win200

I mean, he could be fine. He's 30, not 20, and his native hair looks to be holding up just great. But I've literally never heard of this many grafts used in the hairline. 3,500, yes, but not 5,500.

Is the first picture here the original 'before'--i.e., prior to any of his procedures? I agree with Spanker--this is a TON of grafts for a hairline; maybe the most I've ever seen.

I'd to hear more about this patient. 3,500 is a lot of grafts to use in that region on a 23-year-old--I assume he asked for an unusually aggressive procedure? Phenomenal result, but hopefully he's using meds.

Just bumped the procedure to October 23; some business travel came up that would have had me at conferences the week after the transplant, and who needs that. I'd also like to have a little more time on Avodart before I go under the knife.

I also had the chance to meet one of the world's top strip docs; won't identify him out of respect for his confidentiality, but he's probably one of the top 3-5 surgeons on this forum in terms of reputation. He took a look at me and I filled him in on my plans for a follow-up procedure, and he said, "Well, look... your hair looks great, and my mantra is usually 'If it ain't broke, don't fix it.' But 95% of transplant patients have supply issues, and at your age and with the way your native hair is holding up, you're not one of them. So if you really want more work done, I don't see a problem."

I'm paraphrasing a tad, of course, but this was the gist of what he said. It definitely helped me feel empowered to go forward, because this guy has an absolutely sterling reputation.

I also uploaded a few more pics of my current hair now that it's cut a bit shorter just for the hell of it.

Hair Restoration Site for win200

Agreed...

I don't understand this. The patient was 29, not 21. He has minimal loss and Dr. Rahal used 1,200 grafts. Even if the loss progresses--which, let's face it, it's not likely to to a significant degree given his age--he has plenty of grafts in the tank to do a less-dense transplant behind.

I really don't see a problem with this approach.

Actually it's not that uncommon at all.

Shoot, typing too quickly... 100% meant 'common.' It's really COMMON.

Right you are. I will try my best not to look, as pedantically. Is it normal for the hair to grow in unevenly? Some places have more hair than others.

It's really uncommon for transplanted grafts to grow in unevenly. You can find lots of threads of people freaking out that one side grew in first or something like that. The law of averages says that typically the growth should be relatively even, but not uncommon to have some thinner patches for awhile. Don't worry about it.

I believe Clooney actually has god mode hair like Brad Pitt. He shaved it into a V during ER for the character. He's done stuff like that before in other movie roles too. For example in Syriana and Men Who Stare at Goats he shaved not just the temple areas back but also the entire hairline itself.

 

When you need to shave your hair back in movie roles to look worse because your hairline is just too good... you know you have great hair. Bastard lol.

Yup. I watched the 1998 Clooney flick OUT OF SIGHT a few months ago (great movie, BTW), and his hairline was bugging me because it looked like it had a five o'clock shadow. I did some searching and it turns out that he was shaving it for the ER role, because they actually wanted to his character to look a bit older. Imagine that--having such a low hairline that you have to SHAVE IT UP for acting roles. Dare to dream.

Wow, that Spacey toupee is not good. I've always thought that Spacey wore his hair loss rather well and looked appropriately distinguished, but that rug is a travesty.

Great result. Especially a fan of the subtle temple point work that Hasson did--not something that most people would notice explicitly, but makes a big difference in the overall impression. Good hair color for you, too.

Wow, even the before/after pics on Mosaic's website are appalling. What a travesty of a clinic.

win,

 

You are absolutely correct on both points. I know of a talented plastic surgeon in the Mid-Atlantic region who uses only excision methods in HT repair. To my knowledge, he does not perform FUE so he typically has to "cut out" the large grafts and then dissect them, and and have them re-implanted. He also does HT procedures by strip methods but do not consider him a first choice. But some of his repair cases came out pretty decent I must say. Those patients healed very well with minimal visual scarring IMHO.

 

Yes, I too have seen some repair cases using FUE with punches to remove larger grafts and dissect them and re-implant them as well. Obviously the difference is which method works best in plug or large grafts removal.

 

Sometimes the larger plugs are more "compressed" in the original recipient site where they were initially implanted and then FUE (extraction) to remove them becomes very difficult or they cannot be thinned out. Transection is the concern.

 

There are some cases where the plugs are too large to extract them by FUE intact and in those situations, it's more advantageous to excise them otherwise transection can occur during the extraction process. If the punches are too large, there can be more visible scarring and this is where excision may be a better option because there is a small healed slit rather then a larger pink or discolored dot.

 

There used to be a rather aggressively marketed HT surgeon in the greater DC area who was infamous for his open donor procedures (plugs). He did many of them in the 80s and 90's. He's now retired to play semi-professional golf.

 

I have seen a fair number of his past patients seeking repair and some of them have a dilemma in knowing the best approach.

 

This is where a multi-talented surgeon skilled in both arenas may be the best option for the best possible final repair result because the surgeon can rely on either technique or a combination of both depending on each individual case.

 

But when those unwanted grafts were placed way too low to begin with, there's no point in causing further eye drift by adding more grafts between what is already there from prior surgery. So having a unnatural youthful hairline and adding even more limited donor between the unwanted grafts can only potentially compound the problem...:rolleyes:

That's really interesting and helpful. I think the possibility of graft excision and re-placement changes the analysis a little bit in terms of transplant strategy. I've adopted a relatively aggressive strategy at age 31 with 3,000 grafts placed into the frontal third (or, at least, that'll be the total after my procedure this summer). There's always the chance that, although my native hair is a dense NW2, everything could go south as I get older. But if that happens, I can have the dense-packed grafts excised and re-distributed. Not ideal, obviously, but there are options beyond simply leaving densely packed grafts at the hairline with tons of space behind them. It's something to consider, although it's obviously not a panacea.

Did you mean "extracted" implying FUE or another isolated extraction method?

 

Some repair docs that do not perform FUE are limited to excising the grafts which can in some cases leave more than desired scarring because it can certainly be a more invasive approach utilizing scalpels (surgical removal) versus extraction punches (isolated removal).

 

Yet some of the placed grafts may indeed need to be excised because of the scarring that is already there and also needing removal. So each repair case can indeed be different.

 

It's very possible that both methods of excision and extraction may be needed to avoid transection and also to minimize scar tissue reformation to allow for more blood flow and corresponding yield post-operatively.

My impression is that some docs have removed grafts through--I think--extraction punches. There's always the possibility of scarring, but at least from the reading I've done there are folks who have been able to extract and re-place grafts with only minimal, if any, scarring. I've seen some shots of this done at the hairline with great success. The trouble for mirror is that his hairline is so low, it would be foolish to try to cover up the poor work with more grafts--he'd end up with like 4,000 grafts in an extremely low hairline.

This thread is such a complete heartbreaker. You seem like such a nice kid, and you don't even begin to deserve what's happened to your head. I'm 31, so I remember pretty vividly how impulsive and stupid I was when I was your age, and I couldn't be more grateful that I didn't have the money to pull a stunt like this. I waited until I was 29, which was still somewhat early for the transplant.

But here's the good news: you did something irretrievably stupid, and you're not going to do it again. While you did use 2,000 grafts, that's not a majority of your donor, and now you're on medications to halt/slow further loss. Something that no one on this thread has mentioned is that it's possible to have the grafts that this doctor placed excised and re-placed on your head--some doctors are very proficient at this. Given the atrocious placement and angulation of your grafts, it may make sense in a year or two for you to look for a procedure that doesn't remove any new grafts from the back of your head, but pulls up the existing grafts, re-places them in a denser, higher hairline, and fixes the crop-row placement and screwed-up angulation. That could go a long way towards mitigating the damage here.

But regardless of all of this, my thoughts are with you and I hope for the best for you.

Hey guys,

Long-time lurker and poster at other hair loss forums. I thought I'd finally sign up here and share some info about my first transplant and create a log in advance of my upcoming procedure with Dr. Rahal this June. I'm 31 and hair a 1.450 graft HT via FUT with Dr. Robert Niedbalski in Seattle in June 2012. I like my result, but want some additional work, so I'm getting another 1,500 grafts from the hairline wizard this summer (FUT again). My blog is below; check it out and let me know what you think! Cheers!

Hair Restoration Site for win200