PupDaddy

Truly amazing! And at only 10 months, yet. One of the best ht results, if not THE best ht result, I've seen. Beautiful. Congrats to Dr. Hasson and to his lucky patient. Pup

Wow, McLoud! What a huge cosmetic difference after vs. before. You look great. Pup

J, Thank you for the excellent writeup and update. You're looking great at only 3 months, with plenty of early growth. Looks like everything is on track for a terrific result. Please keep us updated. Pup

Thank you for sharing your journey, sgs. Per the recent discussions on this site about the hair length "sweet spot" post transplant, it is amazing how much fuller your mane looks with your hair longer. Once the new grafts are fully grown in and matured and you've recovered your shock loss, you should look terrific. Congrats!

Assuming that Dr. Lorenzo's clinic meets the requisite standards for recommendation, I would vote a definite "Yes" based on his numerous impressive videotaped results.

As of today, my vote for FUE in North America would be: 1. Dr. Rahal for larger FUE session, e.g., 2,500 - 3,000 (for reasons stated by HARIRI) 2. Either of the Shapiro brothers (SMG) or Rahal for FUE sessions less than above (again, for reasons stated by HARIRI) PD

There are subsets of people who are good candidates for FUT who are not good candidates for FUE. One such group are people with curly hair because the bulb is not necessarily directly beneath the point where the hairs exit the scalp, which can result in unacceptable transection rates. Other people have, for lack of a better term, "mushy" scalp characteristics or other scalp tensile characteristics that can make it difficult to punch/incise the FU and/or extract (pull) the graft out after it has been incised. Sometimes the doc won't be able to determine whether a patient has these non-FUE characteristics until he tries to incise and extract a few FU's, at which point the patient will have the option to stop the procedure or continue with a strip procedure. Hope that helps. PD

By the way, aim4hair, Another technology to consider regarding FUE is the new ARTAS robotic extractor system developed in collaboration with Dr. James Harris, another recommended doc on this site. You can read about it on his site. It is supposed to make possible dead center, motorized punching out of the FU at the precise angle of the FU's exit, for less transection and damage. It looks to be quite the elaborate and sophisticated contraption, resembling a dentist's chair with lots of computerized gadgetry. Dr. Robert Bernstein, another recommended doc on this site, is reported to now be using an ARTAS in his practice as well. Dr. Harris invented the handheld Powered SAFE Scribe for FUE, which, I believe, is the tool that Dr. Rahal has been using for his FUE procedures. As I understand it, ARTAS employs Dr. Harris' Powered SAFE Scribe for punching the FU's but maps and guides it robotically. Pretty cool. Just some more info for you.

True, but Dr. Wesley claims that the extraction method he is working on is not FUE as we know it and will eliminate scarring completely (including punch/punctate scarring associated with FUE). Whether or not it is similar to Dr. Gho's "Hair Stemcell" extraction method, which is presently in use at his clinics, remains to be seen, but it does appear that technology has rapidly evolved to a point that might permit the "scarless" HT surgery that Dr. Wesley promises. The proof will be in the pudding, of course. I don't want to hijack this thread or engage in speculation, so maybe a new thread could be started once Dr. Wesley announces that he is offering the new technique.

Beautiful work. That's a "yes" from me.

I suppose the technique that Dr. Wesley is working on could be similar to Dr. Gho's (Hair Science Institute) that HARIRI brought to our attention. Dr. Wesley's site says he is working on the technique with colleagues from Yale Medical School, so it sounds as though it could be cutting edge. I guess we'll have to wait and see whether it's anything like Dr. Gho's method (extracting stem cells from the FU donor bulb while leaving enough of the bulb and stem cells intact to permit regeneration of the FU), but something along those lines would satisfy the criteria that Dr. Wesley lists on his site. It will certainly be interesting to see what he's come up with. He says on his site that he could start offering HT's using this scarless extraction technique as soon as this calendar year, so we shall see. PupDaddy

Hi aim4hair, What you're really talking about here is completely recreating your frontal third, with a hairline as it might have been in your glory days. The hairline you say you want (the front of the shadow, spanning side to side, with essentially no recession) is actually quite aggressive. Jotronic (Hasson & Wong) has posted here about the surprisingly large numbers of grafts needed for each mm/cm of hairline advancement. If your consulting docs have estimated 2,500 - 3,000 FUE's with a significantly more conservative hairline, those docs might well tell you to double that estimate for the hairline you want. Having said that, there are a number of FUE docs who post results on this board that could probably get you a nice result for your stated objectives with 2,500 - 3,000 grafts, but with a hairline in between the ones drawn in and your shadowed "ideal." Another possibility to consider is Dr. Carlos Wesley, who was recently recommended on this board, who says on his web site that, in addition to strip and FUE, he will soon be offering what he calls "scarless surgery." Based on the vague description, it is supposed to offer the benefits of FUE but with better yield (minimizes transection) and without punctate scars. Scarless Hair Transplantation by Carlos K. Wesley, MD Maybe it will be worth waiting for. PupDaddy

Looking terrific, Hairfusion! Yep, some grafts to the crown will complete the picture but what a cosmetic improvement as is. Thanks for the update. PupDaddy

Thanks very much, Dr. Lindsey. Most informative and interesting. PupDaddy

Yet another gorgeous result (and beautiful scar) from this artist. Dr. Konior has to be on anyone's short list of top HT surgeons in the world. PupDaddy

Dr. Lindsey, Thank you for that interesting case study. In your experience, does the "unpredictable nature" of FUE pertain to a) yield or to b) the quality of the matured transplanted hairs, or both? In other words, if a given FU survives the extraction and implantation process and, therefore, grows, should the hair(s) produced by that FU be of the same quality (robustness, diameter, characteristics, etc.) as if it had been extracted via strip? Or, rather, can the quality of the mature transplanted hair shafts be compromised as well? Also, in your experience, is the unpredictability of FUE attributable to a) damaging the root bulb during extraction, b) transecting the hair follicle(s) itself, or both? Something in addition? Many thanks for your time, PupDaddy

Holly crap! Based on these photos, at least, your Rahal FUE yield and cosmetic result are indistinguishable from a Rahal FUT. You must be chuffed. PupDaddy

You're right, orlhair1. The hair really does appear more robust now! You look really great and completely natural. Good luck on your FUE (not that you really need it, you greedy bastard). PupDady

Savehair, Forgive me if I am mistaken, but I think you might still be missing the point of what people are telling you. A hair transplant will never give you the ACTUAL density (hair count), or even 90% of it, you had in your recipient area (where the transplanted hairs go) before you lost hair there. Rather, a well performed hair transplant can make it APPEAR that you have not suffered significant hair loss in the recipient area. Why? Because before we start to lose hair from a given area, the average male has approximately 80 - 100 follicular units per square centimeter (FU's per cm2) of scalp. Hair transplants as practiced today generally provide somewhere between 35 - 65 FU's per cm2, depending on donor supply, hair characteristics, extent of loss, and the region(s) being transplanted -- usually higher FU's per cm2 in the hairline zone, but using only single hair follicular units (so lower total hair count), with fewer FU's per cm2 farther back, but often with 2 and 3-hair FU's, which enhances the hair count per cm2. In other words, current technology and technique does not permit transplantation of 90 - 100 FU's per cm2 with acceptable yield (90%+), even if you had sufficient donor supply to attempt it and could be assured you wouldn't need more donor hair for further hair loss in the future. But the good news is that men can lose quite a bit of their native hair from a particular region (thinning) before it becomes cosmetically noticeable. Generally speaking, it is said that you can lose 40%- 50% of your hair in a particular region before it becomes cosmetically noticeable. The area will start to appear noticeably thin once this threshold is passed. A well executed hair transplant can return that region to the cosmetic density threshold (sometimes beyond, depending on circumstances), and with modern implantation techniques, such as lateral slit and close attention to hair angulation, get the most cosmetic benefit out of the transplanted hairs and make the region appear even denser than it actually is. This is what is meant by the ILLUSION OF DENSITY. You will not obtain the ACTUAL density you had in your recipient area before you started losing hair there, or even 90% of it, but you can obtain a sufficient cosmetic illusion of density in your recipient area that the average eye will be "fooled" into perceiving that this person has not suffered significant hair loss there. I hope that helps. PupDaddy

Congratulations to Dr. Wesley! I understand why some might say, well, other docs do more grafts and denser packing per session and seem to get good yield, but these are extremely natural and refined results, the kind where the patient doesn't look as if he has experienced marked recession or thinning for his age and no one would ever suspect that the patient had a transplant. I personally love Dr. Wesley's hairline work. He looks to have mastered a hairline layout and technique that produces results that really do mimic mother nature, especially for patients whose 20's are in their rearview mirror. Check out those immediate post op recipient site photos for the rather distinctive hairline pattern that Dr. Wesley uses, with intentional small "gaps" amongst a series of angular "continents," which, to me (and to my girlfriend who checked out the pics) produce utterly natural results that look just right on the patient. I think it's good that this site recommends docs with different approaches and philosophies, so long as their work is stellar, refined, and undetectable, as I think this doc's is from the examples he has posted. Good decision to recommend Dr. Wesley, in my view. PupDaddy P.S. Hi everyone. Long time lurker. First post.