hairweare

While I think that it is a good for prospective patients to hear about both the good and bad experiences former patients have had with their surgeons, the anonymity of the forum makes it all too easy for both shills and those who would unfairly defame physicians to disseminate false information. Therefore, without photographic evidence and the opportunity for the physician to respond, your post is pretty much worthless.

Bake, no doubt the decremental reduction in yield from multiple FUSS has more to do with scalp laxity or lack thereof but the observation is still a valid one. I am sure that Dr. Rassman attempted to maximize each procedure but in my case and I am sure this is not uncommon, there were less grafts available for each subsequent procedure at a cost of a widened scar. I did not mean to imply that Dr. Lorenzo claims minimal post op shedding but several other pts of his that I have corresponded with have noted the same. I would assume that the telogen phase of the initially transplanted follicles might last longer than non transplanted follicles perhaps due to ischemic shock or other factors related to the delayed reestablishment of the capillary blood supply. After my 3 FUSS procedures all of the transplanted hairs fell out within two weeks and growth seemed to occur in natural waves over the next 4-6 months. Following my FUE the growth cycle of the grafts seemingly kept pace with the surrounding follicles again with minimal shed. I can't explain why, but neither time did I experience the "ugly duckling" phase." I could tell that the hairs were not shed because the tips were thicker and often bent while the shafts were thinner as they began to initial grow longer. Perhaps I was just lucky this time around.

Well, from personal experience I would have a hard time accepting your theory. My first FUSS yielded 3600 grafts, the the second 1200, and the third 800. After each surgery the follicular yield decreased inversely proportional to the widening of the occipito-temporal scar. So one might conclude that serial FUSS yields decrementally lower number of follicular grafts while risking a widening of the scar. On the other hand after the first FUE of 1500 we looked at the donor area under the scope and saw minimal gross scarring and no gross visual change in density. 5.5 months following the second FUE of 1400 grafts there is still no visible change in my donor area. The implant zones were totally separate in that the first procedure covered the hairline to mid scalp and the second covered the vertex to lower crown. Growth is symmetric and even throughout both zones so again I sense no obvious reduction in yield from the second procedure where the native hair was absent and only a few hundred misplaced poorly angulated grafts were there previously. Others have noted the same phenomena of immediate growth and minimal shedding following procedures with Lorenzo so perhaps it is related to his specific technique. It would be interesting to hear if Dr. Vories is seeing the same pattern with his cases.

Blake do you have any references demonstrating decremental reduction in FUE yield with multiple procedures? Leading surgeons such Lorenzo do not seem to be concerned about this and routinely stage large procedures over 2 and even 3 sessions. In my case after 3 FUSS and a depleted donor zone, he staged 1500 and 1400 FUE extractions over 8 months. The second procedure seemed to go even quicker than the first. In both cases there was minimal shedding and no obvious signs of unsatisfactory or compromised yield. Anecdotal I know but is your hypothesis backed up by any credible research or publications?

I agree with Spanker. Your hairline is a bit too linear and could be softened up somewhat with a few well placed singles but the bulk of the work should address the mid scalp area.

Not to rain on your parade but I think your mid scalp and vertex appear to have miniaturization and without response to meds may continue to thin and contrast with the hair that was just transplanted. At your age I would definitely advise aggressive medical therapy but also resign yourself to the fact that a second or even third procedure will likely be in your future.

There is nothing more natural appearing than a natural hairline. Why would you want to mess with it?

Perhaps a minority opinion, but I see these examples as handsome men in their 30s who traded an attractive natural mature hairline for one that looks somewhat artificial and less flattering. I would guess that most posters here would be delighted to have the head of hair that these guys had prior to surgery.

While both FUSS and FUE procedures can be repetitive and tedious to a technician arguably it is much more so for the latter. I suspect burnout and turnover to be higher than you may think. For the extraction phase I seriously doubt that even among experienced operators transection rates like batting averages are all identical.

Blake, I can say with first hand knowledge that there is a turnover amongst all medical practices (my own included). People get married, have kids, move to another city, or just tire of the job and move on, etc. I also know that the results of my beard extractions from the the docs most experienced tech was not quite at the same level although perhaps that was a pretty high bar to set. Nonetheless there will always likely be new hires, trainees, or just the natural variance in skills that will have a variable impact on the outcome. When down to you last out in baseball or follicles in this case, don't you want your clutch superstar hitter up at the plate going to bat for you? (Sorry for the analogy that for the ROW people who only know soccer might miss)

For those who follow the American pastime closely, the game provides many metaphors for life!

From my understanding permanent is anything but and the color may fade or change with time. Temp lasts up to a year and touch can be done at a significantly lower cost. As I said lots of info here so take your time and read up on it.

My point has always been that when you view the work of doctor's such as Vories or earlier examples of Lorenzo, you pretty much know whose hands will be on the case and at what skill level. Even in the most reputable clinics that have rotating techs doing part or all of the work, this adds layers of uncertainty that I as a patient with a limited bank of donor follicles would not wish to leave to chance. If you think that all humans doing the same task have equal abilities, why do baseball hitters in the lower half of the order have lower batting averages?

NHI in LA is doing it but is probably very expensive. There have been numerous threads on the subject here so the search function is your best source.

If you like buzzing your hair down and just want a denser look why not consider temporary SMP? You might just like the look and save thousands of dollars over the surgical approach.

Some quick research reveals that Dr. Hall has a general plastic surgery practice and does not specialize per se in hair restoration. His webpage also states that he utilizes the Neograft procedure so the question arises did the doctor or a technician do the actual procedure? Dr. Vories who commented earlier once used this device but has subsequently abandoned it in favor of the more hands on manual methodology which requires the full participation of the physician, skill and experience in addition to a learning curve. I wish that your result will be satisfactory but I have my doubts based on the pictures that you have posted.

Too bad we are not told who performed the procedure. I am somewhat suspicious of the technique since in FUE each step must be done correctly in order to optimize the yield to which is equal to or nearly as good as a strip procedure.

"not true. u need between 6000-7500 to achieve desired density." That would be the exception doc, not the rule.

Again, it would be best to present detailed unadulterated photographic evidence than repetitive copy and paste defenses. Everything else is just relative. Granted in cases in need of extensive repair there presently is no other alternative. Sad nonetheless that some have spent a good portion of their life's savings on both the initial injury and subsequent repair in the quest of just looking more "normal".

I realize that success is a relative term but to be more convinced that this $80K procedure was objectively successful I would like to see photos and video in good lighting, unfiltered video images than do not blur and fade out as the camera zooms in, and close ups of the facial skin after being shaved.

To achieve adequate cosmetic coverage for most NW 6-7, anywhere from 9K to 10.5K grafts would be required. Did you really expect a full head of hair from only half of that?

As one if not the only adopter of Lorenzo's method for FUE in NA, I would have expected a more impassioned response from Dr. Vories.

Joe a mea culpa, sometimes physicians come up with new solutions that are in search of a problem.

I agree with most of your assessment but FUE when done well is still the superior procedure. Most young patients do not take into consideration that their hair loss will be progressive and even after it appears to stabilize will likely continue to accelerate later in life. The scar may not bother you today but more than likely one day it will. With a single exception that I am aware of, FUE is too expensive in NA. It is no big deal to travel abroad for a procedure that will forever after affect you.

Recall that Romney had the best hair of all and still lost!