RecedingTide

I'm a big believer in the possibilities of FUE but I am going to be controversial and pose this approach:

Could a strip procedure target the thin area in the donor and oppose the higher density areas above and below this area as a solution?

Just a thought.

I really hope you get the result you're looking for Sean. Often when people are Norwood 2 they envision getting back their pre hair loss hairline. I understand that feeling well. As one loses more hair the expectation changes and 3000 grafts in the frontal third can leave a lot of people happy.

If I am honest I actually think the hairline design Dr. Rahal came up with was quite aggressive. I do not understand the large forehead comments. I would be more concerned about the donor recovery than the hairline height. While I understand you are chasing a dense hairline going too dense can impact yield. Suffice to say I cannot know why results have been sub optimal but you need to consider the next step very carefully. You have used 4500ish grafts in an area significantly smaller than the frontal third. Perhaps more like the frontal quarter of your scalp.

I am urging you to please consider the ramifications of losing the hair behind it as you do have some thinning in the crown. Medications do not work forever and the only way to put hair permanently on your head is transplantation so you need to consider having enough in reserve to take care of the frontal half.

I wish you all the very best on your journey Sean. Fingers crossed for you.

Very nice result Dr. Erdogan. I see his donor capacity was estimated at 7900 fu preop. With uniform density of 60fu/cm2 I can only surmise that you feel it is possible to extract well over 40% of this patient's donor. I know there is one doctor in particular that believes we can take up to 50% of the donor via FUE. It would be interesting to hear a little about your philosophy on managing the donor area with FUE in the long term.

Dr. Hasson is the GOAT. Stunning result. Exceptional yield and fantastic hairline. Must be nice to have that head of hair.

It's very impressive for 5 months. One would worry about BDD in this young gentleman if he really doesn't see the difference.

Looks like a cracking result from the first op. I was wondering if the irritated area in the hairline also had worse crusting than the rest of the recipient? I have heard different approaches to removing crusts with many post-op protocols advising gently wetting and massaging to loosen them from day 8 or 9. I find this interesting as some will say it's paramount to massage off crusts to avoid infection while other doctors advocate a less active approach due to concern that grafts could be pulled out with the crusts. I'm inclined to believe that any hairs lost in crusts from day 8 will likely regrow given no blood appears. I am aware of Dr. Bernstein's plucking study.

What I am basically asking is why and how do crusts affect growth?

50% is too much I agree, unless we're talking about an untouched donor of uniform 100FU/cm2. In most non curly haired Caucasians you can take a third of their donor via FUE. I can guarantee that there are patients walking around with almost 3.5k FUE transplanted with a uniform density of 86% of their preop donor density left. 8k for 33% of their donor no problem for many Europeans, particularly Spanish, Portugese and Italian.

A lot of people have a donor capacity of 8000 +\- 10%. I'd bet this guy may have up to 4400 grafts left. 1400 to finish mid scalp and then 3000 (if he needs or wants them) in the crown. Even if he only had 1400 left he would never look abnormal. FUE has come along way in the hands of the top clinics. This is a great result.

I kind of appreciate the transparency but this looks like amateur hour with this discussion being carried out on a public forum. Someone pick up the phone.

Big result for 2023 grafts. I wonder what the hair count was? I ask this as I am wondering if a high number of multi hair grafts were cherry picked to maximise coverage. Patient could consider topical finasteride also if worried about systemic side effects. It can be imported from Milan.

Whoa. Awesome result. He must be delighted. Hair restoration has come a long way.

This guy can definitely get another 2000 grafts. It already looks amazing but 1000 more in the front half and 1000 in the crown would send it over the top.

Definitely Europe for FUE. Lorenzo is probably the best FUE practitioner in the world. Feriduni & Bisanga in Belgium are ace. Recently Doganay and Erdogan have put Turkey on the FUE map. Some great options.

Not familiar with Dr. Mohmand but Dr. Feriduni and Dr. Hasson are both top 5 in the world.

Yes and no. Yes in as far as FUE has come on leaps and bounds in Europe with loads of great results emerging. No in so far as people with extensive balding will be best served by stripping out and then adding 2000 more with FUE. For example a norwood 6 may get 11000 grafts with FUT+FUE or 7000 with FUE alone. It may still be worth going strip first for some.

Their gallery of results is a joke. They stick maybe 1500 grafts up front onto a norwood 6. They're probably charging so much because 3 surgeons have to get a slice and they have massive overheads for Samson house. Not impressed.

Lorenzo must be making some serious bank. However he does all the extractions and planting so you really get what you pay for. Feriduni and Bisanga are well priced too for European outfits.

Lorenzo's work is immaculate. You will be delighted when it grows in. His extractions are phenomenal and I think that's the reason why he can go into the donor again and again and pull out the big numbers over the years. I'm sure we've all seen the shaved donor vids by now.

Great result. You're right Patriot in that he's headed for norwood 6 but that will not be a problem at all as H&W consistently manage the donor area well and get big numbers over the multiple surgeries. 8000-9000 grafts? No problem over 3 or 4 surgeries.

Whoa. What a fantastic result. It looks really dense. Dr. F is a wizard.

This is how it's done.

It's all well and good but this is well over 10 years away. Realistically more like 20 years.

Great coverage. How is the scar? Looks like the hair on the sides is 2 different lengths.

I once thought it was legit too and yeah the small study probably is honest. In practice though Gho is doing something else. Where are these results? He's transecting hairs in practice without regeneration. The study was just a means of promoting his clinic as something it's not. I have yet to see a recipient after multiple sessions that can compare to a 4000 graft fut.

That's insanely good. Looks more like 6000 grafts.