Jeff Hamm

Shown here are a number of scars that resulted from a strip harvest HT. These various patients are at least one year following HT surgery. The goal is to show actual scars from my patients with differing hair color, texture, skin type, ethnicity, etc. The type closure used varied as well, some were closed with a layered closure, using subcutaneous suture. Others were closed using only staples. I only use suture as a cutaneous closure in very specific circumstances. Some had Trichophytic closures, and some did not. Several had more than one procedure, and the pic shows the final scar. We review each patient's medical history prior to surgery. We then decide on the type of closure to use based on the patient's medical/surgical history. Some patients have a tendency to develop ingrown hairs or cysts, and may not respond well to a Trichophytic type closure. Some patients have an adverse response to certain types of subcutaneous suture. You can see a wide variety of scarring from strip surgery, some are more impressive then others. Regardless of the circumstances, medical history, or type of closure used, I hope you would agree, any one of these scars would be considered cosmetically acceptable by most reasonable people. We look forward to showing similar examples of the donor areas following FUE surgery on the FUE forum very soon.

This is an interesting case of a patient with a surgical history of large FUE grafts or "plugs" done by another doctor many years ago. We performed two smaller strip surgeries prior to the most recent procedure one year ago. The goal for this patient was to give him a more normal looking appearance so he didn't feel self conscious about his natural hair. He used a hair piece to conceal the large FUE plugs improperly positioned from several hair transplants many years ago. Improving the frontal hairline was the first priority, but he also needed more volume around the large grafts to give him a more natural looking hair style. The last procedure was done with strip surgery and included 3,071 hairs. We have done 3,230 total grafts in three small surgeries that began in 2000, until his most recent surgery last year. I hope you agree that although it is not perfect, it is drastically improved. At this time he is extremely happy with his progress. Also, he no longer wears the hair piece.

Without a crystal ball it can be a difficult task to demonstrate what is possible with a HT surgery prior to a procedure. Before and After examples give the best impression. But not all patients are the same. Here is a patient with dark very fine hair. He prefers not to use pharmaceuticals to maintain his hair, but instead would like a more "natural" remedy. Propecia and Minoxidil to date do not have many "natural" products that have as proven a track record with hair loss prevention. Low level red light has some benefits as well as the other natural supplements, vitamins and minerals that we will not review at this time. See our website for more details. Is it realistic to expect a "full" head of hair with surgery? What if you are not preventing further hair loss either? This case shows a very nice improvement with 2,320 FUG from strip harvest, resulting in 4,904 hairs. Is it completely full? No, but it looks natural and you can see an increase in overall hair volume, despite what is likely going to be more progressing hair loss in the future, unless prescription medications are used. Any additional surgery will give him even more fullness and coverage. But without preventing further hair loss, maximum coverage can be a challenge.

This is a patient with Norwood IV hair loss, fine hair, and good density. Two surgeries were done, the after pics show one year from the last procedure. 3,593 total grafts were transplanted, and resulted in 6,994 individual hair follicles. The patient has also been advised to continue use of HLPT. The after images were taken to mimic the exact preferred hair styling of the patient's before surgery images to demonstrate a relative comparison.

This surgery was done in 2008. The patient recently returned to discuss another procedure to improve overall coverage. In the initial consultation it was discussed that more than one procedure may be needed for optimal fullness due to his extensive hair loss. Surgical plan was designed to have more emphasis on the "part from" side to create an option for greater cosmetic coverage with a single surgery. Any additional procedures could be done to address any other areas of concern at a later time. Six years later, here we are. The patient has continually used HLPT over this period. Strip harvest was done, and dissected into 529 single hairs, 1658 doubles, 1085 triples, and 156 quadruples, totaling 3,428 grafts, with a yield of 7,724 individual hairs. Believe it or not the closure was a simple closure using only surgical staples, without subcutaneous sutures or Trichophytic maneuver. A transforming and natural looking improvement was the first step.

Women with androgenetic hair loss that are considering a hair transplant surgery should mentally prepare to have more than one hair transplant procedure. This does not necessarily mean that an additional surgery is performed. However, in order to get the highest possible density, more than one surgery is recommended. Ultimately, happiness is defined by each individual. If a second procedure is recommended, but the patient is happy with one surgery, awesome! Every one of my patients with androgenetic hair loss is encouraged to use HLPT. This patient had strip surgery, 2,429 grafts were transplanted in one procedure, including multiple unit grafts (MUGs), resulting in 4,904 individual hairs. Prp was processed and used as the graft media, as well as injected into the scalp. The patient photos show a significant improvement, with a noticeable increase in hair body created by the increased volume of hair visible in the hair clips. However, since she is a woman, our societal expectations suggest that she should pursue more fullness. At this time, she has declined any further surgery, but instead has chosen to enjoy her improved appearance and a higher level of self esteem. As long as she is happy, so am I. For now.

An ideal time to have a surgery may be before lose too much hair to hide the evidence of the surgery. This patient is beginning to show evidence of front to crown hair loss. Hair loss prevention therapy (HLPT) is the first priority! A strip surgery was the treatment of choice. Regardless of the number of grafts recommended (unless minute), many patients are simply not interested or are completely unable to withstand having their head shaved, even for a short time until the hair grows out. 2,123 grafts containing 4,754 hairs were transplanted in one surgery. The images are not as clear as usual for some reason. But what is clear is the level of improvement with a single surgery. Another surgery could be helpful, but as long as HLPT is continued he should be just fine. Notice the increase in volume in the amount of hair, especially in the hair clips. And the scar does not remotely resemble the scary scars from strip surgery found on the internet.

Here is a Male patient with temporal hair loss. His right side being the thinner of the two areas. When considering hair transplantation in smaller areas, there is a limited number of hair grafts that can be transplanted with one procedure. Over "packing" a smaller area jeopardizes graft survival, and risks loss some individual hairs forever more. Multiple smaller procedures will preserve hair grafts, and is a more efficient way to distribute valuable delicate hairs to achieve optimal fullness. This surgery was performed by strip harvest, with Trichophytic staple closure. 1,331 follicular unit grafts were transplanted, resulting in 3,128 individual hairs. The images show before surgery, blue surgical plan markings, immediately following the procedure, and one year after the surgery. Notice the hairline looks completely natural and the improvement in the total amount of hair within the hair pins. Also take notice of the overall increase in "hair body", a characteristic which gives his hair a richer, healthier looking appearance. High graft counts and significant improvements with very bald patients are dramatic. But, I personally feel that the patients with imperceptible and natural looking before and after improvements are far more impressive. Thank you for the opportunity to enjoy and appreciate the talented work of other Physicians and Technicians on this Forum.

This patient had a medium size surgery of 1,791 FUE grafts that resulted in 3,598 total transplanted hairs. It is not the most impressive result we have achieved with a patient. There are areas within his scalp that could look fuller. But wait, he stopped using the medications that were suggested to help prevent hair loss progression. Specifically, Propecia ® (Finasteride), and Rogaine ® (Minoxidil). AND he has been prescribed medications for an unrelated problem by another physician that have side effects that can potentially increase further hair loss. So, the fact that this patient does show an improvement, and does not appear to have any dramatic increase in his hair loss is very noteworthy. The FUE grafts are likely the reason it looks as good as it does. He has scheduled another FUE surgery and has plans to resume the preventative medications. The images show an overhead view. Also, the donor area is shown to illustrate no visible thinning within the FUE graft harvest region from the his first surgery.

This patient has great hair body or what most people classify as "curly" hair. He had one small procedure of strip surgery using only 1,1185 follicular unit grafts. With budget limitations it is very possible to get an acceptable surgical result with limited grafts with certain hair characteristics. The views show before surgery, one year after and a closer view of the after result. A larger or second procedure could be recommended in the future, however hair loss prevention measures may render that unnecessary. Time will tell.

Here is a female patient with classic female pattern hair loss. She has below average donor density,and fine hair. The combination of those two characteristics can present a challenge as far as improving her hair volume. Especially, in one procedure. She is using preventative medications to minimize any further hair loss. A strip procedure was done, MUGs (multiple unit grafts) were used with FUGs totaling 2,313 grafts. The combination of both types of grafts can dramatically improve the overall follicle count with a fewer number of grafts. The donor area was closed with staples and Trichophytic closure. The images show before treatment, surgical markings prior to the procedure, immediately following the surgery, and one year after the procedure, including the donor scar. The patient was counseled in the initial consultation, and advised that multiple procedures would likely be necessary, due in part to her fine hair and limited donor density. However, after the first procedure it is obvious that may not necessarily be the case!

Patients with extensive hair loss and dark hair, regardless of hair texture, commonly desire a second procedure. To achieve a fuller looking head of hair, subsequent procedures may be requested to increase overall volume and density. This patient has had two procedures. Both surgeries greater than 4400 hairs were transplanted via 2200+ FUGs each surgery over the span of two years. Hair loss prevention was recommended, however holistic measures were preferred. The images show before any surgery, and then one year after the second surgery, totaling greater than 4500 grafts, with a yield of over 9000 individual hairs.

This patient had his first procedure three years ago. He was very happy with his results from the procedure. He has been using hair loss prevention as suggested. Unfortunately, hair loss preventative medications do not completely stop 100% of any further hair loss. However, you are certainly much better off preventing most, than none. If your goal is to have a fuller look, consider an additional procedure to increase overall density in the areas of concern. In the images you will notice in the frontal region there is more hair volume overall with his second procedure. The change from the surgery is subtle. The objective was to replace any hair lost, without drastically changing how he looks. A smaller session of 1,354 grafts, totaling 2,888 hairs were all that was needed to increase his hair volume. Despite darker hair coloring than the previous surgery, there is a noticeable improvement in hair body, which enhanced his appearance with a relatively smaller, more economical surgical option. The second procedure was also done using strip harvest, since there was a scar from the first procedure. The initial scar was removed during the tissue harvest for the second surgery. The images show the "Before", "After" the first surgery, and last image is the most recent image taken one year after the second procedure. I advise all of my patients on continued use of hair loss prevention medications.

Dark coarse hair with texture helps cover baldness with fewer grafts. 2,248 follicular unit grafts were done on this patient by strip harvest with Tricophytic closure using staples. 5,144 hairs were transplanted in one session. And hair loss prevention is recommended for every patient concerned with MPHL or FPHL. The photo was taken one year after surgery.

Hair loss in the crown can be greatly improved with a single surgery. But it is unrealistic to expect complete or "Full" coverage with only 1 procedure. Why? The direction of the hair in the Vertex grows in multiple directions. Therefore creating a "Vortex" or whirl in the crown requires more grafts. Some patients have multiple "whirls" or "Cow-licks" in this area. Consequently a 2nd procedure may be necessary, if your goal in complete coverage. This patient had a strip procedure performed and 1,424 grafts were transplanted over five years ago using MUG's and FUG's. The surgery size performed is usually directly related to each patient's budget. More grafts could have been transplanted in the first session. A second procedure has been performed and results can be posted once follow up photos are taken 1 year later. The photos shown were taken five years after the first procedure, and prior to the most recent surgery.

This patient has Medium textured "salt and pepper" colored hair. This combination of texture and color does very well in helping create the illusion of a fuller looking head of hair with fewer grafts/hairs. This patient preferred a very conservative restorative improvement for personal reasons. He would rather have a "thinning" look, as opposed to looking like Jon Hamm or Bradley Cooper for example. This type of hair texture/color combination can look harsh or more coarse than it is in actuality. In reality his hair is actually very soft when felt,and not coarse at all. Two separate strip procedures were performed over a 3 year period. The first procedure 1,909 grafts were transplanted containing 4,519 individual hairs. The second procedure was done 3 years later and 1,518 grafts were transplanted containing 4,649 hairs. The image of the scar is after the 2nd procedure taken 1 year after the 2nd surgery. Please be aware that the "see through" appearance is intended to provide a more conservative looking result. This look can be easily avoided or eliminated at any time with more grafts within the areas of hair loss. What is most important, is that the patient's wishes were met and he is very happy with his final result. He still has the option to elect to have another surgery to achieve a fuller head of hair.

This patient had a strip harvest hair transplant. The strip was 25 cm in length and measured 1.5 cm in width and was closed using staples and a layered tricophytic closure for the best possible scar after healing. An image of the scar is included in the images. 5,998 individual hairs were transplanted as a result of 2,868 total follicular unit grafts containing single and up to four hairs, and was performed in one procedure. The body in his hair gives the hair transplant surgery the illusion of greater coverage due to the texture of the hair. As you look at some views it is clear the hair is not as full as it can be. A second procedure was performed to increase overall density and hopefully we can add more images from the results of the second surgery at the one year follow up visit. (The scar image was taken prior to the second procedure).

This patient was treated by strip surgery 1,489 Follicular Unit Grafts, 2,748 hairs in one procedure. Multiple Unit Grafts (MUGS) were primarily used for this procedure to increase overall density in the affected areas. The pictures show two different angles of the treated area.

Frontal hair loss treated by Dr. Edmond I. Griffin with HT surgery by strip harvest. All patients are strongly encouraged to use hair loss prevention measures to minimize further hair loss. 2,421 follicular unit grafts totaling 4,928 hairs were transplanted. Images show various frontal views and a view of the scar from the strip. The remaining strip scar demonstrates that with good closure techniques, minimal scarring can be possible, even with larger session size strip procedures. Certainly not every patient heals identically. So, it is important to keep that in mind as a patient. Not all scars, whether strip or FUE heal the SAME for every patient. Not all strip scars are BAD, not all FUE scars are imperceptible. Conversely not all strip scars heal as well as this one, etc.

This patient was scheduled for a Blepharoplasty (eyelid surgery) with another physician in our practice and decided that she would like her eyebrows improved with a hair transplant on the same day if possible. Easy! FUE! So we discussed that she may need several tiny procedures to get optimal fullness in her eyebrows, and that the eyebrow hair would require constant periodic trimming. Patient is of Latin decent and the hair texture is very coarse. However, with FUE the most delicate hairs within her scalp could be harvested without any sign of a linear scar that is inevitable with strip harvest. 165 single and two hair follicular grafts were extracted and then transplanted into .6 mm sites. 236 individual hairs were transplanted. The images show surgical markings outlining the eyebrow of each eye, as well as the excess skin on the upper eyelid and lower fat pads. The "after" result of the surgery 18 months after the procedure. The next procedure would increase the overall number of hairs in each eyebrow, and is planned for this summer. The hairs in the photos could be trimmed shorter to more closely resemble the natural length of hair typically found in the female eyebrow in my opinion. Not perfect, but a work in progress.

Frontal hair loss, with hair loss prevention use daily. One session 1,381 follicular unit grafts strip harvest. 2,775 individual hairs transplanted in the frontal region as indicated with before and after images showing various views. Note the increase in hair density noticeable in the amount of hair within the hair clips. High graft count not always necessary to look better if you can't afford it.

This patient has Norwood Stage 3a hair loss. At the initial consultation, upon examination, it was suggested that it was quite possible that two surgeries could be necessary for optimal fullness, due to the fine texture of the hair and the extent of the frontal hair loss. The surgery was performed with a strip harvest measuring 28 cm X 9 mm, and a Trichophytic dual layer closure with staples. PRP was processed and used as the graft media as well as injected into the scalp prior to implantation of the follicular unit grafts. Graft count consisted of; 314 single hairs, 808 double hairs, 545 triple hairs, and 43 quadruple hairs, totaling 3,737 individual hairs. Patient currently uses oral finasteride and topical minoxidil for hair loss prevention therapy. He is also considering a second procedure to increase density. The images show before and after photos, followed by surgical plan marking, immediately after all grafts have been implanted, then one year after the surgery. The last two images are close up photos of the strip scar, with the hair separated with a comb. Compare the thickness of the "pocket" comb to the width of the scar.

3,245 Follicular Unit Grafts transplanted in a single session resulting in 5,721 individual hairs into the frontal and mid scalp to restore a patient with Norwood VI hair loss. (No grafts were planned for the crown with this patient for his first procedure) Strip harvest and two layer, stapled trichophytic closure. Images show before surgery, followed by surgical plan markings, immediately following transplantation of all the follicular unit grafts, and finally one year after the procedure showing near complete makeover. Optional second procedure would certainly increase fullness and density, or improve the crown if desired by the patient.

Frontal hair loss restoration with one session 2,169 follicular unit grafts with strip harvest 9mm in width and dual layer trichophytic closure of donor area utilizing staples. 4,795 individual hairs were transplanted resulting in great coverage of frontal region. Hair loss prevention is encouraged with every patient to maintain and help prevent further hair loss of existing hair. First photo is before the procedure, followed by the marking on the day of surgery; with attention to patient's preference for even distribution, immediately after the procedure, one year after surgery including the donor scar.

This patient, believe or not is a young twenty something patient that has Norwood VI hair loss. Homeopathic medicines are preferred by patient for management of preventing further hair loss. Patient counseled that multiple sessions may be necessary for optimal fullness. In part due to his extensive hair loss this age. But more so, due to his unconventional and unpredictable choice for prevention therapy. Characteristics of his donor region suggest high yield/density, dark, coarse textured hair. Strip surgery was method of choice. Strip obtained with multi-blade handle, 9 mm in width. Two layer, stapled tricophytic closure. Recipient openings were made utilizing custom blades, sized 0.8, 1.1, and 1.4. Follicular unit grafts consisted of one and up to four hair grafts, totaling 2,462. Resulting in 4,999 individual hairs. These grafts were distributed from front to back, with slightly higher concentration on the "comb from" left side. Photo's show day of surgery and one year post operative. Second session planned to increase fullness throughout the scalp.