven Gabel, MD, FACS

This 35-year old patient desired to thicken the hairline and frontal scalp. Even though he has hair in that area, we designed a conservative hairline following his current pattern, and increased the density throughout the frontal hairline.

The 12-month photographs show the excellent growth he has had in the frontal zone. Notable, however, is that his hair loss is continuing in the crown and he has lost some density. We are now trying some other options to help maintain the genetically susceptible hair in the posterior mid-scalp and the crown. He will return in 12 months for his 2-year results.

This patient is a 48-year-old who desired to restore and define his frontal hairline and frontal scalp. He had 2,474 follicular unit grafts grafts placed into the hairline densely packed and frontal scalp as depicted in the before and after photographs.

The postoperative photographs are 6-months after the procedure which shows excellent growth at this early stage. We plan to post his 1 and 2 year results when available.

Thank you for the positive comments.

Also, this patient also commented to me that he has no problems keeping his hair short in the donor area.

This patient is a 32-year-old male who desired to restore his frontal hairline and scalp. He is on medications to help maintain his current pattern. The patient had 2600 grafts placed into the frontal hairline and frontal portion of the scalp. The photographs show his before procedure and 6-month progress.

He is extremely happy with the results thus far and we plan to show his 1-year results when he returns for follow up.

Windjammer

Here are the photographs you requested without the headband and immediately after the grafts were inserted. As you see, I trim some of his natural hair back so there is a smooth transition between the transplanted hairs and his natural hair. If that is not done, then the patient will end up with an appearance of decreased density at his “natural” hairline. By transplanting into this “transition zone” with 2-hair and 3-hair follicular unit grafts, it gives a more natural appearance to the final result.

What method was used (FUE or strip) and how many grafts? I don't see either mentioned above. Also, are there any immediate post-op photos showing actual graft placement? Lastly, it would be nice to have seen the patient's hair lay normally, without the hair band, pre-op for a better comparison of the before/after result. Glad to hear this man is happy. He has terrific hair.

Windjammer

This patient had the strip method performed with 1943 grafts placed into the frontal hairline. I will look for some photos that show the frontal hairline prior placing the headband. The reason I show the headband is to clearly delineate the exact area where the follicular unit grafts will be placed. I will also show the immediate post operative photographs.

This patient is a 57-year-old gentleman who desired to enhance his frontal hairline. He feels that he has had a slow recession of hair in the frontal region. He did not want to bring the hairline down significantly and wanted to increase the density to make his hairline fuller.

The before and after photographs are presented side by side to compare the 18-month results. The patient is extremely happy with the results as it has defined the frontal hairline and produced a more youthful appearance for him.

Yes: this patient has aged very well. He really takes care of himself with diet and exercise. And yes, he is thrilled with the results that were obtained.

This patient is a 41-year-old male who desired to increase the hair density in the frontal scalp via the FUE method. He wanted the option in the future to keep his hair short. He says that he is a good healer, but since he wanted the short haircut option, the FUE method of follicular unit transplantation was performed. 2168 grafts were extracted and transplanted into the frontal hairline and frontal scalp regions.

The 6-month postoperative results are displayed. It shows excellent growth of the transplanted grafts. The patient stated that his hair started growing several months ago and continues to thicken up and the density is improving monthly. He feels it is completely natural and has no issues with anyone recognizing that he had a hair transplant performed since the frontal hairline is so natural appearing. Since the patient is only 6-months out from the procedure, he still has 20 % - 30 % more growth expected. He plans to return for his 1-year and 1.5-year post-operative progress checks.

A video will be added shortly.

This patient is a 45-year-old male who desired to increase the hair density in the frontal scalp. He had been slowly losing his hair for years, and has been taking medications to slow down the loss. He keeps his hair short in the donor area therefor the FUE technique was used.

The 6-month postoperative results are displayed. It shows excellent growth of the transplanted grafts and the patient is so far thrilled with the results. He feels it is completely natural, and he is able to keep the hair in the donor area short at his desired length. Since the patient is only 6-months out from the procedure, he still has 20 % - 30 % more growth expected. He plans to return for his 1-year and 1.5-year post-operative progress checks.

This patient desired to increase the density of the hair in his beard and mustache. He said he was unable to grow significant hair on the cheek area, the sideburns, the chin region, or the top of the mustache. The lower portion of his beard grew well, but the hair was lacking in the upper aspect of his beard. The overall goal of the transplant was to increase the density and fullness of the facial hair in the regions were hair was lacking.

The patient had 1891 follicular unit grafts placed into the beard as shown in the immediate post-operative photographs. For facial hair transplants, Dr. Gabel makes all of the sites, and places 100% of the grafts. The exact positioning, hair direction, and angle that the hairs are placed are absolutely critical for a good result with facial hair transplants. Dr. Gabel has a particular interest in facial hair transplants as he has extensive fellowship training in facial plastic surgery and is board certified in facial plastic and reconstructive surgery.

The photographs were put together by the patient to show the progression from the preoperative phase, immediately after the procedure, 10 days, and at 6 month. The patient was recently in for his 6-month post-operative visit and his results have been absolutely outstanding. He is extremely happy with the results as he feels the hairs are growing in as he desired, and the results are very natural. The patient will be returning for his 1-year post-operative visit at which time we will post his progress.

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This 59-year-old patient desired to have his frontal hairline redifined and filled in, and also increase the density of his crown.

The photographs show his before and 1-year results in which approximately 1600 follicular unit grafts were placed in the frontal area of his scalp, and 1200 grafts were placed into his crown. This patient lives close by the office so we plan to have him back over the next year to follow his progress and show his 2-year final results.

This patient is a 32-year-old gentleman who is a Norwood Class VI. He likes to shave his scalp. Therefore, we discussed performing a full scalp Tricopigmentation to give him the appearance of full hair density, but with a shaved look. He was not interested in surgery at this time.

The patient had 3 sessions to give him the desired appearance. The first and second pass are on consecutive days, and the last pass is about 4 – 6 weeks after.

The photographs were taken after we touched up the frontal hairline. He is extremely happy with the results as it gives him the appearance of a full set of hair, with the shaved look.

This patient is a 29-year-old patient who desired to restore his frontal hairline. Because of his age, we designed a conservative hairline. He is on medical therapy which has helped maintain his current pattern for the last several years.

He had 1629 follicular unit grafts placed in the frontal hairline region 6-months ago. His growth has been excellent, and when he returns for his 1-year visit, we will post the results.

This patient is a 35-year-old gentleman who had a hair transplant several years ago with another physician in the Northwest. He was very disappointed for two reasons: the density that was achieved was not near what was promised, and secondly, the hairline design was too aggressive. His main goal was to increase the density in the frontal half of the scalp, make the frontal hairline more natural, and address the crown at a later date.

2490 follicular grafts were placed 5-months ago into the frontal half of the scalp. The photos are 5-months after surgery which demonstrates excellent growth of the transplanted hairs so far. He will experience more growth and maturation of the follicles over the next year. He is using Toppik on the crown to help conceal balding in that area, but there was no Toppik in the frontal half of his scalp when the photos were taken.

Thanks Dr.Gabel

Just curious, is this FUT or FUE?

This was a strip, FUT, procedure.

Pomade

Here are the photos you requested to be shown. I appreciate the positive review that you have posted.

@ontop: I agree with you that this patient not only has "above average going for him" and even more so has excellent hair characteristics such as hair shaft diameter, color, and area that was transplanted in his favor. However, if the transplant is not done well, and the grafts are not placed correctly, and the grafts don't survive, then hair characteristics aside, they will not obtain the results they wanted. In this patient's case, his hair characteristics are optimal for a hair transplant, and the surgery was very successful giving him a fantastic result.

@spanker: Yes: placement was in the frontal 1/3. One of the reasons he had the transplant was to grow his hair long and he loves it now - that is his style.

@Pete-from-Farjo and @David and @Biz: Thank you for positive feedback

@Mickey85: I will prepare some immediate postoperative photos and post them. And I appreciate the positive comments as well. My team and I take great pride in making sure the grafts are prepared and placed perfectly. My lead tech as over 14 years experience in hair restoration and yes: I still place grafts on my patients.

I want to echo the statements by Dr. Lindsey and Dr. Charles. This is becoming a very familiar story from patients in the Northwest as well: they went to a clinic that “only specializes in FUE” and had a procedure performed with almost no physician involvement. I had a consultation by a patient yesterday who said he had 1000 FUE grafts performed by a “specialized” technician (he had only 1 person do the entire case from start to finish in 4 hours) who traveled to their clinic to perform the case. The physician “approved” the design and was not seen until the end when he asked if everything went well. The patient’s result: No Growth after 18 months. He honestly can not decipher if he had a single graft that actually grew.

There are many reasons why this type of practice is highly unethical: as mentioned, many states do have laws which limit an “incision” to a physician. In my opinion, an incision can be either a linear incision or a punch incision – each is scoring the skin and the blade (straight or round) is going deep to the epidermis. Secondly, the results from many of these clinics are horrible: no growth, and the hairline design is poorly planned and unnatural. And last, the donor hair is a priceless area on the scalp – once the donor hair is exhausted, at this stage in technology, we don’t have any more sources of hair so each follicle needs to be utilized in the best way possible. These clinics are wasting the donor hair so future hair transplants are limited.

This patient from the Los Angeles area desired to have his hairline and frontal area of his scalp transplanted to restore his hair in those areas.

3655 follicular unit grafts were transplanted into the frontal hairline region in one session. The photographs demonstrate his appearance before the transplant and at his one-year follow up visit. Additionally, we included close-up photographs of the hairline and transplanted area in the frontal region of the scalp.

The patient is on finasteride and minoxidil which are helping to maintain his natural hair – in fact, he has had an excellent response to the medications which have thickened his hair. The patient is very active in sports and is extremely satisfied with the results he has obtained as he feels he has gained a more youthful appearance by framing his face with the transplanted hairs and boosted his overall confidence.

This patient is a 46-year-old gentleman who desired a more youthful appearance as his hairline had receded over the past 20 years. He wanted to have a natural, age appropriate hairline and increased density throughout the frontal scalp.

The patient had 2344 grafts placed in the frontal hairline and scalp over a year ago. The patient does not live in the Portland area, but sent in home photos showing his 5-month and 13-month progress. So far, the patient is very happy with the results. He will continue to send in his photos so we can present his 2-year results.

This patient is a 44-year-old gentleman who desired a subtle improvement to his eyebrows. He wanted only a few grafts placed on the outside and central body of his eyebrows to give a mild increase in density. He has always had sparse density on the lateral aspect of his eyebrows so he did not want anything drastic which would too noticeable as he is a public figure.

We transplanted approximately 50 grafts to each eyebrow to give it only a subtle change. As seen on the postoperative photos, the eyebrows are slightly thicker but very natural.

I am presenting this case as an illustration that each patient has unique situations and desires – and to illustrate that not every patient needs a huge number of grafts to accomplish their goals. If we were going to do a full eyebrow transplant for a big change in density, we could have transplanted several hundred grafts on each side; however, that was not what the patient desired. He only desired a very mild improvement so transplant would be undetectable. Since he always had sparse hair density on the lateral eyebrows, and he is in the publics eye, he did not want anything that would indicate he had a transplant. These photographs are 1.5 years after the transplant and the patient is extremely happy. It satisfied his goal to increase the density in a subtle and effective fashion.

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This patient is now 16 months following 3439 grafts to the frontal zone. These photos were taken 1 week ago as seen in the print out reporting on the snow storm in the east. I have taken these photos in real-time so we could observe how the hair transplant progresses and changed her appearance.

She normally has curly hair, but now is straightening her hair because the transplant allows her to style her hair differently. She told me that she is wearing her hair down, and now she has options to wear her hair back which she was never able to do with confidence. She is clearly satisified with the results or she would not have been returning for monthly photographs for the first 12 months and now she is coming back every few months until the 2-year mark. I have a short video to show the progress as well.

I added this patient's video we made at 1 year after the hair transplant. This can now be compared to the video we made at 2.5 years after the hair transplant which was with the original post. I need to re-edit the second video for consistency. The first video was made with a dedicated video camera; the second video was shot with an iPhone.

Negative. I'm just posting his 2.5 year results.