Rootz

Oops yeah read wrong, 1484 grafts. Really nice.

Anyone else having everything on the forum taking a lot longer to load? Pictures in particular have been taking 10+ seconds to view for me. Going to a thread with a bunch of pics -> click on a picture, go do something else, come back, repeat for each picture. Takes forever.

To clarify, the immediate post op pics show 4040 grafts? Wow, never seen so many grafts packed in that small of an area before. The result pictures are not great, but from what I can see it looks good.

Result pictures could have been better, they're either close ups with the hairs pulled at a diagonal (to overlap and appear more dense) or far shots with hair combed to obscure the hairline/density. But for 2041 grafts I think this is pretty good. Was the patient aware beforehand that this was not an ideal number of grafts for the surface area? I think he would have needed another 1000-2000 grafts to achieve a "full" look with the hairline.

Considering the large surface area and only ~3200 grafts the frontal forelock area turned out nicely. There is nice overall improvement in the areas behind the hairline. There is no good view of the temple corners however based on what I can see they appear they're weaker than what I would expect. In the immediate post op it looks like quite a few hairs were put there, but in the result I'm not seeing much there. Overall I think this is just OK, but the scar turned out great.

Hard to appreciate the result because the post op pictures are extremely limited. It is basically the same view from above with the hair combed forward. Was this a good result for ~2700 grafts? Can't tell.

Hard to tell how good this was for 2827 grafts because the improvement is not much bigger than what differences in angle, hairlength, and lighting can create in pictures. The hairs are presumably spread out over a massive area and there is no immediate post op pic. One reason his crown looks better is his hair is longer and styled better post op. As a sidenote, in the before pictures he's shirtless whereas in post he's wearing what appears to be a suit. Whether or not this bias was intended, just for that reason alone the post op pictures will look more appealing. Doctor your best bet for this case would have been a short video comparing before and after. Either way, an immediate post op pic would have been very helpful.

1) Need an immediate post op pic 2) Apples to oranges comparison 3) If you had told me this guy didn't have a HT at all I'd be apt to believe you

In my opinion the pictures do a poor job of telling the story here. Definitely need post op pics showing where the grafts went. The before/after comparison is not good because of the difference in hairstyles. If he had the same hair style in both pictures, it's unclear how much difference there would be. I suspect there's improvement, but again it's very unclear in my opinion. Apples to oranges comparison.

Seems legit

Seems bizarre they're OK with you wiring the initial 1,000 deposit, but you can't just wire the rest some time before the procedure. What's the difference.

They won't let you wire the rest of the payment before the surgery?

Thanks, was the crown touched? The pics don't show it and the description "1791 FUT grafts transplanted in the frontal area" seems to indicate no, but his crown looks better post op. Is the difference in hair styling then?

An immediate post op would be helpful. But I think this is a nice result for the grafts.

eyebrowqueen, that is interesting. I'm not sure why, but my guess is SMG and Rahal think the strip will be very small and thus will leave an insigificant scar... and since FUT generally has a slightly higher yield (and costs less), you would be better off going that route. I guess it depends how concerned you are about having a small linear scar that might be visible with short hair. If you scar aggressively, even a small incision can stand out. Of course if you don't care, or never plan to wear your hair on the short side it might not even matter. GreatPaleo, I think that is a good and reasonable approach. Of course there are gray areas with different levels of loss and there's uncertainty with predicting future loss, but in principle I agree. If it is likely that not enough grafts can be judiciously harvested from FUE alone to meet someone's short and long term goals down the road, and they accept this and want to move forward, starting with FUT and finishing with FUE makes sense. Unfortunately I don't think this is the reason why most people do FUT though... I would be willing to bet most go with it to save money and/or because their HT doc just prefers that method. I also think if hairloss is semi-aggressive (gray area) then it is probably safer to err on the side of FUE... as you can still do FUT later on down the road it's just not quite as ideal an order.

eyebrowqueen, I know you directed the question at Mickey, but I would like to point out that cosmetic surgery is very much a product of demand. In other words, as long as people are willing to line up to get FUT done, and it's a reasonable procedure, I'm sure many ethical and competent doctors keep doing FUT and not worry about FUE. Supply and demand. They already know FUT, FUT is easier to supply than FUE, and there's still a lot of demand for it.

I see. So you would agree that FUE should generally be the plan A course of action if the amount of grafts you need can be conservatively harvested (~20%) with FUE?

How long post op is this patient? The pictures are blurry and the comparison isn't great, but it's probably pretty good. Cases like this one where the very front of the hairline is intact with high native density tend to turn out well. Even if the temple areas are low density or have issues, the frontal centerpiece is still intact and helps brings everything together.

Sometimes it's just nice to be reassured that things are going along OK. The dulldrum period, as they say, is drawn out and the duration varies from person to person. You can start to question if things are really going as planned if you're not at or ahead of the curve. I think month 3 is generally the period where things start to happen... key word is "start," because you won't necessarily be able to see it. By month 4-5 if you can't actually see noticeable peach fuzz then I think you're either a slow grower or may have a problem.

Diffusing the donor area by around 20% from native density generally has no meaningful impact on the appearance. If you need so much hair that you need to harvest more than that, then yes I can see how a FUT + FUE combo can come into play. However, as you know, the linear scar may very well be a problem... so in my opinion it's best to use FUE as plan A, and FUT as plan B. The more grafts you need with FUT, the larger the scar also. I'd rather take small white dots that are almost imperceivable over obvious line scars.

When FUE is done by a reputable doctor the difference in density in the donor area is unnoticeable. Only around 20% of the grafts are harvested in any given donor area. We know if you can transplant hairs at 50% normal density, the result looks natural... FUE will leave the donor area at 80%+ normal density. The white dot scars are really only noticeable if you're completely shaved to guard 1, someone is staring at your head, and the extractions are clustered together (as opposed to spread out)... and if by some miracle someone notices them, they'll probably have absolutely no idea what it is and think nothing of it. There is really no comparison with FUT scars. Yes, some FUT scars turn out well but a lot do not and it's very hard to predict... going to the best FUT doctor in the world is in no way a guarantee the scar will turn out well. It's a roll of the dice, and even when it turns out well it's still usually 100x more noticeable than FUE scars.

I agree, this looks good for the amount of grafts used and appears natural. He could have gotten a better result with more grafts, but I'm sure he needs to conserve. Looks like he has thinning elsewhere.

This is probably a decent (maybe better) result for the grafts, but it's hard to say for several reasons. I don't consider a result good just because there was an improvement. In my opinion if he had grown out his hair pre-op and combed it the same way post-op he would have looked similar to his result. Compare pic 4 and 5 for example. The main difference I can say for sure is there is now low density hair at his temples that wasn't there before. I think his crown is improved, but it's hard to say (shaved vs non shaved comparison) and there's no immediate post-op pic... the only description of where the grafts were placed is that, "Dr. Friedman helps dense pack a hair line" - the hairline is certainly not densely packed, unless you consider what appears to be 10-20 hairs/cm^2 densely packed. Again, probably a decent result... key word probably. If all the grafts really did go into the hairline, I would say this was not good. My opinion of course.

This desperately needs an immediate post op pic, or at least a pic showing the drawn areas. I'm assuming the 2750 grafts were spread over the hairline and top of the head back towards the crown, in which case this is simply not enough grafts for the job. In any event, "dense pack a hair line" does not describe this case.

I can already see their slogan, "Tired of hair loss? Phuket."