Steven Gabel, MD, FACS

This patient is a 61 year old gentleman who is 1 year out from surgery. He had 2581 grafts placed in one session to the frontal scalp.

This is a video presentation showing the preoperative photos, immediate post-operative photos, 6 month post-operative photos, and 1 year result with photos and video.

http://www.nwshrdata.com/HR1year.wmv

This patient is a 64 year old gentleman who has been slowly thinning to the point where he desired restoration to the anterior scalp area.

The preoperative photographs show significant alopecia at the front half of the scalp, with some alopecia of the crown.

The postoperative photographs are 14 months after 1 procedure where 2656 grafts were placed in the coronal orientation. His hair was not cut to perform the procedure, and grafts were placed between his existing hairs at approximately 45 grafts/sq. cm (see close up of identified slits with ruler).

This patient is 1 year following his hair transplantation surgery. His main goal was to fill in and thicken the frontal third of the scalp. At this point, he is starting to thin in the crown and is on medical therapy (minoxidil and finasteride) to hopefully maintain it.

Stats:

One session

Strip method: 22.3 x 1.4 cm strip

1 hair grafts: 637

2 hair grafts: 1756

3 hair grafts: 520

4 hair grafts: 50

Total grafts: 2963

Dr. Konior

This is another example of the outstanding results you are able to obtain for your patients. Excellent work.

I appreciate all the positive comments for this result. This patient is very active in the Seattle area and it has met his expectations and goals form the procedure.

Azn-guy-001: Right now, he is satisfied with the result he obtained. We had originally discussed a possible second procedure, but we were able to accomplish his goals with only one. He does understand that hair loss is progressive, and he may require a procedure down the line, but after our last conversation, he is going to enjoy the results.

Sorry for the delay in responding, I've been in and out of the country traveling with family and friends. I spent a ton of time last summer training for the Ironman and was able to participate and finish Ironman Canada a couple months ago in Penticton, Canada. Now that I've had a little time off, I'm starting to train again to compete in next years Ironman Canada 2010 in August 2010.

This patient is a 61 year old male who was interested in thickening up the frontal area of his scalp. He has hair in the area, but wanted to have a fuller and more youthful appearance. Although he has thinning in the crown, his primary goal at this point was the frontal area.

Transplant details:

One procedure - 2581 grafts total

Single hair grafts: 684

Two hair grafts: 1472

Three hair grafts: 398

Four hair grafts: 27

The patient is now 6 months after the transplant and is noticing the transplanted area is starting to thicken up. He is early in the post-operative period and just starting to grow. I plan to post his 1 year photos when he returns for a visit.

This patient is a 44 year old gentleman from Seattle, Washington, who is 1 year out from his transplant. His main concern was restoring his hairline and filling in the balding areas in the frontal scalp. He was a NW 3/4 who had 3852 grafts placed in the front part of his scalp in 1 session.

Specifics: 26.0 cm x 1.8 cm strip

1 hair grafts: 512

2 hair grafts: 2315

3 hair grafts: 1025

I saw him last month up in my Seattle, Washington office where the post operative photos were taken. I did not have my usual set up so the lighting and background are different from the preoperative photos. He will be coming down to my Portland office in the future where additional photos will be obtained. I included intraoperative photographs showing the slit design and placement as well as immediate postoperative photographs.

Dr. Cooley

Excellent work and result. She now has a very natural appearing female hairline.

50 year old gentleman with who is a NW 4 and with considerable alopecia of the crown. He has had a total of 9965 grafts placed throughout the scalp in 4 procedures over the last 5 years.

For the last several years since his first transplant, we have been following the progression of his natural hair loss and transplanting into those areas. Since this patient cuts his hair very short, it has required a high number of grafts to fill in areas of alopecia with enough density to obtain a very natural appearance.

whyhowhy

That is where I saw it listed for the first time as well.

This takes the cake, or should be up there, in a list of top 10 bogus solutions for hair loss. There is now an IPhone app for hair loss: 'HAIR CLINIC: for man and woman.' I just found this on the internet and had to check it out and it is true. Go to Apple's website in the app store and you will find it.

They call it 'The World's first Mobile Hair Clinic System.' From briefly reading this, people are supposed to put the IPhone to their head and the app makes the phone generate inaudible high and low frequencies to promote circulation around the hair follicles.

The best part is the disclaimer: may cause headaches if the built in speaker is used close to the ears. The company states that it is not responsible for the headaches.

And all this for $3.99.

Here is the link to the videos:

Low res (faster loading/viewing): http://www.nwshrdata.com/2315GraftsE

Hi res (needs a little time to load): http://nwshrdata.com/HairVideo2315Hi

This patient had 2315 grafts placed in the frontal hairline and midscalp 3 years ago. Grafts were placed posterior to several of his native hairs (which have remained) to produce a natural, soft appearing hairline which he desired.

He continues to use finasteride on a daily basis which has been working well to maintain his crown.

Our address is:

601 108th Avenue Northeast, 19th Floor

Bellevue, Washington 98004

I would like to announce that we now have a consultation office in the Seattle-Bellevue area. After a long application process, I have obtained my Washington Medical license and will be performing consultations in the Seattle area.

If you are interested in scheduling a consultation with Dr. Gabel in our Seattle-Bellevue office, please call 877-936-4247 (HAIR). My staff will be happy to assist you.

Patient is a 50 year old gentleman who wanted his frontal hairline restored and to thicken up the frontal scalp.

2506 grafts were placed into the frontal hairline. A majority of the rest of the grafts were used to rebuild the lateral anterior 1/3 of the frontal scalp and grafts were also scattered in the frontal tuft to thicken it up.

bash77 - I'm not aware of the other doctors using the device; hopefully as they use it they will post their experience with it. As I wrote, it has made the FUE process much easier and more precise.

HairHope: The first patient I used the device on was a patient of mine who has had many transplants that he had very limited donor hair. Before he met me, he had several scalp reductions and "plug" procedures that his only option was FUE. He was very excited to be my first patient with the new device and it went well. Because I was new to the device, I did not charge him for the FUE. I would not call it an experiement - I've been performing FUE for years. This is new instrumentation for a procedure I've done many times in the past. This patient probably got a better result with a higher yield using the Feller instrument as it makes the whole FUE process easier.

Bash 77

I have used the Feller Motorized Extraction Device now with several patients since receiving it. It was definately made the extraction process easier and more efficient.

What I have found great about the device is that I can concentrate more on the exact angles and depth of the extraction process then having to manually twist the punch.

I have some video that I took that I will post in the near future using the Feller Device.

chan123

I recommend my patients use an airplane pillow around their neck after surgery. The airplane pillow is soft enough to minimize irritation and discomfort at the donor site while keeping the grafts safe from any rubbing of the pillow. If the crown was transplanted, an airplane pillow can still be used, but it must be used with caution to minimize any forces that can dislodge the grafts.

I also recommend that my patients sleep in a more upright position (30 degrees or so) to help with the swelling.

Dr. Linsey

Can you give a little more detail? He had an implant placed centrally? and how big is the implant? Do you know where the incisions are for the implant? Also, where did they put the grafts - are they spread out over then entire crown or just at that central necrotic area?

Interesting situation.

Absolutely - but it is good to try to think of new ways of doing things to see if our techniques can be improved. Good discussion!!

The day after surgery, patients will have some residual blood and dried serous fluid that has accumulated on their scalp. I have my patients return the following day after surgery to have their scalp cleaned of these. It is well documented in the facial plastic literature that keeping wounds clean helps prevent infection and generally patients heal better. I have them do this for several days until all the dried serous fluid has been washed away and they are not accumulating more on their scalp. There is no magic formula for the number of days as it varies from one patient to the next - as I have stated, I instruct my patients to "keep it clean and don't touch" and they grow out great. I saw a patient back yesterday for his sutures to be removed and he followed the regimen as best he could and his scalp looked great, very little redness, and almost 100% of the crusts had been washed away.

I have never suggested acetic adic (vinegar) to be added to the saline/water spray as I have not had experience with that for hair restoration. Yes, for facial chemical peels, we had all patients on day 1 through day 7 (or if needed) wash their face with vinegar/water solution as it has antimicrobial properties. Also, it is a common agent to use for patients who have outer ear infections to put them on Domboro, which is basically vinegar and water. Putting it on a freshly transplanted area - I'm not sure how the grafts would react and the saline rinses have been doing a great job.

I agree with Dr. Lindsey

I did a transplant on a patient yesterday whom I was able to obtain 2500 grafts on a second session. His scalp was so tight on his first case that I was only able get 2150 grafts. I had recommended the scalp stretching exercises, but he did not do it for the first case. He had not the greatest density in the donor area is the reason for the low number; on the second session, he was very diligent about exercising his scalp and we got out 2500 grafts.

Glenn

If you have made the decision to have FUE, Dr. Feller has consistently provided example after example of his FUE work; not only his immediate postoperative results, but most importantly, the long term grown out patients. Also, I agree that the punches that he developed are far superior to other "standard" punches. He put a considerable amount of time into the mechanical and engineering development of an instrument that extracts the follicles with the least amount of trauma then several other punches I have used. In fact, I have several FUE cases coming up and those are the only punches I use at this point. So the bottom line is: do your research: if you decide on Dr. Feller, your in great hands.

There are so many lotions and potions popping up at alarming rates to prey on peoples emotions. I've states this before: I want to see the data specifically on this product if it does enhance hair growth. There are multiple studies documented on the web site discussing the ingredients and their mechanism of actions: several are from the 1950s - 1960s and a few in 2002; however, looking scientifically at this, I did not see anything comparing this specific product with blinded studies to show any improvement or not. Until I see that, I'm skeptical. Thats the long answer. The short answer: if your looking for a topical, go with the one that has been tested and proven effective: topical minoxidil.

In terms of Propecia, according to the product rep from Merck (the maker of Propecia), it is OK to continue on the medication while trying to conceive.