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Dr Blake Bloxham

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About Dr Blake Bloxham

  • Rank
    Senior Member

Hair Transplant Clinic Information

  • Hair Transplant Surgeon
    Dr Blake Bloxham
  • Hair Transplant Network Recommendation Profile
  • Hair Transplant Clinic Name
    Feller & Bloxham Hair Transplantation
  • Primary Clinic Address
    287 Northern Blvd, Suite 200
  • Country
    United States
  • State
    NY
  • City
    Great Neck
  • Zip Code
    11021
  • Phone Number
    516-487-3797
  • Website
    www.fellermedical.com
  • Email Address
    drbmbloxham@gmail.com
  • Provides
    Follicular Unit Hair Transplantation (FUT)
    Follicular Unit Extraction (FUE)

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  1. We know people are busy; we also know people like to view hair transplant results. To try and help, we started a video series called "Quick Vids." And it is exactly what it sounds like: a quick run through of a hair transplant result, only requiring a minute or less of your finite time. Here is a "Quick Vid" of a 2,500 graft hair transplant I performed on a patient 9 months prior: Thanks for viewing and commenting, Dr. Blake Bloxham Feller & Bloxham Medical, PC
  2. Hi PA, Thank you for the kind words. He's on minoxidil, but not finasteride. If I remember our initial consultation correctly, he has his reasons for not taking finasteride. Absolutely it will stand the test of time. His frontal foundation is solid. Regardless of what happens behind it, he will always look good from any reasonable angle. His worst case scenario if he never wants to have another transplant is that he will look like a guy with good hair in the front and mid-scalp, and some thinning in the crown -- which is a pattern found in nature so it does not look odd. However, he has lots of good donor tissue left because he started as an FUT so he can continue to do procedures to address any changes in the back -- and I believe he may do that eventually. Thanks for viewing and commenting. Dr. Blake Bloxham Great Neck, NY
  3. Almost daily, I see patients with thinning in both the "back" and "front" of the scalp. And while many of these patients tell me the back bothers them the most and they would prefer to do "everything" in one shot or focus on restoring the back first, I almost universally advise them to focus on the front "half" of the scalp first. This is for a few reasons: 1) Because it is a more visible and cosmetically significant region. 2) A full front with a thinning back is a pattern found in nature and, therefore, looks natural regardless of whether the patient has a second procedure to address the "back." 3) Because the back frequently appears fuller and the overall appearance of the ENTIRE scalp looks fuller when the front is done. And reason 3 is where today's patient comes into play: The patient is a male in his 30's with NW VI patterned hair loss. The front is more pronounced than the back, and he's consistent with daily minoxidil usage in the "back" region. I had the above conversation with him and despite reservations about not addressing the back during the first surgery, he understood "point 3" and trusted that everything would look thicker. Here is how he looked 6 months after a 3,000 graft transplant. Now, these are not the best "apples to apples" comparison pictures here. Obviously his hair is combed back in the befores and down in the afters. But this is the point of the presentation: he was unable to comb his hair how he wanted before (down) because there was a lack of hair in the front and the thinner hair in the back looked like a "comb over" when he tried to swoop everything down. Now with 3,000 grafts in the front, he's able to "bring it all together" and create a thicker, fuller look in the entire scalp despite having no transplants in the back whatsoever. So, if you have thinning throughout the whole scalp and are somewhat worried about the doctor's recommendation to start with the front first, remember the thickening effect that a single transplant in the frontal half can have. This patient will continue to see how the back holds up on minoxidil and possibly do a second procedure to address the mid-scalp and crown thinning in the future. He will return at 12 months for a fully matured evaluation. Thanks for viewing, Dr Blake Bloxham Feller & Bloxham Medical, PC
  4. It tends to work out very well for patients. You can really get solid coverage, a good scar, and the ability to then do FUE for any little improvements they patient may desire over the years. Here is a picture of the scar. As I said above, it's about 1-2mm. I would consider this my average scar. I tried to blow it up big so you can really get a feel for what I'm referring to here. This is the little "PSA" I give all FUT patients about the scar during the consultation: Around 95% of patients fall within what I consider the "normal healer" category. Within this category, the scar will typically heal somewhere between a "pencil line" if you're a perfect healer (harder, thicker skin -- typically with less glide too) to a "marker line" of around 3mm if you're a bit of a natural "stretcher" (more rubbery skin, more scalp glide). Anything within this realm can be easily covered with any reasonable length of hair and most can go as low as a number 3 or 4 on the buzzer before it's noticeable. This patient fell right in this category and as you can see, it is not affecting this ability to have a clean, cropped hair style in the donor region. And now he has another great strip left to do the back.
  5. Thank you for the kind words. And very fair points all around. A patient 5+ years out would be a better example. However, I do believe he has absolutely lost a significant amount of native hair since the original transplant. An examination of his scalp revealed that the front is pretty much completely transplants at this point, and the crown -- where no grafts had been transplanted -- is much more bare compared to before. But the points you bring up are very important and it's really why I made the thread instead of just posting this as a "before and after" result: The hair loss is progressive; transplants must be designed and executed with the "long-term" in mind; and transplants can stand alone when the progression continues -- as long as they were thought out and performed properly. Thanks for viewing and commenting. Good commentary and I really hope others get the chance to read it.
  6. Nicely stated. I spend a lot of time explaining this exact same concept to consulting patients. People are often very self-conscious about the crown, but it is almost universally better to do the front/middle first. Having a strong frontal foundation provides you with a much more natural and cosmetically pleasing result, regardless of what happens beyond it. Thanks for viewing and commenting.
  7. Hi PA, Thank you for the kind words. His scar is good; 1-2 mm and easily hidden -- even with shorter hair. I have some pictures of it I can put up as well if people are interested. I definitely understand the hesitance with the difference in FUT vs FUE scarring, but FUT is still a much better approach for a big portion of patients and the scarring is typically very manageable in comparison to the huge potential benefits. I would not let the scarring alone completely deter you from researching FUT. I typically suggest doing these full NW VI cases in two surgeries. In my opinion, The front/middle and then the middle/crown really deserve their own surgeries days. There are always those cases where you can knock it all out in one go -- and I've done it many times; but most people really need two to do everything from front to back. And that's how I like approaching a big case like this: do two big strips, knock it all out, then you can do FUE for any small touch-ups or if you want to put a little into the scar to wear the hair even shorter.
  8. Dr Blake Bloxham

    Is this infection?

    KP, I would advise your friend to immediately be seen by a doctor in-person. While some redness and scabbing/flaking around the grafts post-transplant is normal, there are a few concerning things here: There appears to be a red, swollen, defined area around those small wounds. It looks like it may be somewhat tender and warm to the touch as well. If the entire scalp looked this inflamed, I'd probably think less of it. But the definition of the area and the fact that those small wounds are in the center of it makes it more likely that it could be infection. This isn't something to wait on. Please seek medical attention.
  9. "What happens when the other hair falls out?" "What will the transplants look like when the native hair falls out?" These are two very common questions I'm asked by diffusely thinning or patterned diffusely thinning patients during consultations. What they want to know is what the results of their transplant will look like after the supporting, native hair we work though eventually thins and falls out. And I tell patients that because modern techniques allow us to carefully work through instead of completely going around these native hairs, the transplants will stand on their own after you lose the hair around the transplants. And that is exactly what happened with today's patient: This patient is a very diffuse thinner with NW VI potential. I did a 3,200 graft FUT procedure on his frontal and mid-scalp in 2015 and carefully worked through his native hair at the time. He was worried that it would look thin when these hairs fell out, and I assured him the transplants would stand on their own. Here is how he looked immediately post-op: The patient came back 6 months later and looked great. At that point, all his native hair that we worked through came back and was working with the transplant to give a very full look. Here's how he looked then: I saw him next two years later. He stopped by the office to discuss a planned follow up to address the crown. He looked great. In fact, he was sporting a "gelled and slicked-back" hair style that he hadn't previously been able to wear. At that time he told me that he believed the rest of his original native hair had shed. And based upon an examination of the transplanted area and the rest of his scalp, I agreed that the front was almost all transplants at this point and the back was thinner without any native hair. Despite this, he looked great and he agreed that my original assessment was correct: the transplants will stand on their own when the native hair thins. Here's how he looked at 24 months post-op, with loss of the native hair in the transplanted area, and with his hair gelled and slicked-back: So for those concerned about what a thinning region that will be augmented with transplants may look like after the native hair thins, rest assured; as long as the native hair is carefully worked through the transplants should stand on their own. Thanks for viewing. Dr. Bloxham Feller & Bloxham Medical, PC
  10. Indian hair type is a definite "catch 22" in my book. Altogether, patients of Indian-descent are good hair transplant candidates. And this is good news because hair loss, from how it has been explained to me, is a very big aspect of their culture. Because of this, I do surgery on at least one Indian patient per week -- with good results. I say the hair type is a catch 22 for the following reasons: It is true that Indian hair, for the most part, does seem to be somewhat "silky" and the follicles -- though large -- can be fragile -- as jj described above. What's more their donor density tends to be lower on average. I also tend to see a lot of Indian patients with advanced NW patterns. This means a big area to cover with less than ideal donor characteristics. Having said that, the plus side to Indian characteristics is: Excellent hair-to-skin contrast ratio. The tanner skin tones with dark hair tends to give excellent coverage. So despite typical lower number procedures and somewhat challenging follicles to work with, patients of Indian descent make excellent FUT candidates.
  11. Today's patient is a male with fairly classic thinning in the hairline/frontal band and "fronto-temporal corners" regions. Based upon his hair type, pattern and likely progression, I agreed with his request for a strong, defined hairline, a thick rebuild of the frontal band region, and some "corner closure" -- not something I do on everyone. Presented are the 7 month results of his surgery. While I shared a few key images here, I highly recommend watching the video. The video contains more pre-op, immediate post-op, and "after" images, and it also includes dry hair video and wet comb-through video. The wet comb-through is my favorite because if a hair transplant looks good wet and slicked back, it will look dense and full with pretty much any style. Video: Comparison Pictures (wet and dry): Thanks for viewing and commenting. Dr. Blake Bloxham Feller & Bloxham Medical, PC Hair Transplant & Hair Restoration Services in New York
  12. Native hair can play a role depending on how prevalent it is before the procedure and how well the doctor is able to worth with/through it. The key with native hair, in my opinion, is to not count on it or create a design that depends upon it in the future. This is because androgenic alopecia is progressive by definition and it is not likely to be there in the future. If you carefully work through it safely (trim it up so you can closely follow the angles, use high magnification, pump the tissue up with some fluid, use very small blades, etc) and create a plan that doesn't need the native hair to be successful, you will should end up with a good result whether or not the native hair sticks around. Maybe it will be very slightly thicker with it, but the transplants will stand on their own and look natural regardless of what happens with the native hair. Thanks for commenting.
  13. Very nice assessment. Thank you for sharing. I think this will help researching patients in the future.
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