JoeTillman

Mickey my friend, this is not accurate. If we go by your statement that 10% to 14% of ALL hairs are dormant at any given time on someone's head the statement above is assuming that all of the hairs dormant are single hairs follicular units. This is not true. In reality, the former part of your statement is correct, 10% to 14% of all hair on one's head is in telogen (according to various studies) but when you factor in that up to 25% of all follicular units on the scalp are single hair units on their own, and apply this to the larger picture, then we are looking at 2.5% to 3.5% (25% of 10 = 2.5 or 25% of 14 = 3.5) of all SINGLE hairs follicular units are discarded through the strip process (assuming complete invisibility). However, this is assuming that multi-hair follicular units go into telogen as a complete unit which is not true either therefore if we take the 10% to 14% number and apply that to ALL follicular units in the strip, both single hair and multi-hair, with the understanding that some hairs will go into telogen in the same follicular unit that other hairs are still in anagen, the kill rate is not so clear but appears to drop further for strip thus it is a safe assumption that the actual percentage of discarded hairs (due to lack of visibility via telogen) from a properly and efficiently removed strip will be somewhere below 3.5% assuming the high end of the averages and below 2.5% assuming the low end of the averages. Conversely, because individual hairs in a multi-hair grouping can go into telogen while the neighboring hairs that are part of the same bundle can remain in anagen we see the potential for peripheral transection from FUE going up. Aside from this the kill rate is dependent on the surgeon skill and the tools he uses. For example, if you have a surgeon with a multi-blade scalpel he/she will have a massive kill rate on the grafts through transection regardless of skill whereas a surgeon that uses a single blade scalpel, tumescence and pushes the blade so he can see the path between bundles as opposed to pulling will have an extremely low kill rate due to transection. In the end, this is all academic and if the patient has a choice, he'll usually go for FUE due to the lack of a linear scar as long as the result looks natural with regards to graft angulation, direction, etc. and enough obvious growth to have an aesthetically pleasing result. If this is accomplished no one really cares about the details. If the patient wants the most grafts at once and has an advanced pattern of balding, doesn't ever want to shave and understands the risk then he'll choose strip.

It doesn't seem unusual. On some patients the pinkness is gone by now, others not so much. It is still healing so take another photo at the 12 month mark and you'll most likely see the pinkness has disappeared.

His answer was on topic because you mentioned that the doctor is new and that you are scared of the possible outcome. KO is a smart and experienced forum member and his question is valid. I see on your profile that you are in California but you mentioned there is this only clinic in your country. There are a few very good doctors in California so maybe you are sticking to your native country for cost concerns? This is why I mentioned that the hairline placement would need to be higher to counteract the lower density of using less grafts. The larger the area of placement, the lower the overall density assuming you are working with a set number of grafts. I hope this helps.

Looks good, well done.

There is nothing wrong with taking a more cautious, conservative approach. Just be aware that the placement may need to be a bit higher and the density will be lower so don't expect miracles. In addition, I would seriously consider the fact that the doctor is new and you should realize that you are, in essence, a guinea pig. Every doctor has to start out new at some point and there is nothing wrong with that but you have to ask yourself if you want to put yourself in that position. If you haven't already, ask the following questions... 1. Who trained him? 2. What method is he using? 3. If strip is it single blade or mult-blade? 4. If FUE is it robotic, manual or motorized punch? 5. What size punch if FUE? 6. Who will be doing placement of grafts? 7. Who will be doing extraction of grafts? This only scratches the surface, and you may have asked these questions, but it should be mentioned just the same.

Indeed, it is a difficult concept to visualize and even more difficult to explain as I do not have a math background. I think Young's modulus can help explain it but I'm not sure it applies but this is where my experience comes in to play because I have seen this day in and day out for over a decade and it is obvious to me on my own scalp. Yes, you can refer to visible hair density as the "illusion" of density. I hate that word but you get the idea. Now, to maybe better visualize what I'm talking about consider the space between follicular units. This distance can be 1mm to 1.4mm from one grouping to the next. When you use a punch to remove a grouping you increase the distance between the groupings surrounding the extraction point. If the punch is .8mm or just large enough for a two or three hair graft, then that "gap" is now considerable (contextually) and is absolute throughout the donor zone. Multiply that by 2000 and you've got 16 cm2 of newly exposed scalp on TOP of the already normal amount of scalp visible between follicular units, depending on hair length, type, blah blah blah. If you "stretch" the distance of a half inch, per your original question to cover a strip removal you have to remember that both sides only need to move 1/4 inch to meet in the middle. Now, I don't have any specific numbers to measure how the distance between each grouping is increased from the donor closure but if we stick to the basics we can extrapolate a general idea of what's going on. Assume an average donor density of 80 per cm2 and factor in that in order for us to get 2000 grafts the half inch (1.27cm) wide strip will have to be 20 cm long (19.6851cm x 1.27cm x 80 per cm2 = 2000.00616 grafts). We are closing the donor wound by pulling the top edge of the wound and bottom edge of the wound no more than a quarter inch each in total (6.35mm). The part that may be difficult to understand is that the stress from stretching is not isolated to the areas above and below the donor wound inside of your 2.5 inch wide box. It expands beyond this due to elasticity so it is more stretched out in the beginning along the immediate perimeter of the donor wound but it relaxes as new tissue growth relieves the stress and the overall reduction in density is more uniform and even. With 6.35mm (1/4 inch) of stretching on either side will not be distributed through each space between grafts like it does with FUE. Each new space between existing bundles is an absolute with FUE whereas with the spaces caused by a donor wound closure is more gradual and the aggregate of so many more bundles being pulled away from each other through the larger donor area, but in much smaller distances, makes up for the equal number of grafts removed. This is where I get the comparison that the reduction in density with FUE is on a one to one ratio whereas with FUT it is not so stark as it is gradual and relative to the amount of stress in the immediate area of tension. Keep in mind that the .8mm punch is not taking out a graft that is exactly .8mm in diameter. Each hair is considerably smaller and make a larger footprint when they are in a bundle but also length and angle make the diameter appear larger than it really is. This is nitpicking and dealing with issues that no one really sees but I hope that this is more clear. This isn't a matter of saying that 1 + 1 = 3. It's a matter of knowing that there are more variables to consider to get to understand why the answer is 3.

Olmert, Density, in the context of surgical hair restoration, does not equal hair grafts /surface area of the scalp. It is more micro than macro, measured by each cm2, as this helps to determine where the surgeon will harvest the hair from. There are wide variations of density in various regions of the scalp. You asked which method or combination of methods will allow for more hair to be transplanted. I gave you the answer without saying that more hair is generated or the surface area is reduced (although volume is). The point is to stay below the threshold that eliminates the illusion of nature by not reducing VISIBLE density too much to cause notice. As I stated at the beginning of my first post, with FUE alone you can pluck yourself clean like a turkey to get FAR more grafts if you wish but that eliminates the "undetectable" issue that we all strive for. If this is not an issue then FUE, all the way, will give the most grafts. This isn't a debate on which procedure is better, just what will give the most grafts over the long term, assuming the goal is to remain relatively undetectable in the donor zone. If someone has a tight scalp then obviously FUE will win assuming average density in the donor zone. If laxity is fine but the density is low then FUE might still be the better choice but if the laxity is there and is considered average and in the hands of a competent surgeon then a combination approach will get the most hair. Just because you may not understand does not mean that 1 + 1 = 3 but because you most likely are too linear in your thinking the answer just might be 3 indeed.

Hi KO, I think I should clarify. With each FU removed via FUE there is a clear and specific gap created that is greater than the diameter of the FU removed. I have had no such reduction of my density. My density has been reduced due to stretching the remaining tissue to make up for the gap left from the strip removed. Let's remember what density is. It is the number of follicular units, or to some it is the number of hairs, in a specific area of measurement. Normally we refer to this in square centimeters (cm2). In my case all of the hair AND the tissue that supported it were removed, dissected, the excess tissue disposed of and then the hair was reimplanted to the recipient zones. The edges of the donor wound were pulled together to fill the gap. The remaining density of the donor zone was not depleted on a 1 to 1 ratio of what was removed due to the mechanics of skin elasticity as previously explained. As the tissue is stretched to make up for the "gap" each hair is pulled slightly further away from each other. If the gap from strip removal is 2cm there is not an equal stretch between follicular groupings to make up for this. It is subtle between each FU, and the combination of these small changes is what makes up for the difference of the larger area removed. The tension, and therefore the reduction of density, will be greater in the vicinity of the donor strip immediately post-op and for the first few months but because of the new tissue growth triggered by the sustained tension the issue will become less noticeable, physically and visually, as the tissue relaxes due to eventual tension relief. Remember, the tension is not completely isolated to the first few millimeters of the strip perimeter as it is spread out beyond into the greater donor zone, the sum of which is far greater than the size of the strip removed to begin with. This is why strip patients can liken the overall post-op feeling to wearing a helmet. They feel the end result all over the back and sides of the scalp due to a combination of the obvious tension but also minor short term general swelling.

There are a few problems with the answers because there are problems with the question. FUE will give a patient FAR more grafts over multiple sessions than strip or a combination of strip and FUE. There is NO way to dispute this. Just ask this guy... In all seriousness, every hair in the donor zone, outside the donor zone, the ears, the nose etc. can be extracted via FUE and placed into the target recipient area. Thirty thousand, fifty thousand, seventy-five thousand grafts (?) can be moved if the patient has them to accomplish their goals but at what cost ( cosmetically )? The whole point of having any cosmetic procedure is to achieve the desired outcome with no evidence of the procedure having been performed to begin with. This is where the answer will be different for every patient. *NOTE* With each point below keep in mind that the scenario assumes that we are trying to avoid the cliche'd "moth eaten" appearance. In my own case, I could never achieve the results I have been blessed with by FUE alone. No way, no how. I've had seven strip surgeries... 1.) Mini-micro grafts, 300 to 400 grafts, Dr. Norris. 2.) Mini-micro grafts, 300 to 400 grafts, Dr. Norris. 3.) FUT - 2406 grafts, Dr. Wong. 4.) FUT - 2425 grafts, Dr. Wong. 5.) FUT - 2488 grafts, Dr. Wong. 6.) FUT - Scar revision - 144(?) grafts, Dr. Wong. 7.) FUT - 1399 grafts, Dr. Wong. Add it all up and I've had nearly 10,000 grafts transplanted via strip alone. This, from a donor zone that had moderately fine hair, average density and in a hair loss pattern between a NW6 and a NW7. At this point I can have haircuts as short as a #3 guard due to the nature of the donor scar and no one on the street would suspect that my hair is unusual in any way much less would they think I've had seven surgeries on my head. At this point in the game, should I ever decide to have more work, I *could* have more strip on the sides but I would not get over a few hundred grafts and it would also risk widening the scar which I'm currently very happy with. FUE is the only way I will ever consider having more work and it would allow me to have, most likely, in the neighborhood of 1500 to 1800 more grafts from head hair alone. I am the perfect example of how a combination approach will afford me the ability to have more hair than I would get from strip alone. This does not include the option of utilizing body hair or beard hair which is another discussion entirely. Now, consider how much scalp tissue was removed from my procedures. Dr. Wong and I actually calculated this based on my charts and by estimating how much was taken by Dr. Norris back in the early 1990's. Dr. Wong and I concluded that my donor scalp has had no less than 6 cm of tissue removed. Again, this was from a donor zone of a patient with a pattern of loss between a NW6 and NW7. You can see my donor zone, before I ever set foot in the clinic of Hasson & Wong, in the photo below which was taken nearly fifteen years ago. Here is a photo I took this morning, with a ruler, to show how the donor zone measures out. In this image, it shows that my safe donor zone is approximately 3cm wide at the back. I uploaded an image nearly 5mb in size so you can enlarge it for a better view. And here is a rough side by side comparison, fifteen years and seven surgeries apart. My hair is now much shorter but I don't have two wide donor scars to hide any longer:) Notice that there is not a big difference between the overall surface area of my crown border and the donor zone. The comparison is not perfect but I think it is easy to see that my donor zone does not appear to be showing a deficit of a full 6 cm. How can this be??? It is not something that can be explained by linear theories on elasticity (Hooke's Law) as we have to consider the mechanics of skin expansion. Skin expansion is what happens when you remove one or multiple strips. Remove a strip, pull the upper and lower edges of the wound together, suture or staple and you have tension that is spread out above and below the incision wound. When skin is put under sustained tension it activates mechanotransduction pathways which leads to cell growth and the formation of new cells in the skin tissue. Quite literally, new permanent skin is formed and it eventually lessens the tension from the initial strip excision. This is the same process behind balloon expansion treatments. It does NOT however produce more hair. The spaces created between the remaining hairs of the surrounding scalp tissue (due to the initial stretching of skin to close the gap created by the strip removal) are lessened as the tension is reduced due to the new tissue formation. This allows for a more uniform density throughout and an eventual reduction of "gaps" between hairs that may be more evident immediately post-surgery. My donor density is certainly lower than it once was but the reduction in density is NOT on a one to one ratio. Far from it actually and when the hair is lifted the density does not appear to be reduced as much as one would assume if they do not understand the mechanics of skin expansion. Had I been in a position to have high yield FUE back in March 2002 (my first sx with Dr. Wong) and have multiple subsequent high yield FUE procedures many of the grafts would be taken from outside of the safe strip donor zone but not outside of the safe FUE donor zone. The two are not synonymous. I would have hair taken from below the strip zone, above the strip zone, higher up, but not into, my parietal humps (as mine are gone) and further forward into my temple points. However, because the density is reduced on an exact one to one ratio my overall density would be VISIBLY lower. There is no way I could have nearly 10,000 grafts removed via FUE without having a noticeably thinner donor zone. For many years when someone would ask me or Dr. Wong why I was able to continuously come back for more surgery the answer has been, simply, that my laxity keeps returning, but in reality the real answer has been more complicated in that enough new tissue was being generated from each prior procedure that it would allow enough laxity to return for subsequent procedures. Most people do not have this option as their scalps will be tight after one or two surgeries of moderate size and to continue to have more strip will jeopardize the strip scar. THESE are the types of patients that would benefit more from an FUE only approach in order to get the most grafts (if it were one procedure vs. the other) but of course this greatly depends on the density of the donor zone and the size of the target recipient area. In the end, arguing about which technique will yield the most grafts in multiple procedures is secondary to what the patient wants to deal with as a consequence of surgery, or it should be. Have they sworn off head shaving and want to gamble on doing anything and everything to get as much hair as surgically possible? There are options in FUE, FUT or a combination of the two with FUT being first and FUE being the secondary adjunct for maximum graft harvesting. The same goes for those that have already had strip, have a tight scalp because of it but still have ample amounts of donor hair remaining. There are also the patients that are going to stress over having even the thinnest and finest of donor scars regardless of how great the final result is. There is one option for them and that is FUE because in the end, if the donor scar is a big deal to the patient, the result of growth could potentially be overshadowed no matter how great it may be. This may mean fewer grafts if only scalp hair is utilized but for many the trade-off is well worth it.

Very nice hairline design, Dr. Gable. Well done.

A patient is unhappy. Because of this, everyone loses. From early on I have been trying to work with HairFarmer79 to find some sort of resolution for him. He made multiple comments online several weeks ago stating that he wished to address matters "privately" with "all parties involved" yet while he continued to berate me publicly he did not once approach me about addressing said matters. I was the one that had to eventually initiate contact to which he was quite negative. After considerable "debate" he finally agreed to allow me to communicate with Dr. Wong on his behalf, which was my suggestion. This, after I had already left the company and moved on so there was no real personal gain for me. How this has turned out is something I'm not privy to as I ceased being involved a few weeks ago. However, per usual, there are always two sides to every story. Unfortunately, with so much embellishment inserted into this "truth", it will be difficult to address thus I will stick to the facts. With regards to me and Hasson & Wong, Hairfarmer79 has ONE year of experience, not two, unless he was conversing with me in one of his aliases. He first started posting as "AussieMale33" in October, 2013 which is when I reached out to him. http://www.hairrestorationnetwork.com/eve/172493-hair-transplant-reversal-surgery.html In my first post I told him he had two options, take the route I took with camouflage or to have his grafts removed (which was his original goal). To accomplish the latter I advised that he could visit the inventor of modern FUE who resides in his area. Some have taken issue with my recommendation but for a simple removal of grafts via FUE it is my educated and experienced opinion that staying in Australia would have been fine. I echoed this in PM's to Hairfarmer79/ AussieMale33 and I believe I may have mentioned traveling to Thailand as well if he didn't want to stay local. I don't have those PM's any longer so I cannot confirm this. The point was that he need not travel halfway around the world to Canada just to have a simple extraction procedure. It's not rocket science and there is little aesthetic skill necessary compared to the level required for building new hairlines or crown whorls. Again, he was seeking REMOVAL only and I stand by this opinion. This is false. After a few PM's were exchanged he sent in his online consultation form with the only request being for removal of grafts. At this point I recognized who he was and replied that I was the one that he was dealing with in PM (on this website) and that I still felt he was better off staying local. It was at this time that he responded telling me that since he had originally submitted his online consultation request for removal he had contacted H&W through other means (email to Christina) to inquire about having more hair transplanted and not having his existing graft work removed. Before I could carry on with my points he had gone around me and Dr. Wong had already seen his case and email exchanges between he and Christina (office manager) had commenced. This was the beginning of dozens of emails between not only he and I but also Christina and Daria as well before his procedure. I did not "withdraw" my recommendation as it was not a recommendation to begin with. It was an opinion based on what he stated he wanted to accomplish . HE reversed the goals by changing his mind as to what he wanted to do with zero input from myself. He sent in his consultation request, changed his mind on his goals, contacted Christina directly and booked his surgery, all within close to a 24 hour window. Furthermore, I did not say he could achieve what I have as that would require several surgeries and over nine thousand new grafts. Any thinking man would realize this. I told him he could take the route I took, not get the result I got. Anyone that has been on the forums for long knows that I NEVER tell a patient that he will have my result. I did this once, about eight years ago, and I learned a valuable lesson of which I have not once repeated. This is false. My previous mini-micro grafts are still indeed planted in my scalp, growing as well as they ever have with one exception. I had one removed after my second procedure as it was chronically inflamed and would cause issues every once in a while. I'm curious how Hairfarmer79/AussieMale33 could "find out" if it is not in my medical chart and it has never been said, written, implied or hinted as it is simply not true. This is however a question that he has asked me on more than one occasion to which the answer has always been the same...my mini-grafts are still present. I had one removed after my second surgery due to chronic inflammation issues. Hairfarmer79/AussieMale33 received his recommendations per Dr. Wong's review of his case nearly three months prior to his arrival. I think that explains it all. Again, false. The record will show that Hairfarmer79/AussieMale33 stayed in Vancouver for a solid week post-surgery to insure proper healing before returning home. He was in the clinic DAILY having his hair washed, his scalp and grafts monitored with Dr. Wong inspecting his recipient scalp and donor area each time. His procedure date was January 30th, 2014. Not once during this extended stay did Hairfarmer79/AussieMale33 mention any issue with his hairline design. On February 10th Hairfarmer79/ AussieMale33 sent me two emails and on February 11th I responded. This being four or five days after he returned home. The emails he sent were with regards to the glowing review (including the great hairline design) he gave to another patient after he told me, face to face, that he wanted to share his story. His concern was that maybe he was making his experience look too positive. From the first email sent to me on February 10th and my subsequent response on February 11th there were a total of at least fifteen emails sent from me to Hairfarmer79/AussieMale33 over a span of four months. I do not know how many emails were exchanged between he and Christina and Daria but it was on the magnitude of at least triple the number of emails he and I exchanged and it was during the same time frame. I've no doubt, since I have left the company, that this number has significantly increased. One of these emails he sent to us was around the three month post-op mark. He revealed to me that he had extensive experience in the hair replacement industry where he was the sales manager for one company and part owner in another. I found it odd that in all of our conversations before his surgery he never once mentioned this. It only makes sense that if one were in the hair restoration industry they would mention this whilst having their own hair restoration procedure. Regardless, he also sent an email saying he was investigating legal options for the "butcher job" that Dr. Wong performed on him. Again, this was at three months after his procedure because he said he had no growth. The scar was and is fine and he was only referencing what he felt was zero growth with no improvement predicted by him. False. Again, I did not convince Hairfarmer79/ AussieMale33 to not have FUE. I was the one that suggested he have FUE in the first place, more than once, to which HE decided against. He has said as much himself. And as mentioned, and revealed three months AFTER surgery, Hairfarmer79/Aussiemale33 is no novice. He even owned his own hair company at one point. Hairfarmer79/AussieMale33 has had a rough time, no question about it, but it is not because of anything that Christina has done. She has been with Dr. Wong since before there was a Hasson & Wong and she is one of the most efficient, responsible, reliable and caring people I have ever met. She taught me more than a thing or two when I was working with her for eleven years. For the life of me I cannot fathom why Hairfarmer79/ AussieMale33 would disparage her publicly like this because I know for a fact that his claims of not being contacted are false. Christina is the consummate professional when dealing with patients as evidenced by the years of positive comments in this regard. In one of his emails to me he told me how helpful Christina had been to him. He and I were in contact a mere four days after he returned home with each question answered politely and professionally. This, even after he began throwing F-bombs three months post-op when telling me that my "smoke and mirrors" response about his lack of growth and "complete failure" was insulting. Again, this was at three months post-op and it continued to degrade from there, causing great amounts of unnecessary stress for the staff. - A side note. I am all for holding clinics accountable for their treatment of patients. I am in fact working on something to help with this issue but there is a point where enough is enough. When you have a patient bombarding a clinic with multiple expletive filled emails from three months post surgery, making all manner of wild accusations based on fantasy and throwing around empty legal threats, there has to be a point where one's foot must be put down. All of the above is documented in emails and are actual facts that can be referenced over and over. They are not embellishments or recollections that have been thinned and changed with continuous reflection over time. In retrospect, I believe that Hairfarmer79 had modest and achievable ambitions to which I tried to give solid guidance. I reached out to him, unofficially, to give him some basic and friendly advice to help him with graft removal. He eventually ignored this advice (documented) and now he is lashing out. He has shaved his head at least twice since his procedure and I know that his results were looking much better than he would have you all believe. His hair was longer, much fuller looking with regards to volume and frontal zone density. Improvements can be made with a small number of grafts to refine the hairline and balance things out a bit more as is common with repair cases (including my own). Hairfarmer79/AussieMale33 has chosen to drag Dr. Wong's name through the mud, undeservedly. He has embellished the communication issues between he and Christina, told flat out lies about me (really, I have been lying about my old grafts???) and has conducted himself in a less than honorable manner. The amount of stress that he has caused the clinic is, simply, undeserved and unfair. My opinion is that Hairfarmer79/ AussieMale33 should have been turned down from the beginning and that responsibility was within my power at the time. If someone is seeking removal of grafts and then, quite literally overnight, changes his mind into having more transplant work then that indicates that perhaps a different direction should have been more strongly encouraged. Dr. Wong however did his best (as is his nature) to make Hairfarmer79/AussieMale33 happy and I firmly believe that a strong and quantifiable improvement has been achieved. His interpretation of events and his result is sporadic, misguided, contradictory and just unfortunate. Now he has taken to attacking anyone that has disagreed with him and has resorted to calling them "trolls". I think this speaks volumes and should be considered when formulating opinions. Hairfarmer79/Aussiemale33 will come out swinging. He'll talk of the most serious state of this situation and how he's been manipulated and lied to. He'll threaten to show side by side photos and emails that were exchanged back and forth. I say, share it all! Dr. Wong and the clinic now have the right, by the terms and conditions of this website, to show any photo and email they wish in order to counter the position of Hairfarmer79/Aussiemale33 as long as reasonable efforts have been made to hide his identity. I think they should do so, in short order, to put this issue to bed and move forward in peace. I want Hairfarmer79/AussieMale33 to find a resolution but the way he has been trying to achieve this resolution is counter-productive and dishonest.

I'm still around, thank you for asking, and no I've not been on vacation, although that would have been nice:) I've been busy working on some things. I'll update everyone shortly.

Looking good, Voxman. I agree with Spanker. The placement is very appropriate and being conservative is always a sure bet. Congratulations!

Hi Joe, I've seen cases like this before and it has nothing to do with your procedure being FUE. If it were a surgical issue it would be due to the placement, not the extraction. Transplanted hair will actually start to shed mere days after the procedure and the shedding can continue for several weeks. Once the grafts shed they should start sprouting again, some of them at least, between three to five months. Some people say sooner but I like to be a bit more liberal in how much time should be allowed before the panic button is hit:) If you still have the original transplanted hairs sitting in the recipient zone, no longer than the day they were planted, at 2.5 months then maybe you are being too careful with them. Are you washing your scalp vigorously or are you babying them by barely touching the recipient zone? If this is the case, STOP! Get in the shower and scrub with the pads of your fingers. Do this every day and this will help to encourage the hairs to shed. If these hairs were not meant to fall out then they'd be growing from the beginning. Because they have not changed in length in all this time you should encourage their exit. Of course, call your doctor to ask about this.

Thanks for the additional information. The number of grafts that were estimated for your case is in line with the general rule of thumb that roughly 1000 grafts are necessary per NW level but I find that this is not always a reliable formula. It depends on a few other factors. 1.) Hairline placement. The lower the hairline is placed the more grafts you'll need for coverage to extend into the crown. 2.) Density. The higher the density the more grafts you'll need. 3.) Hair color to scalp color contrast. The higher the contrast you have in this regard means you'll need more grafts to reduce the amount of scalp that is visible. Did the doctor suggest that all 5000 grafts were to be transplanted during one visit or is this over two or three visits?

I think someone should ask you a few questions. How old are you? What is your NW level? Are you taking medications. Do you prefer hairline work or are you in need of something that covers a bigger area? Have you already had an assessment by a doctor that told you that 3000 to 3500 grafts are needed or did you come to this number yourself?

Here are the final results from the procedure. The results are just shy of nine months at the time of the documentation.

This patient traveled from Italy to have his diffused pattern of loss thickened as much as possible in one procedure. He kept his hair long to help hide the diffused loss as much as possible. Dr. Rahal and his team placed 4103 grafts in one procedure via FUT. Placement was primarily into the hairline and the front half of the patient's scalp. With the increased density at 12 months post-op he has more styling options for his hair as shown in the below photos.

This patient arrived from the United States and presented with mild temporal recession. The patient described the recession as being a "confidence destroyer" and the constant worrying about windy days revealing his recession caused a great deal of anxiety that affected his personal relationships. The patient described a very favorable family history of minor hair loss with most males in his family progressing no further than a NW3. Dr. Rahal and his team moved 1201 grafts to fill the temples and to thicken the frontal/central hairline. The photos are one day post-op with more results to follow shortly.

I knew there would be a few individuals that would take my move as an opportunity to utilize the anonymity of the internet for mudslinging. I can take it. But what I won't take is being called a hypocrite by a hypocrite... By Baldingbogger - 07-11-2013, 08:14 PM... I agree 100% with your statement above with regards to the need for FUE and FUT. However, your duplicity is astounding. My stance on FUE has "EVOLVED" which was not overnight as I clearly laid out earlier in this thread. Now that I've done EXACTLY as you indicated FUT only proponents (clinics) should do, "evolve", I'm now somehow being vilified for exactly what you said should happen. It certainly does appear that the cat is out of the bag.

And a word about the lighting situation at Rahal. One of the things that I like about Dr. Rahal is that he "gets it". When I arrived at the clinic I was pleasantly surprised to find a dedicated photo/video room. I couldn't wipe the smile off of my face when I saw it:) The facility itself is brand new and Dr. Rahal wanted to have a proper environment for documenting our results. Rahal is one of the few elite clinics in the world that has standardized on no flash photos and hopefully, with the support of everyone reading this, more will follow suit.

Mickey85, I get your point but I know the foreign forums quite well. I've taken part in some of them for the past ten years or so. In reality they are no different than this forum. The clinics that post here will use the same blown out flash images on the foreign forums. The patients themselves will use bad photos more than clinics will and many times it is the patient photos that a clinic will use when sharing results. Have you ever noticed the patient photo that looks like he's in a dark room but his head or hair is bright as if out in the sun? This is a common theme among patient photos in that they are usually worse than clinic photos. Iphones, Galaxies, etc. are great for candid shots but everyone has the flash turned on when taking hair shots. I won't even start on the issue of focus and clarity;) These aren't selfies for Facebook, people! I can't tell you how many hundreds (thousands?) of emails I've sent out to patients over the years asking for better photos when trying to get an assessment completed. If I can't see it, no one else is likely to either, lol! Sometimes it's like pulling teeth:D Patients that post their own results in photos have just as much responsibility as those from clinics especially when everyone tells newbies to trust photos by patients more than those by clinics. I'll put something together to help identify flash photos when I have a chance. I'm glad to see this topic getting some traction. Thanks everyone for your input.

Wow, thanks guys:)

Why is this "urgent"? Are you in a time crunch? Maybe you should take some time and visit each clinic since Houston is not so far away and Konior is in your back yard. I HIGHLY suggest you ask to meet patients in person because that will tell you a lot.

Blake, Of course I'll contribute. I've already published information on this and there is a video I made on how patients can take photos when they submit to a clinic. If the photos are not accurate, or even "deceptive" then how do you KNOW the work is as good as you say it is? Its like looking at a painting draped in a veil and saying how beautiful it is. You don't really know until the veil is removed. See my point? THAT is why I'm so passionate about this. Photos are shown, people say "ooh" and "ahhh" but they don't know what the result really looks like. What they think it looks like is a complete fabrication. This has nothing to do with any specific clinic, btw, just the issue in general. Good stuff. Agreed, the wet hair shots are more easily detected. I'll look into putting something together that can help people spot flash shots. I know what to look for but it may be difficult to quantify in text. Maybe a video? I may have to just show a bunch of examples. I'll think about this.