Jeff Hamm

Patient with Strip surgery 17 months after procedure. 1,803 FUG's. Singles used along Frontal hair line. 3,860 total follicles restored overall hair density in areas of concern. Optional 2nd surgery if desired for optimal fullness in crown. ALL patients are encouraged to use HLPT with oral or topical Finasteride or Dutasteride. This patient uses topical preparation as suggested for preservation of as much hair as possible AND to assist/aid in best looking result from 1 surgery. Best wishes for a safe and healthy 2018!

Frontal forelock and bi-temporal peaks transplanted using 3,920 individual follicles. Notice the improved overall hair volume within the hair clip. This patient could have really benefited even more with several hundred more grafts/hairs ideally, but good improvement with the number used. Great healed scar line, barely detectable.

Hi Mike03980! This is Jeff and I am a Technician serving as a representative for Dr. Griffin. We are sincerely sorry we didn't exceed your expectations with your HT surgery. We do our very best for every patient and try to treat each patient as though a member of "our family". Ultimitely our goal is a "happy" patient. Results with any cosmetic surgery are subjective. With all due respect to the responses on this thread, I can honestly say having personally worked with Dr. Griffin for 25+ years we have never "botched" a single patient. You as the patient can argue your expectations, as far as the level of fullness you imagined or expected from one procedure. Other responders can debate which techniques used in hair restoration today are arguably the best. But our results always look natural. Never "pluggy". We appreciate your choosing us and giving us an opportunity to serve you, and we wish you the best moving forward. Hopefully you will acheive the goals you seek. Please make sure you continue the use of HLPT. Dr. Griffin has performed Scalp Reductions, Flaps, Extenders, Expanders, HT's, FUE and now SMP scalp procedures for over 30 years. Every Provider that practices medicine has had or will eventually have a patient whose expectations were not met. ANY surgeon that has performed literally thousands of scalp cases will inevitably have an occassional patient that is not satisfied. This does not "define" their level of expertise or diminish the quality of their care or workmanship. We appreciate your comments, we will use it as motivation. It gives us an opportunity to reflect on how we can improve our care and better serve our patients. I apologize for the late response, the email listed for this site is corrupt and has now been properly updated. Best of luck to you Mike03980 and thank you fellow Forum members for your unbiased responses.

Frontal transformation with one strip procedure in the forelock and included the bilateral temporal points. ALL patients are encouraged to use HLPT for as long as they want to keep hair loss from progressing. If a patient expresses or states a refusal and is not serious about the use of HLPT prior to a HT surgery, we now refrain from offering a surgical procedure. Perhaps PRP or another non-invasive procedure as an option. You will not look your best if you continually lose hair regardless of the number of grafts or procedures. 2,000 grafts, 4300+ hairs with the linear scar.

Every patient should use some form of HLPT for the best possible surgery result. We encourage EVERY patient to use something for as long as they want to keep hair. This patient had 1 strip procedure and the after pics were taken 1 year later. 2,038 FUG's, 4,551 individual hairs were transplanted. The goal with every patient is to provide an improvement after surgery. But, MOST importantly, we want a natural looking result. I don't get caught up in what is the highest number of grafts I can do with any given patient, but how many or what is needed to make them look naturally better after hair restoration surgery.

Here is a patient that has dark fine hair and hair loss in the crown. You can see quite easily thru the hair in the scalp as a result of those characteristics. We did one modest strip FUG of 1,283 FUG's or 2,736 follicles. Look at how much improved the result is with the increase in hair volume in combination with the change in hair color. Less contrast in the hair and skin comparison, yields a better illusion of coverage. Afterall, the surgery is ALL illusion, we don't give patients MORE hair than they already have. We just make it look that way. Hopefully, one day we can indeed give more hair without removing anything.

Hair loss prevention is without question the single most crucial element of treatment with any patient that is experiencing hair loss. Some form of Finasteride or Dutasteride is critical. Minoxidil, Red Light therapy and other things can be helpful, although probably not as helpful. EVERY patient that I see in my practice; whether a surgery candidate or not, has been strongly encouraged and offered some form of Finasteride or Dutasteride for the prevention of further advancing hair loss. Patients should not think "I'm either choosing surgery OR HLP". If you are a patient that needs some type of HT surgery, please understand HLP when combined with surgery will give you a better opportunity to look your best. Using those medicines for the hair is a lot like you flossing your teeth. Does flossing eliminate the need for regular cleanings? Of course not. One without the other is not as effective as the two together. Here is an example of two surgery patients with a relatively similar hair loss pattern. Both had strip surgery. The graft counts are similar as well, although the patient on the left had approximately 1000 more grafts transplanted with his strip procedure. The patient on the left personally chose to use only Minoxidil for prevention, and decided NOT to use Finasteride or Dutasteride as suggested and documented in his files. The patient on the right has used Finasteride since his intial consultation and continues daily use. The other image is of the "Finasteride" patient that shows the before, surgical marking, graft placement and one year after comparison with the "before" directly above.

This patient had HT strip surgery 3,711 two years ago, he admittedly did not use HLPT for hair loss prevention as advised over that period, and yet he still looks reasonably good. The scar is minimal and a future procedure may be done at some point this year for increased volume.

"How many grafts do I need for a significant improvement in my hair?" This is a common question from patients considering HT surgery. There is no simple easy answer. Fullness is subjective. Are you using some form of Finasteride or Dutasteride as a recommended HLP regimen? Are you happy with an improvement simply visible in photos? Or are you more pleased with a change in how your hair "feels"? Some people are happy with not having to "work" as much with styling. It is not realistic to expect a dramatic positive change in your hair volume if you are continually losing hair? If you are opposed to using Finasteride or Dutasteride, please understand you WILL need more than 1 procedure over your life time. Especially, if your goal is to have some "reasonable" level of fullness. This patient has continually used a HLP therapy with Finasteride. He had less than a mega session and only 1 procedure. The "after" photos are 1 year after his surgery. I must apologize (to those that may feel the images inconsistency is intentional) the "after" images of this patient's head were not tilted down more to show the degree of fullness throughout the hair. I hope to get the "ideal" photo angle while using a comb, to show the amount of fullness that is there, when he returns to our office .

Frontal hair loss treated in one procedure with strip surgery. Curly hair does well, may not need as many grafts to get a good natural looking improvement. Of course when the hair is wet, it still could look somewhat thin. It is natural to see some skin and scalp when the hair is wet, even in people that don't have genetic alopecia/hair loss. How many people get this surgery to look good after the shower or at the pool? If a patient states that is the goal, more grafts can be transplanted in a single surgery to achieve that goal. Otherwise, 2000+ grafts may not be necessary for a significant improvement in every day appearance. 3,293 hairs transplanted using 1500+ grafts. After (last image) is taken one year the procedure. Each patient seen in my practice is counseled and encouraged to use some form of Finasteride or Dutasteride to minimize future hair loss. HLPT does not replace the potential need for surgery and surgery does not exclude anyone from needing to continue some form of Finasteride or Dutasteride. This information is well documented in the information I give to every patient seen in my office or via virtual consult.

Patients with limited hair loss are ideal patients for FUE. Minimal hair loss can be easily improved with small FUE sessions until the desired fullness is reached. This small FUE surgery was done in the crown using Neograft. 1,737 hairs from 658 grafts. Finasteride recommended for HLPT. When the patient is ready for more we'll be willing and ready to help!

Here is a different case than the usual MPB or FPB HT surgery you see just about everyday on the hair loss forum. This scar was from childhood/childbirth? and located in the foremost front of this patient's scalp. The hair texture and color make it very difficult to conceal without a hat or HT surgery. The hair texture is coarse and jet black hair on whitish skin, makes it stand out dramatically. Patients are counseled that more than one surgery may be needed for the best possible result, regardless of the circumstances associated with hair loss. In this case this patient was not prescribed HLPT, since he shows no symptoms of MPB. (Please note: EVERY patient that has MPB, we strongly encourage the use of a Finasteride/Dutasteride HLPT.) Over packing a scar could result in fewer grafts actually surviving, due to the changes in the vascular anatomy associated with trauma or from a prior surgery. The other factors to consider; not only it is more safely improved by adding more after healthy full growth from the first surgery, but at that point a patient can decide if the surgery met the imagined expectations. Maybe they are happy with only one HT afterall! This is 1 surgery 369 follicles. The scar shows an obvious improvement. But, to match the natural density of "a", one more procedure is needed to improve the hair thickness in "b".

As you examine the first 4 patient photos in this post your first impression may be that the photos are out of sequence. They are not. The patient was seen by me in consultation several years ago. He had a HT surgery done by another physician prior to my consultation. The photo with more hair was taken at that consultation to document his hair loss BEFORE a possible procedure with me. I never performed the HT surgery we discussed. My recommendation for some form of Finasteride for HLPT is documented in the consult notes. I recommend this with EVERY patient. The photos with more baldness are the more recent. You can see the hairs from the grafts from the other physician's HT surgery. Does this mean it was a poor result? After all, the patient looks worse! Luckily, for THAT physician this is a reasonable patient. He accepts personal responsibility, understanding that his failure or refusal to use HLPT resulted in the latter photos. The other 2 set of pictures show a similar patient, except with NO prior history of HT surgery. He returned a decade after our initial consult, looking to finally have the surgery. He feared he had more hair loss, "I forgot about the HLPT". No surgery was performed or recommended. The goal of this post is to demonstrate the importance of combining HLPT AND HT surgery. If you chose to ignore or refuse Finasteride HLPT you WILL NOT get your best benefit from adding more hair via HT surgery. Look at the other photos in this post. 1 with topical Finasteride, NO surgery, NO worse. And the last I prescribed oral Finasteride prior to his surgery. REGROWTH in the crown, no grafts needed there at this time! Save your hair, you AND your physician will both be pleased. If you chose to spend more personal income than you save, is it fair for you to blame your employer for not giving you enough to save?

Responding to any complaint only through a public forum and not directly to the patient is not how I view appropriate “care” for my patients. At The Griffin Center, we work hard to make our patients journey with us a pleasant, comfortable and positive experience. And it’s rewarding the vast majority of the time as most of our patients are very pleased with the overall process as well as their surgical results. For nearly 40 years, I have gone to great lengths to provide every one of my patients with the best care possible and I personally stand behind the results of my work. While I would like to address this particular patient’s concerns directly, HIPAA (patient privacy) regulations prohibit me from discussing the details of any patient’s specific case on an open forum. That said, it is important for the general public to know the truth. At the Griffin Center, my entire team and I spend a great deal of time and effort explaining the hair transplantation process along with answering any concerns or misconceptions so that when and if a patient is ready to have surgery, their expectations are clear. In every consultation I stress what I think is the most critical point to each patient, the important fact that male pattern hair loss is progressive and that every transplant patient should begin and stay with a hair loss preventative program. It is my belief that any patient that chooses surgery and wants the best possible result has a responsibility to follow the medical advice given by the physician. If a patient chooses not to follow the recommended medication and treatments for hair loss prevention, then he/she must understand they will continue to lose their hair. I make this fact very clear when meeting with each and every patient both verbally and given in writing. When I see each hair loss patient at their consultation and in consecutive follow up appointments, I reiterate again that additional hair loss progression will continue if some hair loss prevention treatment is not followed diligently. Additionally, I explain that Rogaine alone is not enough (even if used regularly) to stall the expected progression of baldness. Even if I repeated the transplant again in another year, for patients who only use Rogaine or nothing at all, their hair loss progression may appear that a procedure never took place. Some patients may not like to hear the truth and just outright reject it. They just look at their hair loss and want it fixed as soon as possible with whatever it takes with an unlimited number of grafts. This approach can be problematic and is unrealistic in long term planning when dealing with a progressive problem. It is impossible to tell any patient exactly how many transplants they will require in their lifetime. The extent of balding an individual will undergo is unpredictable and many outside factors can play a significant role. This process of loss will continue as long as a patient is circulating testosterone in his body. Without a good preventative program, in one year a patient could easily lose the same number of hairs that were transplanted and possibly even more. In regards to session size. I will perform a session of 3,000 grafts or more, if the patient requires such numbers of grafts, if their donor area has it available and if their scalp area and degree of balding will accommodate the blood supply needed for this number of grafts to survive. On The Griffin Center consultation sheet provided to every hair transplantation patient who comes in for a consult, the MD fees are currently broken down into graft session sizes: 1-1,000, 1100-1900, and so on. The last session size states “3,000 Max Graft Surgery” (meaning 3,000 to the maximum number of grafts that can safely be obtained in one session for that particular patient). It is misleading to others to state on the internet that I don’t do more than 3,000 grafts in a session. It is simply untrue. Additionally, at my practice we always take photos to show overall results and improvement. Careful examination will reveal good growth of transplanted follicles if the patient is following the recommended hair loss preventative treatment as I only have control over the hair transplantation portion of the scalp and not the others hairs that are lost. As a physician, I always want the best possible result for each and every patient. However, it is certainly the patient’s choice to follow my recommendations and I certainly can’t force a patient to do something he/she is not comfortable with such as taking medication. I take pride that my practice is able to consistently offer an exceptional surgical experience, and although I believe we do everything possible to set realistic expectations, I am disappointed if I am unable meet a patient’s expected results and will do everything I can to change this. However, patients are free to choose whether or not they will follow my recommendations. Respectfully, Edmond Griffin, MD

Most patients looking to restore hair loss in the crown should honestly consider having at least 2 HT procedures for optimal fullness. In large part due to the natural occurring pattern the hair grows in the vortex. Notice the "blue" markings before the surgery. That doesn't mean you will necessarily have two procedures, it just our way of keeping patient expectations reasonable. If you have extensive baldness; (obviously this patient does not) and regardless, of the expertise of the surgeon, it's not realistic that you will look like Bradley Cooper with one minimal HT surgery. This patient one year ago had one strip procedure, 2,219 FUG's, 5,022 total hairs transplanted. HLPT with Finasteride or Dutasteride, and that may also include Minioxidil and Red light therapy are always recommended with EVERY patient we see in consultation. Does he need another procedure?

These are all scar pics of various ethnicity, hair colors, hair styles and hair textures. I usually post examples of some of our patient's scar pictures near the end of the year. These are all at least 1 year after the procedure. Some are more inconspicuous than others, but we feel all are acceptable. Three out of the six had more than one surgery. Can you tell which ones? #'s:2,4 and 6

Before we discuss any plans for hair restoration surgery, we start by asking every patient "What are you using for hair loss prevention?" Patients that are not conscientious about using some form of hair loss prevention are potentially risking a mediocre result following hair restoration surgery. Hair transplantation surgery does not preclude hair loss prevention. Here is a patient following successful hair restoration surgery in the crown, an area I refer to as "the bottomless pit". Due to the natural 'whirl" growth pattern in the vertex, this area of the scalp requires a high number of grafts, usually beyond one procedure. However, consistent use of hair loss prevention therapy, with optimal effectiveness, a nice improvement may be possible without multiples procedures depending on your goals for desired fullness. This result is after two procedures. We have discussed a third for complete coverage.

What would make most patients "happy" after HT surgery is subjective. Would 3,036 FUG make YOU "happy" as a patient? How about 11,230 hairs? Here is a patient that was done via strip surgery in one procedure. The case resulted in exactly 3,036 grafts (including MUG's) and yielded 11,230 individual hairs. And although an improvement is visible, this patient was disappointed. Despite written info and discussions in the initial consultation suggesting/recommending multiple surgeries may be needed for optimal fullness, this patient had expectations that we did not meet. An obvious improvement? Yes. Happiness? Not yet. We recently performed a second HT. Hopefully, we can report that we satisfied expectations in another year.

Our goal with every patient is always the same. Make them look better "naturally". Regardless of sex or ethnicity. If you see someone with natural unusually thick hair, they really "stand out" as someone who looks....different. Better? I think the most "noticeable" thing about artificial hair is the absence of flaws. Here is a patient with a history of having had prior HT surgeries. We planned 1500 grafts by strip surgery. 1,622 follicular grafts, 3,576 hair follicles. Could we have done more grafts to get it thicker? Of course. We still can with another procedure. But, having some skin show through the hair makes this look more natural. Adding more hair is the easy part. It is only one fragment piece of the puzzle. We make a point to consider the "art" of the entire process, so you can really appreciate the final image.

Here we have a familiar story of a patient in his prime, who like many sought help because he had concerns over losing his hair. As with most of our patients, we had him start using HLPT. As he has gotten older, despite HLPT, he begin to see more noticeable hair loss. The first two images were taken before any procedure. The third image with white hair shows his level of hair loss prior to the surgery. Of course the benefit of using HLPT has helped him maintain more hair, that he would have otherwise lost without medication. Decades after his initial visit, we did one strip procedure of 2,894 grafts, 5,970 individual follicles. The fourth image shows one year after surgery, along with the other images compared with the white hair. His hair has been restored, just about as full as it once was at his very first consultation. Notice he can even color his hair darker, close to the same color as his early natural hair, AND the hair line looks as natural as his original hair line, which is not an easy accomplishment with exclusively white/grey donor hair.

When patients hear about graft counts recommended during the consultation, there can be some difficulty to imagine how a number of grafts or hairs "translates" in to an actual amount or level of thickness. Coverage percentage numbers are relative or subjective. Some people are happy with any amount of new hair with one procedure. While others expect to look the way they did in the "good ol' days". From College days or perhaps even High School, long before they showed any signs of hair loss! Counsel is extremely important. In hair transplant surgery the number of hairs received from the surgery, is equally important to the number of grafts. Hair texture and body also have an influence on the final surgical results. This case had a modest graft count, but the hair count yielded 3,888 hairs. A 3:1 ratio, is well above average, as it relates to hairs/grafts. A 2:1 ratio is usually more common. Ultimately, regardless of the number of hairs or grafts, the most important thing is for the result to look completely natural. A larger number of grafts would have provided an opportunity for even greater coverage in the crown. Hopefully we have another opportunity to give him better coverage in the crown in the future.

This patient had one procedure, one year ago. Notice the increased hair volume and body. Despite her hair staying relatively close to the same length, it looks so much fuller as a result of the procedure. It also helps that she has changed the color of her hair, but she now has more hair, that she can actually change her hair color and have it make a significant difference! We make it a point to counsel or female patients that it is very common and more likely that one surgery may not restore their hair to an "ideal" optimal fullness, and that a second surgery may be necessary. This patient is happy with one surgery, and so are we.

Darker hair is a preferred hair color.........for Doctors, Nurses or Technicians trimming follicular grafts from a strip or if harvesting by FUE. However, if the darker hair belongs to someone with very fair skin, the color of the hair as it contrasts the skin can be more of a challenge, as far as making the transplant look natural and undetectable. If you have unlimited grafts, of course you can really make the area thicker, fuller looking. But what if you have a limited number of hairs/grafts. Circumstances sometimes dictate your course of action. This was one surgery, done with strip harvest. The graft count was 1,891, totaling 4,571 hairs. The images show before surgery, after surgical marking, immediately after graft placement and 1 year post operative and includes the scar within the hair. Sure it could be fuller if we had a high volume of grafts. Using the number of grafts available, we were able to make a very natural looking improvement with the characteristics I mentioned before.

I have worked in hair restoration with Dr. Griffin since 1989. I have seen a lot of changes in the field over that span of time. Together we visited many doctors around the world that Dr. Griffin felt had an interesting or innovative technique that could be useful in our hair transplant surgery. Dr. Limmer in Texas, Dr. Dow Stough in Arkansas, Dr. Walter Unger in Toronto, Dr. Marcelo Pitchon in Brazil, Dr. Hitzig in NY, and Dr. John Cole here in Atlanta. These are but a few of the amazing physicians we have had the honor and pleasure of an invite to observe various hair procedures. It seems the current trend in hair restoration is mega and giga graft sessions. Whether it be done by strip or FUE, the number of grafts per surgery have skyrocketed since I started working in hair 25+ years ago. In my opinion the high graft numbers may suggest to some, that unless you have a gigantic session, you may not have a good result from a HT surgery. We perform these sessions sizes in our office using both strip harvest and FUE. Certainly, some patients need high graft counts, but not everyone needs mega or giga sessions for an improvement. This patient had a meager 1,276 grafts, 2,431 follicles in 1 surgery, with photos taken before, on the day of the procedure and 1 year later, including the scar from the strip harvest. Would a 3000+ graft session look 3 times better or thicker? Notice the overall improvement in hair volume from the frontal views. Does the hair line look natural? Compare this case with similar cases.

This is a female patient that has the typical androgenetic hair loss pattern that was treated with HLPT and one strip surgery that resulted in 6,174 hairs from 1,920 FUGs, including predominately MUGs. The images were taken prior to the procedure and one year after the procedure with two images showing the grafts immediately after placement on the day of the surgery. Some of the images are not as clear as we would like, but we did not want to alter or modify the images. You can still appreciate the improvement from ONE strip procedure. The patient has no plans at this time for any further surgery, and has been advised to continue HLPT medications.